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The 2018 questionnaire was significantly redeveloped ahead of fieldwork to reflect changes to primary care services in England as set out in the GP Forward View. The questionnaire development report outlines these changes and how these changes were agreed.

Trends are not presented this year, even where question wording remains similar. This is because the changes to the questionnaire impacted not just the new or amended individual questions but the questions around them ('context effects'). Analysis has found that these changes, together with the inclusion of 16 and 17 year olds, mean that the results are not comparable for most questions. For more information on the impact of these changes, please refer to the Technical Annex.