Health and Care Experience Survey 2025 to 2026: Technical Report

Fieldwork

The Scottish Government contracted IQVIA to administer the survey following an open procurement process. IQVIA has in-depth experience of NHS surveys, and has provided support for other care experience survey work both in Scotland and elsewhere in the UK. Public Health Scotland provided support for the administration of the survey along with Scottish Government statisticians.

Mail-out

The fieldwork began on 22 October 2025 and closed on the 21 January 2026. This is the same time of the year as the 2023 to 2024 survey, which started on 23 October 2023.

Out of 492,976 individuals initially sampled, 466 were identified as deceased and 1,267 were identified as no longer eligible, for example because they failed address checks, for the survey between the sample being drawn and prior to the first day of mail-out. Checks were run daily prior to each mailout day (please see the people who were recently deceased section below for more information).

In total, we sent letters and information sheets to 491,243 people during the first mail-out phase (526,758 in 2023 to 2024). These were posted out in batches between 22 and 27 October 2025. These initial letters asked respondents to complete the survey online and also included a helpline number.

Reminder letters, including a paper version of the questionnaire, were sent out from the 12 November until the 21 November 2025 to those who had not responded to the survey.

Survey Helpline Calls

During fieldwork a free survey helpline offered support to survey recipients to complete the questionnaire over the phone, as well as to provide textphone and translation services. In total, 1,412 helpline requests were received, 14% fewer than in 2023 to 2024 (1,649 helpline requests).

Just over half of the helpline requests received (51%, 720 people) were requests for help to complete the survey. 39% of helpline calls (549) were queries about eligibility, of which 225 people called to say they did not wish to participate and 118 called to say that the intended recipient had moved.

The number of calls to say that a survey recipient had died was 33, one more than in 2023 to 2024. The helpline received 3 complaints (2 in 2023 to 2024).

The helpline received 28 calls requesting a translation, the same as in 2023 to 2024. The helpline also received 7 requests for a large-print version of the survey questionnaire.

People who were recently deceased

In any survey, there is a risk of sending survey materials to people who have recently died. This can cause distress to bereaved family members, and every reasonable effort is made to minimise the risk of this occurring. As with all Care Experience surveys, every possible effort was made by IQVIA, Public Health Scotland and the Scottish Government to avoid questionnaires being sent to family members of people who had died.

We sample people for this survey from the CHI database, which is a source generally up to date with regard to death events. Nevertheless, any death which occurs in Scotland must be registered within eight days of the date of death. This means that there can be a delay between the actual date of death and the date that it is registered and updated on the CHI and National Records of Scotland databases.

In order to address this gap, we ask a specialised team at NRS (NHS Central Register (NHSCR)) to run several death checks of the people sampled, one after we have drafted the sample, and daily checks prior to each mail out. Additionally, the list of people sampled for the survey was shared with the Community Health Index Linkage and Indexing (CHILI) team in PHS (who host the CHI database) for further death checks.

This approach provided a check on a daily basis for people who had died and notifications to be sent to Public Health Scotland throughout the mail-out period. Public Health Scotland subsequently passed this information on to IQVIA, who removed survey packs as required prior to mail out.

Having access to information about recent deaths greatly reduced the number of questionnaires being sent to addresses of people who had died.

The people included in the 2025 to 2026 survey were sampled from an extract taken from the CHI database provided to Public Health Scotland analysts on 22nd September 2025. The sampling, questionnaire printing and mail-out process extended from this date through to the final mailing date of the 21st November 2025. This meant that some people would have died between the extract date and mail out dates.

A total of 466 people were identified as deceased by NHSCR and CHILI checks and removed from the sample prior to and on the initial mail-out day of the survey on the 22nd October 2025. These individuals were not sent survey packs. In addition, 1,267 people were identified through these checks as no longer eligible for the survey.

NHSCR and CHILI identified a further 68 people as deceased and 160 people as no longer eligible across the second, third and fouth mail-out days (23rd, 24th & 27th October 2025) which completed the initial mail out phase. Public Health Scotland subsequently passed this information on to IQVIA, who removed remaining survey packs as required prior to mail out.

NHSCR and CHILI checks identified 456 people as deceased and 793 people as no longer eligible during the reminder mail out period (12th November 2025 up to the 21st November 2025). Public Health Scotland passed this information to IQVIA, who ensured these people were not sent survey packs.

In 28 cases a questionnaire was sent to someone who had died and the person's family had contacted IQVIA. Note that this includes a small number of instances where deaths were picked up via the death checking process after the mail-out of these letters and notification by relatives.