Health and Care Experience Survey 2025 to 2026: Technical Report

Analysis and Reporting

The survey data collected and coded by IQVIA were securely transferred to Public Health Scotland and then from PHS to the Scottish Government. The information was analysed by Public Health Scotland and the Scottish Government using the statistical software package R.

Validation of the survey responses

Survey respondents were able to complete the survey online, over the phone or on paper. As it is not possible to enforce routing or other survey instructions on the paper returns, validation was applied. The validation rules covered the folowing situations:

• If a survey respondent ticked more than one response option to a ‘tick one box only’ question
• If a survey respondent did not follow the routing instructions
• If a survey respondent provided contradictory responses within a question
• When a free-text ‘other’ response is not a valid response.

Reporting the Sex of Respondents

Analysis of survey response rates by sex was undertaken using the sex of people in the sample according to their CHI record at the time of data extraction (22 September 2025). Linking this data allows us to reduce the burden on respondents by avoiding the re-collection of data.

Reporting the Age of Respondents

Respondent date of birth was taken from their CHI record at the time of data extraction (22 September 2025). The age of respondents reported in the survey is as at 22 September 2025. i.e. the date when the sampling procedure commenced. Linking this data allows us to reduce the burden on respondents by avoiding the re-collection of data.

Number of Responses Analysed

The number of responses that have been analysed for each question is often lower than the total number of survey responses received. This is because not all of the questionnaires that were returned could be included in the calculation of results for every individual question. Respondents are instructed to skip any questions they do not wish to answer. Respondents may skip a question or their response may be excluded from analysis because:

• The specific question did not apply to the respondent and so they did not answer it. For example if they did not use Out of Hours services in the previous 12 months and therefore did not answer questions about their experience of it.
• The respondent did not answer the question for another reason (e.g. refused).  People were advised that if they did not want to answer a specific question they should leave it blank.
• The respondent answered that they did not know or could not remember the answer to a particular question (for participants who answered questions over the phone/language line).
• Responses may be removed following validation checks, for example if a respondent selected an invalid combination of responses. Validation rules are automatically applied at the point of data collection through the online questionnaire (for example through enforcing “tick one box only” instructions) and validation checks are applied to ensure consistency between online and paper responses.

Weighting

When conducting a survey, it is important to have a representative sample of the population one is interested in. Applying weighting methods reduces potential bias by making the results more representative of the target population.

Survey weights are numbers associated with the responses that specify the influence the various observations should have in the analysis. The final survey weight associated with a particular response can be thought of as a measure of the number of population units represented by that response.

A review of the weighting methodology was undertaken in 2017, leading to some changes in the weights applied. Details of the methodology used to calculate the weights is set out in Annex B.

The data used to estimate the number of people in the population using their General Practice was updated in 2025 to 2026. Previously this was estimated using the number of people consulting their GP or practice nurse through the 2012/13 Practice Team Information (PTI) programme, which was based on a sample of 6% of practices.

Information on the proportion of patients on the GP list who have received a direct consultation was extracted on the 28th October 2025 by the Primary Care Intelligence Service (PCIS). This more up-to-date information was used in the calculation of the 2025 to 2026 HACE weights. The PCIS information is based on 837 GP practices, which is 95% of the total number of practices in Scotland. Although the PCIS data is in development, it will be more reliable than the PTI data which is out of date and no longer recommended for use.

Updating this information has had an impact on the weights used in the “Your GP practice” and “Treatment or Advice from your GP practice” sections of the survey, as the apparent trend over time is of lower rates of contact between patients and their GP practice. This trend could be due to an actual fall in contact, impact of changes to the GP contract since 2012/13, the expansion of Multi-Disciplinary Teams, differences in GP recording practices, differences in data collection methods or other changes in practice. As such, comparisons over time should be carried out with care, as small changes may be due to the change in data source for the weights.

After incorporating the PCIS data into the weights calculations, the largest difference at the Scotland level is in Q16e: “My treatment and care were well co-ordinated”. Using PTI data to calculate the weights, this would be 74.7% positive. Using PCIS data to calculate the weights, it becomes 75.1% positive, 0.4 percentage points higher. The largest difference in the other direction is in Q12f: “Overall, how would you rate the Arrangements for getting to speak to a: Mental Health Professional”, which would be 42.2% positive if we used the PTI weights, but is 42.1% positive using the PCIS weights (0.1 percentage points lower).

Q13: “Overall, how would you rate the care provided by your GP practice?” is one of the main headline figures from the survey. Using PTI weights, this would be 70.5% positive in 2025 to 2026, but is 70.7% positive using PCIS weights, a difference of 0.3 percentage points (calculated from unrounded data).

Had the data used to calculate the weights not been updated, the overall rating of care provided by the GP would be 0.3 percentage points lower

Table 13: Comparison of survey results by whether PTI or PCIS data is used in the calculation of the weights for selected questions

This change does not affect the weights used for the Out Of Hours, Care, Support and Help with Everyday Living or Caring Responsibilities sections of the survey.

Results at all levels of reporting are weighted, unless otherwise stated. Only the results from the “about you” questions contained in this report are unweighted. This is because the “about you" questions are included in this report to provide an indication of the demographic profile of the survey’s respondents, and hence how representative the survey sample is. The survey was not designed to estimate the proportion of the population that has a particular demographic characteristic.

Analysis Software

Both the Scottish Government and Public Health Scotland use the software package R to analyse the data. This makes it easier for the Scottish Government and PHS to collaborate on the project, share code and reduces duplication of effort. The code used to analyse the data is available to view on a GitHub repository online. The use of GitHub allows analysts in the Scottish Government and PHS to quality assure the code that each other are using, and quickly resolve any issues.

Percentage Positive and Negative

Per cent or percentage positive is frequently used in reporting results from this survey. This means the percentage of people who answered that they had a positive experience. For example, when people were asked to rate the care provided by their general practice, if they answered “Excellent” or “Good”, their answers were counted as positive answers. Similarly, if people answered  “Poor” or “Very poor”, their answers were counted as negative answers, and if they answered “Fair”, their experiences were counted as neutral answers.

We report results in terms of per cent or percentage positive because they are easier to interpret, compared with reporting results on the five point scale that people used to answer the questions. There is also a belief that differences between answers on a five-point scale may be subjective. For example there may be little or no difference between a person who “strongly agrees” and one who “agrees” with a statement. Some people may never strongly agree or strongly disagree with any statements.

Sampling error

This survey is of a sample of people registered with a General Practice and is therefore affected by sampling error. The effect of this sampling error is relatively small for the national estimates, but will be larger when looking at sub-groups with a smaller sample size. Confidence intervals use the standard error to derive a range in which we think the true value is likely to lie. Confidence intervals at the 95% level are used in the survey dashboard and supporting excel tables to quantify that margin of error. More information on confidence intervals, significance testing and how they’re calculated can be found in Annex C.

Quality Assurance of the National Report

A small group of Scottish Government analysts were sent a draft version of the national report for quality assurance. Feedback included suggestions on ways in which to report data as well as comments about the context for the survey. These were taken into account in finalising the National Report. In addition, staff at IQVIA and Public Health Scotland carried out quality checks of figures used in the report.

Timeliness of reporting

The date of publication was announced on the Scottish Government website in the second half of 2025. If there had been any changes to the pre-announced date, this would have been announced alongside the reason.

The publication of results took place slightly more than four months after the fieldwork period ended. This was to provide sufficient time for data entry, quality assurance of the data and code, and production and quality assurance of the outputs. It would have been possible to release some of the results sooner, but we believe it is most useful to users of these statistics to provide reporting at all levels at the same time. As the survey is only run every two years there is no timely opportunity to make revisions and corrections.  Therefore we placed a high importance on accuracy over timeliness.