National Patient Choice Survey, Wave 10

Since the beginning of 2006, patients have been entitled to a choice of four or more hospitals when referred by their GP. From April 2008, this is extending to free choice, whereby patients will be able to choose where they are treated from any hospital that meets NHS standards. The Department of Health commissioned Ipsos to undertake a regular postal survey assessing the implementation of this policy.

The results of the first ten surveys indicate that most eligible patients are not receiving any choice of hospital provider -- although the proportion being offered a choice has improved, from 30% in May / June 2006 to 44% in November 2007.

The results of each wave relate to a two-week referral window:

• Results for the first wave relate to referrals made in May/June 2006 (78,777 responses).
• Results for the second wave relate to referrals made in July 2006 (70,084 responses).
• Results for the third wave relate to referrals made in September 2006 (70,580 responses).
• Results for the fourth wave relate to referrals made in November 2006 (56,928 responses).
• Results for the fifth wave relate to referrals made in January 2007 (73,000 responses).
• Results for the sixth wave relate to referrals made in March 2007 (75,290 responses).
• Results for the seventh wave relate to referrals made in May 2007 (75,191 responses).
• Results for the eighth wave relate to referrals made in July 2007 (62,264 responses).
• Results for the ninth wave relate to referrals made in September 2007 (92,545 responses).
• Results for the tenth wave relate to referrals made in November 2007 (77,804 responses). The November 2007 survey obtained a response rate of 33%.

The questionnaire was changed for the November National Patient Choice Survey, following a review. While the core questions on awareness of choice and whether patients were offered a choice have been retained, new questions have been added.

The main findings of the November survey are:

• Since reaching a peak in March 2007, fewer patients recall being offered a choice of hospital for their first outpatient appointment: 44% in November, compared with 45% in September and 48% in the March survey -- but significantly higher than 30% in the first survey in May / June 2006.
• The proportion of people who were aware before they visited their GP that they had a choice of hospitals for their first hospital appointment has continued to rise, up to 41% in November from 39% in September and 29% in the first survey in May/June 2006.
• 61% of patients who were aware of choice recalled being offered choice, whereas 32% of those not aware of choice recalled being offered it, compared with 64% and 32% respectively in the September survey.
• Approaching two in three patients (65%) were able to go to the hospital they wanted, with a further one in four (25%) having no preference and seven per cent unable to go where they wanted.
• Two in five patients (40%) discussed which hospital they might go to with their GP.
• Half the patients who were offered choice (50%) said they used the GP as a source of information to choose their hospital, with one in three (33%) saying they used their own experience or that of friends and family.
• More than three in four patients (78%) are satisfied with how long they had to wait from the time their GP referred them to when they saw the hospital specialist.
• Hospital cleanliness or low infection rates are cited most frequently (by 76% of patients) as the most important factors when choosing a hospital. In previous surveys, when asked to list three factors unprompted, patients have said location or transport are the most important considerations. When given a list of factors in the revised questionnaire, however, patients cite it as only the sixth most important factor (53%).

Topline Results

• Results for Wave 1 based on 78,777 respondents.
• Results for Wave 2 based on 70,084 respondents.
• Results for Wave 3 based on 70,580 respondents.
• Results for Wave 4 based on 56,928 respondents.
• Results for Wave 5 based on 73,000 respondents.
• Results for Wave 6 based on 75,290 respondents.
• Results for Wave 7 based on 75,191 respondents.
• Results for Wave 8 based on 62,264 respondents.
• Results for Wave 9 based on 92,545 respondents.
• Results for Wave 10 based on 77,804 respondents.

Fieldwork carried out by postal questionnaire among patients referred in the last two weeks of:

• May 2006 for Wave 1
• July 2006 for Wave 2
• September 2006 for Wave 3
• November 2006 for Wave 4
• January 2007 for Wave 5
• March 2007 for Wave 6
• May 2007 for Wave 7
• July 2007 for Wave 8
• September 2007 for Wave 9
• November 2007 for Wave 10

• Where results do not sum to 100%, this may be due to computer rounding, multiple responses, or to the exclusion of don't knows or non-responses.
• An asterisk (*) indicates a finding of less than 0.5%, but greater than zero.
• Results are weighted by age within gender to the profile of those with a first outpatient appointment.
• Base: All unless otherwise stated.
• The questionnaire was altered between Waves 9 and 10 to include a range of new questions -- questions one and three were retained.

Q1 Before you visited your GP, did you know that you now have a choice of hospitals that you can go to for your first hospital appointment?

Q2 Did you discuss which hospital you might go to with your GP?

Q3 Were you offered a choice of hospital for your first hospital appointment?

Q4 Which, if any, of the following sources of information did you use to choose the hospital? Base: All who were offered a choice of hospital (34,187)

Q5 Were you able to go to the hospital that you wanted to go to?

Q6 How did you book your first hospital appointment?

Q7 How satisfied or dissatisfied were you with how long you had to wait from the time your GP referred you to a hospital to when you actually saw the hospital specialist?

Q8 Which, if any, of the following factors would be most important to you in choosing a hospital?