Technical annex Download

2 Questionnaire and material design

2.1 Questionnaire development for the 2025 survey

The 2024 survey was the start of a new time series for GPPS (see the Technical Annex for the 2024 survey). It was therefore important that questionnaire changes were kept to a minimum for the 2025 survey to ensure that results could be compared across 2024 and 2025.

However, as in every year, the questionnaire content was reviewed to ensure it reflects the primary care context and priorities. This led to minor changes to to the wording of some of the response options for two questions, which has impacted trends. These changes have affected the comparability of these questions, even though the question wording remains the same. This is because it is difficult to determine whether a difference in results is caused by the change to the response options or a ‘real difference’.

Changes were made to the following questions:

Q9 'On that occasion, what was your main reason for trying to contact your GP practice?'

• The 2024 response option ‘Ask for help with an administrative request (for example, getting a fit note or updating contact details)’ was split into two new responses ('Make an administrative request (for example, updating contact details or personal information)'; and 'Get help with a fit note or any other medical evidence (for example, for benefit claims or background medical checks)'. This was designed to capture differences between tasks which could be completed by practice staff and those which need a GP or other healthcare professional.
• The 2024 response options 'Get advice or treatment from a healthcare professional for a new health issue'; and 'Get advice or treatment from a healthcare professional for an existing health issue' had the words 'new' and 'existing' changed to bold to help differentiate between them.
• Due to a high level of multi-coding on the paper questionnaire, for this single code question, the instruction ('If more than one of these applies to you, please put an ✗ in the box next to the main one only'), was shortened to 'Please put an ✗ next to the main one only' to make this clearer.
• As a result of these changes, trend data is not presented for this question.

Q39 'Which of the following long-term conditions or illnesses do you have?'

• The 2024 response option ‘Joint problem, such as arthritis’ was changed to ‘Arthritis or problem with your back or joints’ in 2025. This was to better capture the full range of musculoskeletal conditions, including back pain, which contributes most to disability adjusted life year measurements and is one of the commonest causes of loss of work. This response option was also moved to the top of the list of response options, due to the list being organised in alphabetical order.
• Following data analysis, trends are not presented for 'Arthritis or problem with your back or joints' and the 2024 response option ('Joint problem, such as arthritis') as these are not directly comparable.

In addition to these changes, the colour of the routing arrows and instructions on the paper questionnaire were changed from blue to black font to help with navigation.
 

2.2 Online only questions

In addition to the core (online and paper) questionnaire, a small number of additional questions were added to the online version of the survey. These included:

• Vaping behaviour (added to the online survey in 2024, and remained in the 2025 survey).
• Questions on the NHS Accessible Information Standard (new for the 2025 survey).
• Permission for recontact (new for the 2025 survey). General recontact permission for NHS England to find out more about specific healthcare experiences and permission for ONS to recontact carers.

It was not possible to include these questions in the paper questionnaire due to space constraints. However, given the nature of the questions, anyone requesting an accessible version of the paper questionnaire (large print or Braille) was also sent these questions (including the general recontact question only). They were also asked of anyone taking part with Helpline support.

Accessible Information Standard

The next few questions are about communication and getting information from healthcare professionals in a way you can understand. For example, you may need help if you are: A person with a learning disability Deaf Blind, or Have hearing or sight loss   Q65 Do you find it difficult to see, hear, speak, read or understand what is being said to you? Yes No I don't know I would prefer not to say   Q66 Have you been asked by someone who works at your practice about how you prefer to be given information or communicate? For example, you may need information in a different format, such as the following: Yes No I can't remember   Q67 Did your GP or practice make a record in your medical notes of how you want to be given information or communicate? Yes No I don't know   Q68 How often do you get the help you want from staff at your GP practice to communicate and understand the information you are given? Always or almost always A lot of the time Sometimes Never or almost never I can’t remember

The inclusion of online-only questions is a new development for GPPS. As such, these results, where published, are labelled as ‘official statistics in development’, in line with the standards in the Code of Practice for Statistics. The trustworthiness, quality and value of these statistics will be evaluated with a view to removing the ‘in development’ label in time. As a result, user feedback on the need for these statistics and how they are being used is important. Please share any feedback on the online-only questions with: GPPatientSurvey@ipsos.com.

2.3 The final questionnaire

The full questionnaire is available on the website. Chapter 8: Reporting contains more information on interpretation of trend data.

Below is a list of the topics covered in the 2025 questionnaire:

• Your GP practice services

• Your last contact

• Your last appointment

• Overall experience

• When your GP practice is closed

• Your health

• Pharmacy

• Dentistry

• Some questions about you (demographics) (including vaping (online, large print and Braille only))

• Accessible information (online, large print and Braille only)

• Permission for recontact (online, large print and Braille only)

2.4 Materials development for the 2025 survey

The materials used for the 2025 survey were mostly consistent with those used in 2024. However, some very minor changes were made to improve clarity and consistency, including:

• Changing the wording ‘If you have already taken part, thank you for your time’ to ‘If you have taken part in the last few days, thank you for your time - you do not need to do anything else’. This was based on feedback that the original text implied everyone was sent a reminder regardless of whether they had taken part, and to better communicate potential delays due to printing and postage deadlines.
• The job title for Neil Churchill (the signatory for all letters and SMS) was changed to ‘Director for People and Communities’ to ensure it aligned with the information published online.
• The SMS sender name was changed from GP_Survey to NHS_Survey following changes to the branding rules permitted by the mobile networks.
• SMS messages were amended to include either the recipient’s survey number (to help people who did not want to use the direct link and could not find their letter) or name (to convey legitimacy and allow some duplicate mobile numbers to be included).

In addition, the materials used for the experiments also included some changes, including an additional e-letter and email. More details on the experiment design can be found in the appendices.

It should be noted that during 2025 fieldwork, in order to improve response rates, the decision was made to include an additional SMS after the third SMS reminder.

The full set of letters and SMS wording used are available on the website.