Scottish Health and Care Experience Survey 2015/16 - Technical Report

5 Fieldwork

5.1 The Scottish Government contracted Quality Health Ltd to administer the survey. Quality Health Ltd has in depth experience of NHS surveys, and has provided support for other patient experience survey work both in Scotland and elsewhere in the UK. ISD Scotland provided support for the administration of the survey along with Scottish Government analytical staff.

Mail-out

5.2 The fieldwork began on 25 November 2015. In total, 711,159 surveys were posted out in batches between 25 November 2015 and 03 December 2015. No reminder letters were sent out to those who did not initially respond. For the 2009/10 survey two reminders were sent to boost the response rate, but since 2010/11 the survey has been designed to achieve the required number of responses for each practice without reminders, as this proved to be more cost effective.

Data collection

5.3 Data was collected in the form of hardcopy returns and online returns.

5.4 During the fieldwork a telephone helpline answered queries from patients surveyed. In total, 1,128 telephone enquiry calls were answered by the telephone and language line. This was a decrease compared to the number received in 2013/14, which was 1,531.

Deceased patients

5.5 The patients included in the 2015/16 survey were sampled from an extract taken from the CHI database on 20 October 2015. The questionnaire printing and main mail-out process extended from this date through to the final mailing date of 03 December 2015. This meant that some patients would have died between the extract date and mail out dates.

5.6 As with all Care Experience surveys, ISD and 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 Community Health Index ( CHI) database to identify patients who had recently died. This process also helped to identify patients who had died abroad and was carried out 13 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.

5.7 Also similar to previous surveys, 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 ( NHS CR) and linked to the National Records of Scotland ( NRS) deaths database. This allowed NHS CR to provide regular extracts of deceased patients to ISD during the mail-out period. 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 NHS CR for their help and support during this stage of the project.

5.8 Between the CHI and NHS CR databases, a total of 1,104 records included in the initial survey sample were flagged as deceased between the time the 20 October 2015 CHI extract was taken and the final mail out date on 03 December 2015. These records were analysed by ISD and sent to Quality Health Ltd for removal from the mail-out process prior to dispatch. All of these deceased records were removed prior to mailing questionnaire to patients. In a further 23 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 Quality Health Ltd to notify them of this.

5.9 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.

5.10 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.