Inclusion Health Action in General Practice (IHAGP): evaluation

Methodology

This evaluation adopted a mixed-methods approach to provide a detailed assessment of the Inclusion Health Action in General Practice (IHAGP) programme. The approach combined quantitative and qualitative techniques to capture measurable changes in service delivery alongside rich insights into patient and staff experiences. This design ensured that findings were robust, triangulated, and aligned with the programme’s Theory of Change.

Evaluation stages

The evaluation consisted of three main stages of data collection:

1. Surveys: capturing perspectives from patients and practice staff across participating IHAGP practices.

2. Stakeholder Interviews: in-depth qualitative engagement with patients and staff.

3. Theory of Change Workshop: collaborative reflection with key stakeholders to validate assumptions and refine the programme model.

Surveys

The quantitative component of the evaluation was based on three surveys. There were two versions of a survey designed for staff: the first contained the survey questions and included a mandatory monitoring form for all 66 practices, capturing detailed implementation data at the practice-level which is included throughout this report. The second version of the staff survey was designed for wider dissemination among practice staff to gather individual staff views on IHAGP activities and their impact. Surveys were sent via email to participating practices who then disseminated it to their staff. In total, 134 staff members responded to the staff survey.

The patient survey asked about patients’ recent interactions with their practice, specifically which aspects related to IHAGP they had been offered or made use of, and their reflections on their experiences of these interactions. The survey was translated into several languages to ensure accessibility for non-English speakers and was distributed via QR codes and links provided by participating practices. To reduce barriers for digitally excluded participants, the research team also conducted two patient surveys by telephone. In total, 58 patients responded to the patient survey. The surveys were administered online via Survey Monkey; questionnaires are available in the technical annex of this report.

Interviews

Qualitative research complemented the survey findings through in-depth interviews. Interviewees were recruited through patient survey respondents indicating consent to be contacted to take part in an interview, and interviews were conducted on-line or by telephone. Five patients were interviewed to explore their experiences of accessing care before and after IHAGP interventions, the perceived benefits of longer consultations, and any remaining barriers to engagement.

There were 13 staff interviews conducted with 14 staff members, including GPs, nurses, and practice managers. These discussions provided valuable insights into implementation challenges, perceived impacts on patient engagement, and reflections on sustainability. Interviewees were recruited through staff survey respondents indicating consent to be contacted to take part in an interview, and conducted online or by telephone, with flexibility to accommodate participants’ preferences and ethical safeguards in place to ensure informed consent and sensitivity to trauma-related topics. The patient and staff interview discussion guides are available in the technical annex of this report.

Theory of Change Workshop

The final stage of the evaluation was a Theory of Change workshop held in November 2025. This half-day session brought together Scottish Government officials, GP representatives, and HSCP stakeholders to review emerging findings, test the assumptions underpinning IHAGP’s Theory of Change, and co-produce a revised model. Interactive exercises and breakout discussions optimised inclusive participation.

Approach to Analysis

Survey data were analysed using descriptive statistics and cross-tabulations to identify patterns across respondent groups. Interviews were recorded and transcribed, and qualitative data from interviews and the workshop were thematically coded enabling the identification of recurring themes, illustrative quotes, and divergent perspectives. Both survey data and interview data were analysed using Quirkos.

Limitations

Despite the strengths of this design, several limitations should be acknowledged. Engagement was voluntary, introducing a risk of self-selection bias. The results of the staff surveys represent the views of those who participated in the evaluation and may not be representative of the view of all staff in all IHAGP practices. Survey respondents were asked to answer questions about themes their practice had worked on; from implementation data gathered through the monitoring form aspect of the staff survey these were 43% of practices worked on Theme 1, 51% of practice worked on Theme 2, and 91% worked on Theme 3. Additionally, the 58 patient responses may not be presentative of the views of all patients. Time constraints limited the depth of engagement with harder-to-reach groups, and while translation and telephone support were provided, some digitally excluded individuals and those with complex needs may remain underrepresented. Monitoring data also varied in completeness and consistency across practices, which restricted comparability. These limitations have been considered in interpreting findings and shaping recommendations.