Changes to the GP Patient Survey

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2021 survey

1. Questionnaire changes

The GPPS questionnaire was redeveloped ahead of 2021 fieldwork; the majority of the changes were made in order to more accurately capture patients’ experiences of access and type of appointment given recent changes in primary care due to the COVID-19 pandemic.

New questions:

  • Q12 "How did you try to book the appointment?”

  • Q13 "Were you asked for any information about your reasons for making the appointment?"

  • Q22 "What type of appointment was your last general practice appointment?"

  • Q23 "Were you given a time for the appointment?"

  • Q49 "At any time over the last 12 months, have you or someone you live with shielded at home due to being vulnerable to COVID-19 because of pre-existing health issues?"

  • Q50 "Have you, at any time in the last 12 months, avoided making a general practice appointment for any reason?"

  • Q52 "Is your gender identity the same as the sex you were registered at birth?"

Minor changes were made to the following questions (trend data remains):

  • amendment of response at Q18 ("What type of appointment did you get?")

  • amendment of responses and additional response at Q53 ("What is your ethnic group?")

More significant changes were made to the following questions (because of these changes results for these questions are not comparable with results from 2020, even where question wording remains similar):

  • additional response at Q3 ("Which of the following general practice online services have you used in the past 12 months?")

  • changes to responses, including additional responses at Q10 ("Before you tried to get this appointment, did you do any of the following?")

  • changes to question wording and responses, including additional responses at Q14 ("On this occasion, were you offered any of the following choices of appointment?")

  • changes to question wording and additional response at Q15 ("Were you satisfied with the appointment (or appointments) you were offered?")

  • changes to question wording and additional responses at Q16 ("If you did not get an appointment, why was that?")

  • changes to question wording and responses, including additional responses at Q17 ("What did you do when you did not get an appointment?")

  • changes to responses, including additional responses at Q41 ("Considering all of the services you contacted, which of the following happened on that occasion?")

  • changes to question wording and additional responses at Q51 (“Which of the following best describes you?”)

The following questions were removed:

  • “In the past 12 months, have you booked general practice appointments in any of the following ways?”

  • “As far as you know, which of the following online services does your GP practice offer?”

  • “Who was the appointment for?”

  • “How concerned were you at the time about your health, or the health of the person you were making this appointment for?”

  • “How long after your appointment time did you wait to see or speak to the healthcare professional?”

  • “Do you take 5 or more medications on a regular basis?”

  • “In the last 12 months have you had any unexpected stays in hospital because of your condition (or conditions)?”

  • “Have you been given (or offered) a written or printed copy of this plan?”

  • “Considering all of the people that you saw or spoke to on that occasion, did you have confidence and trust in them?”

2. Methodology changes

During January to March fieldwork in 2020 Ipsos MORI and NHS England trialled several experiments on a sub-sample of GPPS respondents. These experiments were designed to test the impact of the move to a new sample frame and the effect of including multi-mode contact with patients by letter, email and text message in order to increase the proportion taking part online and reduce survey costs. The  findings from these experiments led to the following changes to the survey methodology for fieldwork in 2021:

Change to sample frame

In 2021 the GPPS sample frame transitioned to the Personal Demographics Service (PDS); the national electronic database of NHS patient details. Previously, this had been provided by the National Health Application and Infrastructure Services (NHAIS) database, which was due for decommission. In 2020, Ipsos MORI and NHS England conducted a pilot to understand the impact of this change on survey measures and trend data. The analysis concluded that the anonymised populations and survey results obtained from the two sources were similar enough that future trend data will not be impacted by this change. 

Changes to mailing strategy

The change in sample frame to PDS provided access to patient mobile telephone numbers for the first time, and experiments in 2020 found that SMS reminders were an effective replacement for the postcard  reminder, maintaining response rates with no notable impact on demographics or survey measures but at lower cost. As a result of these findings, the mailing strategy for GPPS was changed in 2021 and the  reminder postcard was replaced with an SMS, with a further SMS sent to all non-responders after the second full mailing. More details of these changes (and other experiments tested) can be found in the technical annex.

Changes to questionnaire and impact of COVID-19

The questionnaire was redeveloped in 2021 to reflect changes to primary care services as a result of the COVID-19 pandemic, the effect of which should be taken into account when looking at results over time. 
For more details, see the 2021 technical annex.

3. Organisational changes

Practice level CCG changes

This year, there were no changes in CCG parent for practices sampled in the survey.

Note: Practice information is from the NHS Digital epraccur file. Where CCGs had merged, the CCG parent of practices was updated to reflect the new merged CCG, and any historical regions were updated to reflect the most current NHS commissioning regions, as of April 2020.

CCG level changes

As of 1 April 2021, the following CCG merges occurred:

  • NHS Bedfordshire CCG (06F), NHS Luton CCG (06P) and NHS Milton Keynes CCG (04F) – to form NHS Bedfordshire, Luton and Milton Keynes CCG (M1J4Y).

  • NHS Dudley CCG (05C), NHS Sandwell and West Birmingham CCG (05L), NHS Walsall CCG (05Y) and NHS Wolverhampton CCG (06A) – to form NHS Black Country and West Birmingham CCG (D2P2L).

  • NHS Coventry and Rugby CCG (05A), NHS South Warwickshire CCG (05R) and NHS Warwickshire North CCG (05H) – to form NHS Coventry and Warwickshire CCG (B2M3M).

  • NHS East Berkshire CCG (15D), NHS North East Hampshire and Farnham CCG (99M) and NHS Surrey Heath CCG (10C) – to form NHS Frimley CCG (D4U1Y).

  • NHS Fareham and Gosport CCG (10K), NHS Isle of Wight CCG (10L), NHS North Hampshire CCG (10J), NHS South Eastern Hampshire CCG (10V), NHS Southampton CCG (10X) and NHS West Hampshire CCG (11A)– to form NHS Hampshire, Southampton and Isle of Wight CCG (D9Y0V).

  • NHS Greater Huddersfield CCG (03A) and NHS North Kirklees CCG (03J)– to form NHS Kirklees CCG (X2C4Y).

  • NHS Barking and Dagenham CCG (07L), NHS City and Hackney CCG (07T), NHS Havering CCG (08F), NHS Newham CCG (08M), NHS Redbridge CCG (08N), NHS Tower Hamlets CCG (08V) and NHS Waltham Forest CCG (08W) – to form NHS North East London CCG (A3A8R).

  • NHS Brent CCG (07P), NHS Central London (Westminster) CCG (09A), NHS Ealing CCG (07W), NHS Hammersmith and Fulham CCG (08C), NHS Harrow CCG (08E), NHS Hillingdon CCG (08G), NHS Hounslow CCG (07Y) and NHS West London CCG (08Y) – to form NHS North West London CCG (W2U3Z).

  • NHS Shropshire CCG (05N) and NHS Telford and Wrekin CCG (05X) – to form NHS Shropshire, Telford and Wrekin CCG (M2L0M).