The GP Patient Survey – Your Doctor, Your Experience, Your Say
(Previously National Patient Experience Survey 2006/7)
Briefing for PCTs and SHAs
This briefing is to update PCT and SHA Primary Care following the first mailing out to
patients of the of the “GP Patient Survey – Your Doctor, Your Experience, Your Say”
covering questions on access (during week commencing 15 January) and should be
read in conjunction with the Department of Health Guidance and FAQs (posted on the
DH website on 27 November 2006).
A further questionnaire relating to Choice was issued to GP practices at the beginning
of January 2007 and further details can be found in the last section of this briefing.
Consideration was given to incorporating the choice survey in the ‘Access’ survey.
However, this was not an option this year as it was not possible to identify those
patients to whom the survey should be sent using the Access survey methodology.
Work is underway to ensure that this will be possible for a 2007/08 survey. The Jan-
Mar 07 choice survey is an interim solution to ensure all qualifying practices receive
their Choice DES payment.
Since 30th October, PCC has been hosting a PCT and SHA helpdesk where queries
relating to the GP Patient Survey have been managed - email@example.com.
Queries are responded to within five working days, with a further five day turn around
time for queries needed to be directed to the Department of Health for specialist
Patient helpdesk facilities (both online and via the telephone) have been set up by
Ipsos MORI on behalf of the DH, and details can be found at www.gp-patient.co.uk .
This includes access to the questionnaire, covering letter and FAQs in the 10
languages, other than English, most commonly used by NHS Direct. These are Urdu -
Punjabi - Polish - Bengali - Arabic - French - Gujarati - Turkish - Somali - Portuguese.
Also, patients can call the telephone helplines and speak to someone in one of these
languages, completing the Access questionnaire over the phone if they wish. Or they
can complete the Access questionnaire online (link through from the website) in these
The website is fully compatible with W3C standards to make it accessible for people
with disabilities. This means users can use Screen Reader software and it is possible
to change the font size of the text.
Posters for display in GP Surgeries and a leaflet for practice staff have been
distributed. Electronic versions for downloading can be found at:
Taking part for patients is voluntary and they can opt out by contacting the Department
of Health via their GP practice or PCT. GP practices or PCTs will then need to inform
the DH via the firstname.lastname@example.org mailbox providing the names and NHS
numbers of patients who wish to be excluded from the GP Patient Survey. The
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questionnaire has already been distributed, but should patients wish to opt out of
receiving reminder questionnaires (there are 2), having received the first questionnaire
and not wishing to fill it in, they can do so by using the same arrangements described
above, by 25th January 2007 for the first reminder, or 15th February for the second
About the GP Patient Survey
The Survey has been developed as part of the Direct Enhanced Service (DES)
“Improved Access Scheme”. The GP Survey rewards good access provided by GP
practices by measuring these against the standards set out in the Improved Access
Scheme SLA. The DES was introduced to support the aims of the Government White
Paper public consultation “Your Health, Your Care, Your Say” when members of the
public highlighted access to general practice “as and when needed” as being one of
their highest priorities.
The Department of Health has set standards for the ease at which a person can book
an appointment with a doctor. The survey will measure how well GP practices are
The core of this questionnaire, including the yes/no format of the DES questions, was agreed in
negotiation between DH and GPC. The survey provider, Ipsos MORI, subsequently provided
methodological advice to make the questionnaire as effective as possible within the parameters
set by the Department of Health. Ipsos MORI has also subjected the questionnaire to a
process of cognitive testing to ensure the questions are understood as clearly as possible.
The survey is being administered by IPSOS Mori in the form of a postal survey to
around 5 million members of the public. These will be received between January and
March 2007 (first batch despatched week commencing 15th January 2007 followed by
two subsequent reminder letters). Results will be released in late May 2007, with
practices receiving access target payments in their first quarterly payment of 2007/08.
NHS Primary Care Contracting e-mail helpline goes live 30 October 2006
Ministerial announcement via Press release Week beginning 27
Issue of Guidance and FAQs As above
Distribution of posters and leaflets to GP practices Week beginning 4 December
Further GP Patient Survey Comms Week beginning 18
Ipsos MORI Helpline for patients goes “live Week beginning 15 January
GP Patient Survey delivered to patients 15 Jan – 19 Jan 2007
nd th rd
2 Reminder to patients 19 Feb – 23 Feb 2007
rd th th
3 Reminder to patients 12 Mar – 16 Mar 2007
Final return date 7 April 2007
Results available 31 May 2007
Data Extraction Process
Two methods were used to collect patient information for the purposes of the GP
survey only – Apollo Medical Systems software and NHAIS (also known as the Exeter
system). GP practices were able to choose whether or not to download the Apollo
software and where they didn’t the Exeter system data extraction was used as the
sample – with the exception being those GP practices who indicated they wanted to
opt out of the GP patient survey.
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Extraction via these methods took place during November. Because two methods are
being used, Ipsos MORI, which has extensive expertise in use of different surveying
methods, are reviewing how best to make the data comparable between practices
sampled via the Apollo route and those sampled via Exeter.
Once Ipsos MORI has completed the survey process, all data relating to the survey will
be disposed of securely and not used for any other purposes.
For both Apollo and Exeter extractions, patient information collected included the
patient name, address and NHS number. The NHS number is providing unique
reference coding which enables administration of the survey (eg removal of duplicates
and of deceased patients). No clinical or health information is included in the data
For the Exeter sample gender and date of birth were also extracted to be used for data
analysis and looking at non-response bias (for example whether certain types of
people are more or less likely to respond).
The selected sample is made up of the following:-
For Apollo extractions, patients were randomly selected from those who had a record
made in their medical notes following an appointment (face to face or on the
telephone) between 16 July 2006 and 15 October 2006. For the Exeter extractions,
patients were randomly selected from practice data held up until 16 October 2006.
In the case of deceased patients (and the risk of including deceased patients in the
sample increases for first and second reminder mailings) Ipsos MORI ran the sample
against a list of deceased patients on the initial mail out from both Apollo and Exeter
samples, and will do so again before the first reminder and before the second reminder
is despatched. This is done using the NHS number as reference. The DH survey
mailbox www.gpaptientsurvey.dh.gsi.gov.uk can be used to notify of patient deaths, as
appropriate, alternatively it is likely that the Ipsos MORI Survey helpline (Free phone
0808 2385 385) will be used to inform that the recipient has died. That person will then
be removed from the sample, to avoid sending further correspondence.
The survey provider, Ipsos MORI, is working to maximise the reliability of the survey
within the parameters that have been set for the survey such as questionnaire length
and question structure. There will be further information, in the form of a sample
reliability fact sheet, prepared for PCTs and SHAs and included on the PCC website.
However, in summary, sending surveys to named individuals, gaining advice from the
Plain English Campaign, the lay out of the questionnaire following cognitive
questioning and the inclusion of a post paid envelope, are all aimed to maximise
Practices will receive payment for participation in the survey at the first quarter end of
the 2007/08 financial year based on the outcome of the survey. These payments are
linked to the percentage of positive responses received from patients surveyed. The
access questions have a graded scoring level attached with high percentage scores
receiving higher practice payments. The PCT will assess the levels achieved guided
by the Financial Reporting Standard (FRS) 12 rules around provisions.
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The following table sets out the minimum and maximum thresholds for payment:-
Access % at which % % at % Payment
min payment which payment per head of
payment max registered
made payment population
2 working days 50 50 90 100 £0.41
Advanced booking 40 40 90 100 £0.41
Telephone access 30 50 80 100 £0.41
Preferred GP 20 40 80 100 £0.14
Practices who choose to opt out of the survey or score less than the minimum levels
will not receive payment. However it is likely that some practices may give reasons for
low scores or non-participation in the Survey. PCTS may need to consider whether
payment should be made under these circumstances.
The exact method for reporting results is currently being developed. However, each
practice will have access to their own results. These will probably be provided
Practices who have signed up for the Access Direct Enhanced Service are likely to
have already received aspiration payments according to the DES directions. Practices
will have received payment for their written practice plan and for making a written
commitment to engage in the GP Patient Survey process. Where practices have now
chosen to opt out of the DES, PCTs may consider clawing back any aspirational
Any awards that could be made in the event of practice closures, mergers or splits will
be for the PCT to decide based on advice contained in the SFE (Statement of
It is part of the Department of Health’s work to improve services across the NHS by
offering more choice to patients about their medical treatment. As part of the GP
Patient Survey (GPPS), the Department is conducting research with patients who have
been referred by their GP to secondary care for a condition where the Choice policy
applies. Choice of hospital may not be appropriate for all patients. There may be
clinical reasons for limiting the number of choices, for example, a patient may need
access to intensive care services. Patients are not expected to be offered a choice
where speed of access to diagnosis and treatment are particularly important, for
example patients attending cancer services under the two week maximum waiting
time, or for maternity or mental health services.
Ipsos MORI has been commissioned to assist with the survey and have sent out
questionnaire packs to all GP practices. For practices participating in the Choice DES,
every GP should hand out a questionnaire to all patients where a Choice referral is
made between 16 January and 30 March 2007. Patients are asked to return the
completed questionnaire to Ipsos MORI in a reply paid envelope by 6 April 2007.
Information for patients about the survey is available online at www.gp-patient.co.uk.
SHAs and PCTs can access further information, including FAQs via the Primary Care
Contracting website (www.primarycarecontracting.nhs.uk). Email queries can be sent to
the PCC Helpdesk email@example.com or alternatively, the DH mailbox
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The full value of DES is 96 pence per registered patient and comprises two equal
components, one for choice (48 pence) and one for Choose and Book (48 pence). Half
of the choice component will be made as an aspiration payment to those GP practices
that make a written commitment to ensure that choice is offered to eligible patients.
The remaining half will be paid to the practice if at least 60% of patients agree that
they were offered a choice of provider based on the results of this new survey of
At the end of the DES period, if practices fail to achieve the minimum (60%) level,
PCTs should arrange for repayment of the aspirational funding or for a balancing
mechanism, which offsets the repayment against other income due to the practice.
PCTs have been allocated £50m to fund this DES
Further information, including FAQs can be found at
Department of Health website – “Primary Medical Care Contracting” section:-
Primary Care Contracting website – under Resources - Key Support Areas -
Contracting & Commissioning section:-
Primary Care Contracting GP Patient Survey Helpdesk:-
Department of Health Mailbox:-
Apollo Medical Systems helpline:-
Ipsos MORI GP Patient Survey Website for Patients:-
Ipsos MORI GP Patient Survey Helpline for Patients:-
Free phone 0808 2385 385 (Monday to Friday, 9am to 9pm; Saturday and Sunday,
10am to 5pm)
There will be further GP Patient Survey PCC briefings and FAQs will be updated
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