Technical annex Download

Contents

1 Introduction

This technical annex provides details of the 2026 GP Patient Survey (GPPS) conducted by Ipsos. The survey was undertaken on behalf of NHS England.

This is the twentieth year that the GPPS has been conducted in England. Between 2011 and 2016 the survey took place twice a year, having previously been conducted on a quarterly basis (April 2009 - March 2011) and annually (January 2007 - March 2009). In 2017, the survey returned to an annual format.

Patients are randomly selected from all GP practices in England, using the Personal Demographics Service (PDS). In total, 2.97 million patients aged 16 or over were invited to take part. The survey uses an ‘online first’ approach, using a sequential push-to-web methodology which only offers a paper questionnaire in the final mailing.

In January 2026, paper letters invited patients to take part in the survey online. This was followed by a combination of text message and e-letter reminders (to those with a valid mobile phone number and paper reminders to others). Email was also used in the contact strategy for the first time, for those with a valid email address. In 2026, the approach at the final mailing was changed following experimental testing in 2025; the paper questionnaire was replaced with digital-only contact (e-letter or text message) for 50% of people aged 16-69. Those aged 70 and over and the remaining 50% aged 16-69 continued to receive a paper questionnaire. The complete contact strategy and fieldwork dates are reported in Chapter 5: Data collection.

The 2024 survey was the start of a new time series for GPPS. Since then, changes to the questionnaire have been kept to a minimum to ensure that results can be compared across years. However, as in every year, the questionnaire content was reviewed to ensure it reflects the primary care context and priorities. While there have been no changes to the core paper questionnaire in 2026, there have been some changes to the questions that are only included online. More information on the questionnaire design process is available in Chapter 2: Questionnaire and material design.

Ipsos and NHS England have also trialled several experiments on a sub-sample of survey respondents this year. These experiments tested contacting people in different ways including sending targeted invitations via the NHS App, sending all contacts using the NHS Notify service, replacing the initial letter with a text message as first contact, and replacing e-letters, which are accessed via a text message, with a single text message.In addition, two experiments focused on potential future changes to the questionnaire, testing wording designed to allow the inclusion of partial responses and the impact of changing the wording at ‘Q19. Were you offered the following choices?’ at your last appointment. There is more information about these experiments in the Appendices..

Copies of the questionnaire and materials sent in 2026 are available on the website.

1.1 Survey governance


Since February 2014, the governance of the survey has involved input from a steering group, which meets regularly to provide a forum in which GPPS stakeholders can be kept informed of survey progress. The group provide advice to the research team and debate key issues such as questionnaire content, changes to the sampling strategy and analysis and reporting; review the findings of the survey as they emerge; consider the need for any further research and analysis; and raise any questions about GPPS with NHS England and Ipsos.

In addition to NHS England and Ipsos, the group consists of representatives from a range of stakeholders, including the following:
  • Academics
  • Bristish Medical Association.
  • Care Quality Commission.
  • Integrated Care systems (ICS) representatives.
  • Department of Health and Social Care.
  • Healthwatch England.
  • GP membership.
  • Patient Participation Group (PPG) representative.
  • Patient representatives.
  • Health and social care charities representative.
  • Primary Care Network (PCN) professional representative.
  • Royal College of General Practitioners.
  • National Voices.