Scottish cancer patient experience survey 2015-2016: exploring differences in patient experiences

Introduction

The following report outlines the results of secondary analysis of the first Scottish Cancer Patient Experience Survey, which was jointly funded by the Scottish Government and Macmillan Cancer Support. This analysis examines the relationship between self-reported experiences of service users and a range of factors. All the factors that were analysed are detailed in Table 1.

Investigating differences in experiences is important in helping Scottish Ministers to achieve their ambitions of a fairer society and tackling inequalities. The Chief Medical Officer’s annual report “Realising Realistic Medicine” ^[1] also highlighted the importance of reducing unnecessary variation in practice and outcomes.

A summary of the results of this analysis by factor is provided in this report and a note of which factors were more positive or more negative for each question looked at is provided in Annex A.

Background

The Scottish Cancer Patient Experience Survey was run for the first time in 2015. The survey was sent to a sample of 7,949 cancer patients in Scotland aged 16 or over. A total of 4,385 valid survey packs were returned, giving a response rate of 61 per cent. Further details on the sampling strategy for the survey can be found in the Technical Report at www.gov.scot/Resource/0050/00508351.pdf.

National results and individual reports for NHS Health Boards and Cancer Networks were published in June 2016. The results highlight that the vast majority of people – 94 per cent – had a positive experience of care overall. They also show that while many aspects of care provision are working well, some areas of care received results which are less positive and require service improvement. More information on the survey and results are available at www.gov.scot/cancersurvey.

The Scottish Cancer Patient Experience Survey is one of a suite of national surveys that form the Scottish Care Experience Survey Programme. The surveys aim to provide local and national information on the quality of health and care services from the perspective of those using them. They allow local health and care providers to compare with other areas of Scotland and to track progress in improving the experiences of people using their services.

More information on the Scottish Care Experience Survey Programme can be found at www.gov.scot/Topics/Statistics/Browse/Health/careexperience.

Methodology

A statistical technique was used to allow all available factors that may have an effect on the likelihood of someone reporting a positive experience to be taken into account. This approach does not look at one factor in isolation but takes into account all those which may have an effect.

This report focuses on results that are statistically significant at the 5% level – that is results that can be said to be attributable to the group, rather than random variation, with 95% confidence. Full details of the methodology used are available at www.gov.scot/Resource/0052/00522933.pdf.

Analysis was performed on all questions about patient experience which had distinct positive and non-positive responses. For each factor, responses by sub-category were compared against a reference group. The sub-categories for some factors, such as ethnicity, had to be grouped together due to small sample sizes. Details of the factors, sub-categories and reference groups used are given in Table 1.

The analysis identified differences in the experiences of individuals from different sub-categories, however, it is important to note that it is difficult to fully explain differences in the experience of service users as variation is a complex issue.

The variation reported here could reflect real intergroup differences in the services received or intergroup differences in subjective factors such as expectations or perceptions. Or a combination of both. Due to the complexity of the findings, readers are advised to consider overall patterns and avoid over-interpretation of the individual results for a specific factor.

Table 1: Factors used for analysis