Scottish Health and Care Experience Survey 2013/14 - Technical Report

5 Fieldwork

5.1 The Scottish Government contracted Picker Institute Europe^[6] to administer the survey. Picker Institute Europe is an independent, not for profit research and development institute with charitable status, and has provided support for other patient experience survey work elsewhere in the UK. For this survey Picker employed a specialist company Ciconi Ltd to design, print and mail surveys and to process survey returns. ISD Scotland provided day-to-day support for the administration of the survey along with Scottish Government analytical staff.

Mail-out

5.2 The fieldwork began on 25 November 2013. In total, 584,070 surveys were posted out in four batches between 25 November 2013 and 02 December 2013. Patients were asked to complete the questionnaire by 28 February 2014. Reminder letters were not sent out to those who did not initially respond. For the 2009/10 survey two reminders were sent to boost the response rate, but the 2010/11 survey was designed to achieve the required number of responses for each practice without reminders.

5.3 It proved to be cost effective to send more surveys initially than to send fewer surveys and reminders and the same methodology was used for this survey. As the response rate was observed to be lower than previous surveys a targeted reminder utilising excess questionnaires from the initial mail-out was sent on 27 January 2014. These questionnaires were targeted at GP practices with low response rates and those which had yet to reach the minimum number of responses required to produce a practice level report.

Data collection

5.4 Data was collected in the form of hardcopy returns and online returns (including online returns completed by people using JAWS readers^[7]).

5.5 During the fieldwork a FREEPHONE helpline answered queries from patients surveyed. In total 1,531 telephone enquiry calls were answered by the telephone and language line. This was an increase compared to the number received in 20011/12 (821) and could be explained by the widening out of the survey to social care users and carers.

Deceased patients

5.6 The patients included in the 2013/14 survey were sampled from an extract taken from the Community Health Index (CHI) database^[8] on 22 October 2013. The questionnaire printing and main mail-out process extended from this date through to the final mailing date of 02 December 2013 and then to the targeted reminder date of 27 January 2014. This meant that some patients would have died between the extract date and mail out dates.

5.7 As in previous surveys, the Scottish Government were keen that every possible effort was made to avoid questionnaires being sent to family members of deceased patients. Therefore, similar to previous surveys, a list of patients included in the initial sample was linked to the CHI database to identify patients who had recently died. This process also helped to identify patients who had died abroad and was carried out seven times during the period between the initial sample being drawn and the surveys being mailed out. We are grateful to Atos Origin Alliance (who host the CHI database for NHS Scotland) for their support during this phase of the work.

5.8 As was the case for the 2011/12 survey, an additional process was used during this survey to further minimise the risk of questionnaires being sent to deceased patients. A list of patients included in the survey was sent to the NHS Central Register (NHSCR) and linked to the National Records of Scotland (NRS) deaths database. This allowed NHSCR to provide regular extracts of deceased patients to ISD during the main mail-out period and again before the targeted mail-out on 27 January 2014. This process also helped to identify patients who had died elsewhere in the UK. Having access to death information greatly reduced the number of questionnaires being sent to addresses of deceased patients. We are grateful to NHSCR for their help and support during this stage of the project.

5.9 Between the CHI and NHSCR databases, a total of 872 records included in the initial survey sample were flagged as deceased between the time the 22 October 2013 CHI extract was taken and the final mail out date on 27 January 2014. These records were analysed by ISD and sent to Ciconi Ltd for removal from the mail-out process prior to dispatch. All of the 872 deceased records were removed prior to mailing questionnaire to patients. In a further 28 cases a questionnaire was sent to a patient who had died shortly after the death checks had been made and the patient's family contacted Ciconi Ltd to notify them of this. This is a substantial drop on the number of such cases compared to the 2011/12 survey when 137 such notifications were received.

5.10 The targeted reminder sent on the 27^th January 2014 was sent to respondents following an additional death checking process.

5.11 Any death which occurs in Scotland must be registered within eight days of the date of death. This means that there can be a delay between the actual date of death and the date that it is registered and updated on the CHI and NRS databases.

5.12 This delay, combined with the volume of the mail out process, made it extremely difficult to prevent all questionnaires being sent to addresses of deceased patients. However, as outlined above, efforts were made to avoid this as much as possible.