# Report On The National Patient Choice Survey - February 2010 England

## Report On The National Patient Choice Survey - February 2010 England

Prepared by Sheila Dixon, Department of Health June 2010 

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Title: 
Report on the National Patient Choice Survey - February 2010 England 
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June 2010 
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Statistical publication of the results of the National Patient Choice survey for referrals made in February 2010. 
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© Crown copyright 2010 First published June 2010 

Published to DH website, in electronic PDF format only. http://www.dh.gov.uk/en/Publicationsandstatistics 

Annex D: Combined survey results by age, sex, ethnic group and longstanding illness ..................................................................................................... 33 
Background ......................................................................................................... 33 Age and sex results ............................................................................................. 33 
Ethnic group results............................................................................................. 35 
Long-standing illness results ............................................................................... 37 
Table D.1 Percentage of patients aware of choice by age, sex, ethnic group and  
long-standing illness, surveys to date 
.................................................................. 38 
Table D.2 Percentage of patients offered choice by age, sex, ethnic group and  
long-standing illness, surveys to date 
.................................................................. 39 
Table D.3 Percentage of patients able to go where they wanted by age, sex,  
ethnic group and long-standing illness, surveys to date ...................................... 40 

## Results Of The National Patient Choice Survey - February 2010 England.

Introduction  
Most patients1 have a right to choose any clinically appropriate provider in 
England that meets NHS standards and costs on referral for their first 
outpatient appointment. 

The Department of Health commissioned a series of national patient choice 
surveys to assess the offer and awareness of choice at PCT level.  The results 
were published in a series of reports, the latest was for the survey in March2 

2009. 

This report gives summary results of around 69,000 responses to a follow-up survey, for referrals made in February 2010.  There are no further follow-up surveys planned. 

## Key Findings

- The percentage of patients recalling being offered a choice of hospital for their 
first outpatient appointment was 49% in February 2010, up from 47% in March 
2009 and 30% in the first survey (May/June 2006). 
- 54% of patients were aware before they visited their GP that they had a choice 
of hospitals for their first appointment, up from 50% in March 2009 and 29% in 
the May/June 2006 survey. 
- 63% of patients who were aware of choice recalled being offered choice, 
whereas only 32% of those not aware of choice recalled being offered it, similar 
to the March 2009 survey (62% and 32% respectively). 
- 67% of patients were able to go to the hospital they wanted, with a further 22% 
having no preference and 8% unable to go where they wanted, similar to 67%, 
23% and 8% respectively in March 2009. 
- 88% of patients offered choice were able to go to the hospital they wanted, with 
a further 5% having no preference. This compares with 47% of patients not 
offered choice being able to go where they wanted and 40% having no preference. 

- 77% of patients were satisfied with how long they had to wait from the time their 
GP referred them to when they saw the hospital specialist. 
- For those who were offered a choice, a hospital close to home or work was 
selected most often (by 38% of patients offered choice) as the single most important factor when choosing their hospital. 
Choice of hospital  
The percentage of patients who recalled being offered a choice of hospital for their first outpatient appointment was 49% in February 2010.  This compares with between 43% and 48% doing so in surveys from January 2007 to March 2009 and 
30% in the first (May/June 2006) survey. The percentage of patients aware of choice has risen more consistently over the period, see Figure 1 and Annex Table A.2. In addition, 40% of patients in February 2010 said they discussed which hospital they might go to with their GP.  25% of patients were aware of how to complain if they felt they were not offered a choice of hospital1, with 64% unaware 
(see Annex Table A.3). 

Awareness of choice The percentage of patients who said that they knew before visiting their GP that there is now choice of hospital for a first hospital appointment was 54% in February 
2010, up from 50% in March 2009 and 29% in the first (May/June 2006), see Figure 
1 and Annex Table A.2. 

The 54% of patients who were aware of choice were more likely to say that they were offered a choice of hospital than those who were unaware of choice.  63% of patients who knew about choice recalled being offered it, whereas only 32% of those not knowing about choice recalled being offered it (Annex Table A.1).  This difference is similar to previous surveys (eg 62% and 32% respectively in March 2009). 

## Going To The Hospital Of Choice

67% of patients were able to go to the hospital they wanted, with a further 22% having no preference and 8% unable to go where they wanted.  This is similar to the March 2009 survey, when 67% of patients went to the hospital they wanted, 23% had no preference and 8% were unable to go where they wanted.  For patients offered choice, 88% were able to go where they wanted whilst 6% were not and 5% 
had no preference. This was different from patients not offered choice, 47% of whom went where they wanted but 40% did not have a preference, see Figure 2 and Annex Table A.3. This may imply that the process of being offered and discussing choice helps patients to decide a preferred hospital. 

## Sources Of Information On Choice

The GP was the single most important source of information to help choose their hospital for 43% of patients offered choice. The patient's own experience, or that of their friends and family, was given by 29% as the most important source of information when choosing. A booklet about choice was given by 6% patients, whilst 4% gave the NHS Choices website, see Figure 3 and Annex Table A.4.  
Although not directly comparable with earlier surveys1, the same sources of information were given most often in March 2009.  83% of patients offered choice reported that they had enough information to help them make their choice2 (see Annex Table A.1). 

Factors influencing choice Closeness to work or home was selected most often (by 38% of patients who were offered choice) as the single most important factor1 when choosing their hospital, see Figure 4 and Annex Table A.6.  Other patients cited personal experience of the hospital and good previous experience (given by 12% and 6% of patients respectively), waiting times (10%), accessibility (5%) and quality of care (5%). Location issues (differently defined), waits and quality of care were also in the top six factors selected most often in previous surveys, where all patients were invited to select as many factors as they felt were most important in choosing a hospital. Whilst earlier surveys identified cleanliness or low levels of infection and friendliness of staff as important factors for patients, these were the single most important factor for only 2% and 1% respectively of patients choosing a hospital in February 2010.  

## Booking The First Appointment

34% of patients booked their first hospital appointment when the hospital contacted them following a letter from the GP, compared with 35% in the March 2009 survey.  
Of the others, 27% patients telephoned an appointments line, 22% were booked on screen (by the GP or other practice staff) and 8% used the internet (up from 6% in March 2009). 45% of patients who did not recall being offered choice booked their appointment when the hospital contacted them, whilst only half as many patients 
(23%) who were offered choice booked this way, see Annex Table A.3.   
41% of patients were offered a choice of different dates and times of day when their first appointment was made1. More patients who recalled being offered a choice of hospital were also offered a choice of date and time (56%) than those who were not offered a choice of hospital (27% offered a choice of date and time). The choice of date and time varied by the method of booking (see Annex Table A.4).  26% of those who booked when the hospital contacted them were offered a choice of date and time, compared with 41% of those booked on screen in the surgery, 56% of those calling an appointments line and 85% of those booking via the internet. 

## Waiting For The First Appointment

77% of patients were satisfied with how long they had to wait from the time their GP referred them to when they saw the hospital specialist, compared with 76% in March 
2009. The level of satisfaction was higher amongst those who were offered choice 
(81%, with 16% dissatisfied) than amongst those who were not (74%, with 20% dissatisfied), see Annex Table A.3, which may indicate a benefit of offering choice. 

Results by type of provider The proportion of patients who reported being offered choice whose first outpatient appointment was in an Independent Sector (IS) provider was higher than for patients going to NHS organisations: 60% compared with 48%, see Figure 5 and Annex Table A.7. This compares with 60% for those going to IS and 47% for NHS 
providers in the March 2009 survey. However, only 740 (1%) patients taking part in the survey went to IS providers.  The proportion of patients offered a choice of date and time for their first outpatient appointment was also higher in IS providers: 57% 
compared with 41% for patients going to NHS organisations (not explained by differences in the method of booking). Of those offered a choice of provider, IS hospital patients often gave the length of wait or the location as the single most important factor when choosing, whilst more NHS hospital patients gave the location or their own experience (see Annex Table A.7).  As before, the difference between the proportions of patients from IS and NHS providers who were aware of choice before visiting their GP was smaller. 

Variation by SHA 
The proportion of patients who recalled being offered a choice of hospital for their first outpatient appointment, 49% nationally, varied by SHA as shown in Figure 6 and Annex Table A.10.  Most SHAs showed an increase in the percentage of patients offered choice in February 2010 compared with the March 2009 survey. 

The proportion of patients who were aware that they had a choice of hospital for their first outpatient appointment, 54% nationally, varied by SHA as shown in Figure 
7 and Annex Table A.11. All SHAs showed an increase in patient awareness of choice compared with the March 2009 survey. 

Variation by PCT 
In 21 out of 1451 PCTs (14%), over 60% of patients were offered choice, see Figure 
8 and Annex Table A.9, whilst under 40% of patients were offered choice in 27 (19%) PCTs. This compares with 15 PCTs in the March 2009 survey with over 60% of patients offered choice and 32 PCTs with under 40% of patients offered choice.  
The proportion of patients aware of choice was under 40% in 3 (2%) PCTs, down from 6 (4%) in the March 2009 survey. 

The percentage of patients able to go to the hospital they wanted, 67% nationally, varied by PCT as shown in Figure 9 and Annex Table A.8.  Most of the remaining patients had no preference (22% nationally), although more than 10% patients said they were not able to go where they wanted in 28 (19%) PCTs.  PCTs where fewer patients were able to go where they wanted tended to have lower levels of choice being offered. 

The geographic variation in the percentage of patients who said they were offered a choice of hospital in February 2010 and in March 2009 is illustrated in the PCT maps in Figure 10, see also Annex Table A.8.  However, some PCT figures shown are based on relatively few responses, with the possibility of response bias, so results for individual PCTs should be treated with caution.  

# Annex A: Tables Of Results Of The National Patient Choice Survey - February 2010 England

Numbers and percentages1 
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? 
 
Total2 
 
Yes 
No 
Number 
Percent 
Number 
Percent 
Number 
Percent 
69,040 
100% 
36,984 
54% 
31,523 
46% 
Q2 Did you discuss which hospital you might go to with your GP? 
19,765 
53% 
8,041 
26% 
16,537 
45% 
22,430 
71% 
485 
1% 
932 
3% 
197 
1% 
120 
0% 
Yes 
27,889 
40% 
No 
39,095 
57% 
Don't know 
1,424 
2% 
Not stated 
632 
1% 
Total 
 
69,040 
100% 
36,984 
100% 
31,523 
100% 
Q3 Were you offered a choice of hospital for your first hospital appointment? 
23,324 
63% 
10,096 
32% 
12,304 
33% 
20,201 
64% 
983 
3% 
1,049 
3% 
372 
1% 
177 
1% 
Yes 
33,525 
49% 
No 
32,628 
47% 
Don't know 
2,048 
3% 
Not stated 
840 
1% 
Total 
 
69,040 
100% 
36,984 
100% 
31,523 
100% 
For patients offered choice ('Yes' to Q3) Q5 Did you have enough information to help you make your choice?  
Yes 
27,166 
83% 
No 
4,486 
14% 
Not stated 
902 
3% 
19,750 
87% 
7,345 
75% 
2,320 
10% 
2,146 
22% 
619 
3% 
273 
3% 
Total3 
 
32,554 
100% 
22,689 
100% 
9,764 
100% 

1.  
Apart from Q1, percentages are calculated as a proportion of the total within each column. 

2.  
Total columns include responding patients who did not state whether they knew they had a choice of hospitals before visiting their GP.  This accounts for 534 (1%) responses. 

3.  
Total for Q5 excludes 971 (3%) responses for patients sent the previous survey form and offered choice (see Annex B). 

Percentages 
Aware of choice
1 
Offered choice
2 
Able to go where wanted
3 
Survey 
Total
4 
%Yes 
%No 
%Yes 
%No 
%Yes 
%No 
%No 
preference 
May/June 2006 
78,773 
29% 
69% 
30% 
64% 
July 2006 
70,084 
32% 
67% 
35% 
59% 
September 2006 
70,580 
32% 
67% 
38% 
57% 
November 2006 
56,928 
35% 
64% 
41% 
53% 
January 2007 
73,000 
36% 
63% 
45% 
50% 
March 2007 
75,290 
37% 
62% 
48% 
47% 
May 2007 
75,191 
38% 
61% 
44% 
50% 
July 2007 
62,264 
38% 
61% 
43% 
50% 
September 2007 
92,545 
39% 
60% 
45% 
49% 
November 2007 
77,804 
41% 
58% 
44% 
52% 
65% 
7% 
25% 
January 2008 
72,153 
43% 
57% 
46% 
50% 
67% 
7% 
23% 
March 2008 
109,331 
43% 
56% 
47% 
48% 
67% 
7% 
23% 
May 2008 
89,903 
45% 
54% 
45% 
50% 
66% 
8% 
24% 
July 2008 
93,528 
47% 
53% 
46% 
49% 
66% 
8% 
23% 
September 2008 
93,003 
48% 
51% 
46% 
50% 
67% 
8% 
23% 
December 2008 
75,878 
50% 
50% 
46% 
49% 
68% 
7% 
23% 
March 2009 
93,217 
50% 
49% 
47% 
49% 
67% 
8% 
23% 
February 2010 
69,040 
54% 
46% 
49% 
47% 
67% 
8% 
22% 

1.  
Response to 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?' 
2.  
Response to Q3 'Were you offered a choice of hospital for your first hospital appointment?' 
3.  
Response to Q7 (introduced as Q5 November 2007) 'Were you able to go to the hospital that you wanted to go to?' 
4.  
Total valid responses, weighted by age and sex (see Annex B); includes patients who replied 'don't know' or did not 
respond to the question. 

Q3 Were you offered a choice of hospital for your first hospital 
appointment?
 
Total2 
Yes 
No 
Number 
Percent 
Number 
Percent 
Number 
Percent 
69,040 
100% 
33,525 
49% 
32,628 
47% 
Q7  Were you able to go to the hospital that you wanted to go to? 
Yes 
46,366 
67% 
29,435 
88% 
15,280 
47% 
No 
5,280 
8% 
1,863 
6% 
3,288 
10% 
I didn't have a preference 
15,277 
22% 
1,564 
5% 
12,984 
40% 
Not stated 
2,117 
3% 
662 
2% 
1,076 
3% 
Total 
69,040 
100% 
33,525 
100% 
32,628 
100% 
Q8  How did you book your first hospital appointment? 
GP wrote and hospital contacted me 
23,432 
34% 
7,665 
23% 
14,824 
45% 
Telephoned a call centre 
18,567 
27% 
12,636 
38% 
5,370 
16% 
On screen (with GP or practice staff) 
15,398 
22% 
7,611 
23% 
7,177 
22% 
Via internet 
5,365 
8% 
3,921 
12% 
1,314 
4% 
All other responses 
6,277 
9% 
1,691 
5% 
3,942 
12% 
Total 
69,040 
100% 
33,525 
100% 
32,628 
100% 
Q9  When your first hospital appointment was made, were you offered a choice of different dates and times of day? 
Yes 
27,734 
41% 
18,142 
56% 
8,657 
27% 
No 
35,299 
53% 
12,747 
39% 
21,428 
67% 
Don't know / not stated 
4,130 
6% 
1,666 
5% 
1,722 
5% 
Total3 
67,164 
100% 
32,554 
100% 
31,807 
100% 
Q10 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? 
14,970 
12,103 
3,562 
1,810 
28,383 
24,744 
7,708 
4,790 
1,506 
1,907 
41% 
36% 
11% 
7% 
2% 
3% 
45% 
36% 
11% 
5% 
1% 
2% 
38% 
36% 
12% 
9% 
3% 
3% 
12,469 
11,670 
3,846 
2,833 
918 
891 
32,628 
Very satisfied Fairly satisfied Not very satisfied Not at all satisfied 
No appointment date yet Don't know / not stated Total 
69,040 
100% 
482 
598 
33,525 
100% 
100% 
Q11 Are you aware of how to complain if you feel you were not offered a choice of hospital? 
Yes 
16,999 
25% 
10,623 
33% 
5,806 
18% 
No 
43,057 
64% 
18,828 
58% 
22,876 
72% 
Don't know / not stated 
7,108 
11% 
3,103 
10% 
3,127 
10% 
Total3 
67,164 
100% 
32,554 
100% 
31,807 
100% 

1.  
Apart from Q3, percentages are calculated as a proportion of the total within each column. 

2.  
Total columns include responding patients who did not know or did not state whether they were offered a choice of hospital. This accounts for 2,888 (4%) responses. 

3.  
Figures for Q9 and Q11 exclude 1,876 (3%) responses for patients sent the previous survey form (see Annex B). 

Q9  When your first hospital appointment was made, were you 
offered a choice of different dates and times of day?
 
Total2
Number 
Percent 
Yes 
Number 
Percent 
No 
Number 
Percent 
Q8  How did you book your first hospital appointment? 
GP wrote and hospital contacted me 
22,791 
100% 
5,938 
26% 
15,790 
69% 
Telephoned a call centre 
18,149 
100% 
10,116 
56% 
7,290 
40% 
On screen (with GP or practice staff) 
14,906 
100% 
6,097 
41% 
7,983 
54% 
Via internet 
5,206 
100% 
4,429 
85% 
700 
13% 
All other responses 
6,112 
100% 
1,156 
19% 
3,535 
58% 
Total 
67,164 
100% 
27,734 
41% 
35,299 
53% 

1.  
Percentages are calculated as a proportion of the total within each row. 

2.  
Total column includes 4,130 (6%) responding patients who did not know or did not state whether they were offered a 
choice of different dates and times of day and excludes 1,876 (3%) responses for patients sent the previous survey 
form (see Annex B). 

Numbers and percentages 
Percent of
Sources listed1 
No. patients 
responses 
13,960 
9,556 
1,892 
1,407 
956 
490 
192 
165 
43% 
29% 
6% 
4% 
3% 
2% 
1% 
1% 
8% 
4% 
2,531 
1,406 
32,554 
100% 
My GP Friends / family members / own experience A booklet or leaflet about my choices NHS Choices website Staff at Clinical Assessment or Referral Centre Someone else at GP surgery Local patient organisation Other internet site Don't know 
Not stated 
Total2 

1.  
Patients who said they had been offered choice were invited to select, from a list of sources, the one most important to them when choosing their hospital.  This differs from earlier surveys, where such patients were invited to select as many sources as applied. 

2.  
Total excludes 970 (3%) responses for patients sent the previous survey form (see Annex B). 

Numbers and percentages 
Percent of
Most important factors listed1 
No. patients 
responses 
12,410 
3,874 
3,120 
1,835 
1,696 
1,594 
1,390 
1,257 
924 
812 
775 
712 
671 
344 
209 
143 
24 
358 407 
38% 
12% 
10% 
6% 
5% 
5% 
4% 
4% 
3% 
2% 
2% 
2% 
2% 
1% 
1% 
0% 
0% 
1% 1% 
32,554 
100% 
Close to your home or work Personal experience of the hospital Length of wait for appointment Good previous experience Accessible on public transport / Travel costs Quality of care Reputation of hospital GP / assessment centre doctor recommendation Experience of friends or family members Availability of car parking 
Ability to see consultant of your choice 
Convenience of appointment time Cleanliness / rates of infection Friendliness of staff Cost of car parking Standard of facilities Quality of food Don't know Not stated 
Total2 

1.  
Patients who said they had been offered choice were asked to select the single most important factor when they chose 
their hospital. This is not directly comparable with earlier surveys, where all patients were invited to select as many factors as they felt were most important in choosing a hospital. 
2.  
Total excludes 970 (3%) responses for patients sent the previous survey form (see Annex B). 

Numbers and percentages 
Type of provider of outpatient service
 
Total1 
Independent 
Sector2 
NHS 
Number 
Percent 
Number 
Percent 
Number 
Percent 
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? 
Yes 
36,984 
No 
31,523 
Not stated 
534 
54% 
355 
48% 
36,628 
54% 
46% 
376 
51% 
31,146 
46% 
1% 
2 
0% 
531 
1% 
Total1  
69,040 
100% 
734 
100% 
68,306 
100% 
Q3 Were you offered a choice of hospital for your first hospital appointment? 
Yes 
33,525 
No 
32,628 
Don't know 
2,048 
Not stated 
840 
49% 
442 
60% 
33,083 
48% 
47% 
276 
38% 
32,351 
47% 
3% 
11 
2% 
2,037 
3% 
1% 
5 
1% 
835 
1% 
Total1  
69,040 
100% 
734 
100% 
68,306 
100% 
For patients offered choice ('Yes' to Q3) Q6  Which was the single most important thing for you when you chose your hospital? 
38% 
12% 
9% 
6% 
5% 
5% 
12,410 
3,874 
3,120 
1,835 
1,696 
1,594 
8,025 
12,325 
3,850 
3,035 
1,818 
1,688 
1,573 
7,874 
 
32,554 
85 
25 
85 
17 
8 
21 
151 
391 
32,163 
24% 
100% 
38% 
12% 
10% 
6% 
5% 
5% 
25% 
100% 
22% 
6% 
22% 
4% 
2% 
5% 
39% 
100% 
Close to home or work Personal experience Length of wait Good previous experience Accessibility Quality of care All other responses 
Total1,3
Q7 Were you able to go to the hospital that you wanted to go to? 
Yes 
46,366 
No 
5,280 
I didn't have a preference 
15,277 
Not stated 
2,117 
67% 
489 
67% 
45,877 
67% 
8% 
46 
6% 
5,234 
8% 
22% 
184 
25% 
15,093 
22% 
3% 
15 
2% 
2,102 
3% 
Total1 
 
69,040 
100% 
734 
100% 
68,306 
100% 
Q9  When your first hospital appointment was made, were you offered a choice of different dates and times of day? 
Yes 
27,734 
No 
35,299 
Don't know / not stated 
4,130 
41% 
367 
57% 
27,367 
41% 
53% 
250 
39% 
35,049 
53% 
6% 
28 
4% 
4,103 
6% 
Total1,3 
 
67,164 
100% 
645 
100% 
66,519 
100% 
Q10 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? 
427 
227 
41 
22 
28,383 
24,744 
7,708 
4,790 
1,506 
1,907 
41% 
36% 
11% 
7% 
2% 
3% 
58% 
31% 
6% 
3% 
0% 
2% 
27,956 
24,517 
7,668 
4,769 
1,504 
1,892 
41% 
36% 
11% 
7% 
2% 
3% 
Very satisfied Fairly satisfied Not very satisfied Not at all satisfied No appointment date yet Don't know / not stated Total 
69,040 
100% 
100% 
68,306 
100% 
2 
15 
734 

1.  
Responses may not sum to total due to rounding following age and sex weighting of the survey results. 

2.  
Some Independent Sector providers have taken part in the survey, issuing survey forms to their patients, since the November 2006 survey, see Annex B. 

3.  
Total Q9 excludes 1,876 (3%) responses for patients sent the previous survey form; total Q6 excludes 971 of these who were offered choice (see Annex B). 

Percentages 
Aware of 
choice
1 
Offered 
choice
2 
Able to go where wanted
 to go
3 
PCT
4 
SHA
5 
Total
6 
%Yes 
%No 
%Yes 
%No 
%Yes 
%No 
%No 
preference 
England 
 
69,040 
54% 
46% 
49% 
47% 
67% 
8% 
22% 
Ashton, Leigh and Wigan 
NW
 374 
61% 
39% 
56% 
40% 
68% 
8% 
20% 
Barking and Dagenham 
Lon 
178 
60% 
40% 
62% 
34% 
63% 12% 
21% 
Barnet 
Lon 
166 
60% 
40% 
56% 
39% 
73% 
9% 
15% 
Barnsley 
YH 
612 
73% 
26% 
51% 
45% 
74% 
5% 
19% 
Bassetlaw 
EM 
354 
67% 
32% 
53% 
44% 
73% 
6% 
19% 
Bath and North East Somerset 
SW
 37 
62% 
35% 
70% 
22% 
70% 
8% 
16% 
Bedfordshire 
EoE 
641 
58% 
41% 
48% 
49% 
72% 
5% 
20% 
Berkshire East 
SC 
58 
50% 
50% 
50% 
47% 
71% 12% 
17% 
Berkshire West 
SC 
97 
57% 
43% 
67% 
28% 
76% 10% 
11% 
Bexley Care Trust 
Lon 
60 
53% 
47% 
55% 
45% 
72% 
7% 
20% 
Birmingham East and North 
WM
 43 
58% 
40% 
63% 
35% 
70% 
5% 
21% 
Blackburn with Darwen 
NW 
235 
65% 
35% 
64% 
31% 
73% 11% 
14% 
Teaching 
Blackpool 
NW 
301 
60% 
40% 
50% 
47% 
73% 
6% 
17% 
Bolton 
NW 
400 
62% 
38% 
59% 
37% 
77% 
7% 
14% 
Bournemouth and Poole 
SW 
1,077 
54% 
45% 
46% 
51% 
71% 
6% 
20% 
Teaching 
Bradford and Airedale Teaching YH 
539 
57% 
43% 
45% 
50% 
61% 10% 
26% 
Brent Teaching 
Lon 
193 
50% 
49% 
46% 
46% 
65% 
8% 
24% 
Brighton and Hove City 
SEC 
525 
44% 
56% 
39% 
55% 
60% 
8% 
28% 
Bristol 
SW 
296 
46% 
53% 
48% 
46% 
67% 
6% 
25% 
Bromley 
Lon 
52 
48% 
48% 
31% 
62% 
48% 12% 
31% 
Buckinghamshire 
SC 
850 
47% 
50% 
43% 
51% 
63% 
9% 
22% 
Bury 
NW 
243 
62% 
38% 
54% 
42% 
72% 
8% 
19% 
Calderdale 
YH 
381 
61% 
38% 
55% 
41% 
72% 
5% 
21% 
Cambridgeshire 
EoE 
363 
57% 
42% 
52% 
42% 
72% 
5% 
20% 
Camden 
Lon 
75 
65% 
33% 
57% 
33% 
80% 
5% 
13% 
Central & Eastern Cheshire 
NW
 867 
62% 
36% 
54% 
42% 
73% 
6% 
17% 
Central Lancashire 
NW
 331 
66% 
34% 
64% 
33% 
77% 
7% 
14% 
City and Hackney Teaching 
Lon 
165 
47% 
50% 
39% 
51% 
65% 
7% 
23% 
Cornwall and Isles of Scilly 
SW
 437 
49% 
51% 
41% 
55% 
54% 13% 
25% 
County Durham 
NE 
1,074 
71% 
29% 
67% 
30% 
77% 
7% 
14% 
Coventry Teaching 
WM
 573 
68% 
31% 
54% 
42% 
76% 
6% 
15% 
Croydon 
Lon 
63 
71% 
29% 
73% 
25% 
71% 13% 
13% 
Cumbria Teaching 
NW
 1,162 
63% 
36% 
50% 
46% 
74% 
6% 
17% 
Darlington 
NE 
166 
71% 
27% 
52% 
44% 
75% 10% 
13% 
Derby City 
EM 
463 
49% 
51% 
37% 
60% 
66% 
5% 
27% 
Derbyshire County 
EM 
1,031 
65% 
34% 
58% 
38% 
77% 
4% 
17% 
Devon 
SW 
1,222 
60% 
39% 
49% 
47% 
71% 
6% 
20% 
Doncaster 
YH 
337 
66% 
33% 
47% 
50% 
75% 
5% 
17% 
Dorset 
SW 
1,375 
62% 
37% 
56% 
39% 
74% 
7% 
16% 
Dudley 
WM 
149 
56% 
43% 
38% 
62% 
63% 
9% 
27% 
Ealing 
Lon 
364 
56% 
44% 
45% 
51% 
68% 
8% 
21% 
East and North Hertfordshire 
EoE 
82 
68% 
30% 
54% 
44% 
66% 12% 
18% 
East Lancashire Teaching 
NW
 657 
72% 
28% 
71% 
25% 
73% 10% 
15% 
East Riding of Yorkshire 
YH 
753 
49% 
50% 
42% 
55% 
58% 11% 
27% 
East Sussex Downs and Weald SEC 
875 
54% 
45% 
39% 
56% 
65% 
6% 
26% 
Eastern and Coastal Kent 
SEC 
1,041 
57% 
42% 
52% 
45% 
68% 
9% 
19% 
Enfield 
Lon 
222 
55% 
44% 
43% 
50% 
66% 
9% 
20% 
Gateshead 
NE 
409 
71% 
29% 
59% 
37% 
72% 
6% 
20% 
Gloucestershire 
SW 
1,115 
56% 
44% 
56% 
41% 
73% 
7% 
17% 
Great Yarmouth and Waveney 
EoE 
100 
64% 
35% 
52% 
43% 
71% 
2% 
23% 
Greenwich Teaching 
Lon 
331 
53% 
46% 
46% 
48% 
68% 
7% 
22% 
Halton and St Helens 
NW
 669 
62% 
38% 
60% 
37% 
71% 10% 
16% 
Aware of 
choice
1 
Offered 
choice
2 
Able to go where wanted
 to go
3 
PCT
4 
SHA
5 
Total
6 
%Yes 
%No
 
%Yes 
%No
 
%Yes 
%No 
%No 
preference 
Hammersmith and Fulham 
Lon 
2 
n/a. 
n/a. 
n/a. 
n/a. 
n/a. 
n/a 
n/a. 
Hampshire 
SC 
2,446 
52% 
47% 
45% 
51% 
67% 
7% 
23% 
Haringey Teaching 
Lon 
268 
61% 
39% 
51% 
43% 
71% 
7% 
20% 
Harrow 
Lon 
176 
55% 
44% 
55% 
41% 
68% 
6% 
21% 
Hartlepool 
NE 
40 
65% 
35% 
58% 
38% 
70% 
5% 
20% 
Hastings and Rother 
SEC 
548 
51% 
49% 
35% 
61% 
69% 
6% 
22% 
Havering 
Lon 
271 
59% 
41% 
76% 
22% 
77% 
6% 
14% 
Heart of Birmingham Teaching 
WM
 31 
29% 
71% 
29% 
55% 
71% 
6% 
23% 
Herefordshire 
WM 
548 
49% 
51% 
32% 
65% 
66% 
4% 
25% 
Heywood, Middleton and 
NW 
273 
64% 
34% 
54% 
41% 
70% 
9% 
20% 
Rochdale 
Hillingdon 
Lon 
616 
42% 
57% 
29% 
67% 
56% 14% 
27% 
Hounslow 
Lon 
56 
41% 
54% 
59% 
34% 
64% 
9% 
25% 
Hull Teaching 
YH 
555 
50% 
49% 
41% 
55% 
54% 
9% 
34% 
Isle of Wight NHS 
SC 
387 
45% 
55% 
18% 
77% 
57% 
5% 
33% 
Islington 
Lon 
133 
64% 
35% 
56% 
32% 
74% 
8% 
16% 
Kensington and Chelsea 
Lon 
25 
44% 
52% 
56% 
36% 
76% 
8% 
12% 
Kingston 
Lon 
46 
61% 
39% 
57% 
39% 
61% 17% 
11% 
Kirklees 
YH 
717 
54% 
45% 
52% 
43% 
70% 
8% 
19% 
Knowsley 
NW 
358 
50% 
50% 
49% 
47% 
66% 10% 
22% 
Lambeth 
Lon 
378 
53% 
46% 
49% 
46% 
75% 
6% 
17% 
Leeds 
YH 
1,578 
50% 
49% 
39% 
57% 
55% 11% 
30% 
Leicester City 
EM 
497 
39% 
61% 
33% 
61% 
50% 11% 
35% 
Leicestershire County and 
EM 
829 
49% 
51% 
44% 
54% 
57% 11% 
28% 
Rutland 
Lewisham 
Lon 
482 
52% 
46% 
44% 
51% 
63% 
6% 
27% 
Lincolnshire Teaching 
EM 
740 
62% 
38% 
55% 
42% 
64% 13% 
22% 
Liverpool 
NW 
1,098 
54% 
44% 
52% 
44% 
69% 
8% 
21% 
Luton 
EoE 
166 
51% 
47% 
34% 
61% 
63% 
7% 
25% 
Manchester 
NW 
749 
47% 
52% 
36% 
59% 
61% 
9% 
26% 
Medway 
SEC 
109 
60% 
40% 
63% 
33% 
71% 10% 
17% 
Mid Essex 
EoE 
593 
46% 
54% 
34% 
63% 
59% 
8% 
31% 
Middlesbrough 
NE 
4 
n/a. 
n/a. 
n/a. 
n/a. 
n/a. 
n/a 
n/a. 
Milton Keynes 
SC 
518 
51% 
48% 
36% 
59% 
63% 
6% 
28% 
Newcastle 
NE 
31 
58% 
42% 
68% 
26% 
52% 23% 
19% 
Newham 
Lon 
196 
48% 
51% 
40% 
53% 
62% 11% 
24% 
Norfolk 
EoE 
841 
57% 
42% 
59% 
39% 
82% 
7% 
9% 
North East Essex 
EoE 
620 
47% 
52% 
45% 
52% 
61% 10% 
25% 
North East Lincolnshire Care 
YH 
204 
49% 
50% 
38% 
59% 
59% 
5% 
31% 
Trust Plus 
North Lancashire Teaching 
NW
 805 
66% 
33% 
64% 
33% 
75% 
7% 
14% 
North Lincolnshire 
YH 
306 
69% 
30% 
59% 
36% 
77% 
3% 
18% 
North Somerset 
SW
 302 
54% 
44% 
53% 
41% 
74% 
8% 
17% 
North Staffordshire 
WM
 465 
67% 
33% 
62% 
35% 
77% 
5% 
15% 
North Tyneside 
NE 
239 
61% 
38% 
48% 
49% 
70% 
7% 
21% 
North Yorkshire and York 
YH 
1,160 
54% 
45% 
42% 
54% 
72% 
5% 
21% 
Northamptonshire Teaching 
EM 
657 
63% 
37% 
60% 
39% 
78% 
5% 
14% 
Northumberland Care Trust 
NE 
366 
61% 
37% 
52% 
44% 
68% 
7% 
22% 
Nottingham City 
EM 
374 
56% 
43% 
44% 
51% 
68% 
8% 
20% 
Nottinghamshire County 
EM 
1,236 
64% 
36% 
54% 
43% 
75% 
5% 
18% 
Teaching 
Oldham 
NW 
300 
71% 
29% 
72% 
24% 
80% 
8% 
11% 
Oxfordshire 
SC 
719 
55% 
44% 
43% 
53% 
71% 
5% 
20% 
Peterborough 
EoE 
287 
49% 
51% 
37% 
59% 
57% 
6% 
34% 
Plymouth Teaching 
SW
 379 
57% 
42% 
50% 
47% 
75% 
5% 
18% 
Portsmouth City Teaching 
SC 
470 
50% 
49% 
38% 
59% 
56% 
9% 
32% 
Redbridge 
Lon 
120 
58% 
41% 
55% 
39% 
64% 10% 
22% 
Redcar and Cleveland 
NE 
5 
n/a. 
n/a. 
n/a. 
n/a. 
n/a. 
n/a 
n/a. 
Richmond and Twickenham 
Lon 
19 
n/a. 
n/a. 
n/a. 
n/a. 
n/a. 
n/a 
n/a. 
Rotherham 
YH 
547 
76% 
24% 
54% 
43% 
78% 
5% 
15% 
Able to 
Aware of 
choice
1 
Offered 
choice
2 
go where wanted
 to go
3 
PCT
4
 
 
SHA
5 
Total
6
%Yes 
%No 
%Yes 
%No 
%Yes 
%No pr
%No 
eference 
Salford 
NW 
345 
62% 
37% 
47% 
47% 
72% 
7% 
17% 
Sandwell 
WM 
43 
60% 
37% 
56% 
37% 
63% 14% 
21% 
Sefton 
NW 
261 
49% 
51% 
44% 
52% 
57% 10% 
29% 
Sheffield 
YH 
1,065 
54% 
45% 
33% 
63% 
59% 
8% 
30% 
Shropshire County 
WM
 65 
71% 
28% 
68% 
31% 
75% 
6% 
14% 
Solihull Care Trust 
WM
 11 
n/a. 
n/a. 
n/a. 
n/a. 
n/a. 
n/a 
n/a. 
Somerset 
SW 
555 
67% 
32% 
62% 
34% 
77% 
6% 
14% 
South Birmingham 
WM
 201 
41% 
59% 
26% 
69% 
62% 
5% 
27% 
South East Essex 
EoE 
292 
66% 
33% 
47% 
48% 
73% 
6% 
20% 
South Gloucestershire 
SW
 68 
60% 
35% 
47% 
40% 
74% 
7% 
13% 
South Staffordshire 
WM
 857 
66% 
34% 
53% 
44% 
70% 
8% 
18% 
South Tyneside 
NE 
397 
65% 
34% 
47% 
48% 
69% 
5% 
23% 
South West Essex 
EoE 
604 
58% 
41% 
56% 
41% 
69% 10% 
19% 
Southampton City 
SC 
296 
29% 
69% 
24% 
72% 
53% 
4% 
38% 
Southwark 
Lon 
388 
46% 
54% 
42% 
54% 
66% 
5% 
26% 
Stockport 
NW 
489 
58% 
42% 
57% 
38% 
74% 
8% 
15% 
Stockton-on-Tees Teaching 
NE 
19 
n/a. 
n/a. 
n/a. 
n/a. 
n/a. 
n/a 
n/a. 
Stoke on Trent 
WM
 520 
61% 
38% 
60% 
36% 
76% 
4% 
17% 
Suffolk 
EoE 
693 
45% 
54% 
29% 
67% 
66% 
5% 
26% 
Sunderland Teaching 
NE 
584 
72% 
28% 
52% 
43% 
71% 
6% 
20% 
Surrey 
SEC 
1,133 
53% 
46% 
47% 
48% 
67% 
9% 
21% 
Sutton and Merton 
Lon 
529 
50% 
49% 
48% 
49% 
62% 10% 
25% 
Swindon 
SW 
383 
52% 
47% 
42% 
52% 
67% 
5% 
25% 
Tameside and Glossop 
NW
 458 
66% 
34% 
53% 
43% 
67% 
6% 
24% 
Telford and Wrekin 
WM
 15 
n/a. 
n/a. 
n/a. 
n/a. 
n/a. 
n/a 
n/a. 
Torbay Care Trust 
SW
 436 
56% 
43% 
47% 
51% 
73% 
5% 
19% 
Tower Hamlets 
Lon 
51 
53% 
45% 
59% 
35% 
67% 16% 
14% 
Trafford 
NW 
397 
55% 
45% 
44% 
52% 
69% 
9% 
21% 
Wakefield District 
YH 
586 
62% 
38% 
59% 
37% 
67% 12% 
19% 
Walsall Teaching 
WM
 198 
61% 
39% 
50% 
47% 
73% 
2% 
22% 
Waltham Forest 
Lon 
39 
54% 
46% 
72% 
28% 
69% 10% 
15% 
Wandsworth 
Lon 
79 
49% 
47% 
61% 
32% 
77% 
5% 
15% 
Warrington 
NW 
362 
56% 
44% 
41% 
54% 
67% 
7% 
21% 
Warwickshire 
WM 
813 
61% 
39% 
58% 
39% 
75% 
8% 
15% 
West Essex 
EoE 
105 
61% 
38% 
42% 
54% 
62% 10% 
22% 
West Hertfordshire 
EoE 
564 
48% 
51% 
50% 
47% 
67% 
8% 
21% 
West Kent 
SEC 
1,038 
51% 
48% 
45% 
51% 
69% 
7% 
21% 
West Sussex 
SEC 
332 
49% 
50% 
40% 
55% 
65% 13% 
18% 
Western Cheshire 
NW
 122 
57% 
42% 
62% 
36% 
65% 
8% 
20% 
Westminster 
Lon 
121 
52% 
48% 
50% 
41% 
69% 
6% 
23% 
Wiltshire 
SW 
684 
61% 
38% 
49% 
46% 
79% 
3% 
15% 
Wirral 
NW 
549 
60% 
39% 
50% 
47% 
70% 
6% 
21% 
Wolverhampton City 
WM
 468 
54% 
46% 
38% 
57% 
69% 
5% 
22% 
Worcestershire 
WM 
747 
54% 
45% 
40% 
55% 
61% 10% 
25% 

1.  
Response to 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?' 
2.  
Response to Q3 'Were you offered a choice of hospital for your first hospital appointment?' 
3.  
Response to Q7 'Were you able to go to the hospital that you wanted to go to?' 
4.  
Responsible Care Trusts and Primary Care Trusts, see Annex B.  PCT results are not weighted for any age or sex bias 
among respondents. 
5.  
Strategic Health Authority based on responsible PCT: NE (North East), NW (North West), YH (Yorkshire & the Humber), 
EM (East Midlands), WM (West Midlands), EoE (East of England), Lon (London), SEC (South East Coast), SC (South 
Central) and SW (South West). 
6.  
Total valid responses, including patients who replied 'don't know' or did not respond to the question.  The national total is 
weighted and includes 1,010 (1.5%) cases not listed by responsible PCT because the PCT was not clear.  Results for PCTs with fewer than 20 responses have been omitted, whilst those with fewer than 100 responses should be treated with some caution (see Annex B Issues for PCT results). 

Numbers and percentages 
May/June 
2006 1
 
March 
2008 
May 
2008 
July 
2008 
September  
2008 
December  
2008 
March 
2009 
February 
2010 
No. of 
% of 
No. of % of 
No. of 
% of 
No. of % of 
No. of 
% of 
No. of 
No. of 
No. of 
No. of 
No. of % of 
PCTs 2 PCTs 
PCTs PCTs 
PCTs PCTs 
PCTs PCTs 
PCTs PCTs 
PCTs 
PCTs 
PCTs 
PCTs 
PCTs 3 PCTs 
Percentage of patients offered a choice of hospital 4 
60% and over 
14 
5% 
11 
7% 
7 
5% 
14 
9% 
13 
9% 
16 
11% 
15 
10% 
21 
14% 
50% to <60% 
17 
6% 
49 
32% 
50 
33% 
50 
33% 
52 
34% 
48 
32% 
50 
33% 
55 
38% 
40% to <50% 
34 
11% 
61 
40% 
58 
38% 
52 
34% 
51 
34% 
53 
35% 
55 
36% 
42 
29% 
30% to <40% 
71 
23% 
28 
18% 
31 
20% 
28 
18% 
29 
19% 
26 
17% 
27 
18% 
21 
14% 
20% to <30% 
104 
34% 
3 
2% 
6 
4% 
8 
5% 
7 
5% 
7 
5% 
4 
3% 
5 
3% 
10% to < 20% 
59 
19% 
0 
0% 
0 
0% 
0 
0% 
0 
0% 
2 
1% 
1 
1% 
1 
1% 
<10% 
4 
1% 
0 
0% 
0 
0% 
0 
0% 
0 
0% 
0 
0% 
0 
0% 
0 
0% 
Total 
303 
100% 
152 100% 
152 
100% 
152 100% 
152 
100% 
152 
100% 
152 
100% 
145 
100% 

1. 

For results of the July 2006 to January 2008 surveys, see previous reports. 

2. 

Prior to PCT reconfiguration on 1 October 2006, there were 303 organisations (Care Trusts and Primary Care Trusts), compared with 152 subsequently. 

3. 

In February 2010, seven of the 152 PCTs had fewer than 20 responses and were omitted from this analysis, see Annex B. 

4. 

Percentage of patients who said Yes to: 'Were you offered a choice of hospital for your first hospital appointment?' 

Numbers and percentages 
May/June 
20061
 
March 
2008 
May 
2008 
July 
2008 
 
September 
2008 
December  
2008 
March 
2009 
February 
2010 
Total2 %Yes3 
Total2 %Yes3 
Total2 %Yes3 
Total2 %Yes3 
Total2 %Yes3 
Total2 %Yes3 
Total2 %Yes3 
Total2 %Yes3 
England 
78,773 
30% 
109,331 
47% 
89,903 
45% 
93,528 
46% 
93,003 
46% 
75,878 
46% 
93,217 
47% 
69,040 
49% 
North East North West  
Yorks & Humber East Midlands West Midlands East of England London South East Coast South Central 
South West 
4,238 
28% 
6,824 
51% 
5,587 
47% 
3,922 
52% 
5,577 
50% 
4,958 
50% 
5,235 
50% 
3,334 
57% 
11,252 
39% 
14,117 
52% 
12,751 
51% 
13,139 
52% 
13,084 
52% 
10,447 
51% 
13,002 
52% 
11,805 
54% 
9,321 
26% 
12,486 
44% 
9,831 
41% 
10,699 
41% 
12,165 
43% 
9,083 
42% 
12,253 
44% 
9,340 
45% 
7,240 
38% 
10,269 
56% 
8,514 
52% 
9,701 
52% 
10,113 
52% 
8,489 
51% 
8,937 
50% 
6,181 
50% 
7,355 
30% 
8,605 
45% 
8,208 
43% 
8,002 
43% 
7,119 
44% 
4,840 
46% 
6,964 
47% 
5,747 
49% 
8,580 
24% 
11,442 
40% 
8,976 
37% 
8,295 
39% 
8,764 
40% 
7,252 
42% 
8,959 
43% 
5,951 
46% 
9,350 
30% 
11,563 
45% 
10,433 
45% 
10,318 
45% 
8,634 
43% 
7,224 
45% 
9,180 
46% 
5,864 
48% 
7,490 
20% 
8,642 
44% 
7,530 
44% 
6,880 
43% 
7,797 
44% 
5,950 
44% 
7,712 
45% 
5,601 
44% 
5,204 
34% 
 6,486 
47% 
6,051 
44% 
7,001 
46% 
6,150 
45% 
5,756 
42% 
7,326 
41% 
5,841 
41% 
8,747 
27% 
10,690 
49% 
8,455 
48% 
11,177 
50% 
 8,274 
49% 
8,397 
49% 
10,690 
49% 
8,366 
51% 

1. 

For results of the July 2006 to January 2008 surveys, see previous reports. 

2. 

Total valid responses. From November 2006, total includes cases not identifiable by SHA (see Annex B). 

3. 

Percentage of patients who said Yes to: 'Were you offered a choice of hospital for your first hospital appointment?' 

4. 
SHA results are not weighted for any age or sex bias among respondents. 

Numbers and percentages 
May/June 
20061
 
March 
2008 
May 
2008 
July 
2008 
 
September 
2008 
Dece
2008 
mber 
March 
2009 
February 
2010 
Total2 %Yes3 
Total2 %Yes3 
Total2 %Yes3 
Total2 %Yes3 
Total2 %Yes3 
Total2 %Yes3 
Total2 %Yes3 
Total2 %Yes3 
England 
78,773 
29% 
109,331 
43% 
89,903 
45% 
93,528 
47% 
93,003 
48% 
75,878 
50% 
93,217 
50% 
69,040 
54% 
North East North West  
Yorks & Humber East Midlands West Midlands East of England London South East Coast South Central 
South West 
4,238 
30% 
6,824 
47% 
5,587 
49% 
3,922 
55% 
5,577 
58% 
4,958 
63% 
5,235 
62% 
3,334 
68% 
11,252 
34% 
14,117 
47% 
12,751 
50% 
13,139 
53% 
13,084 
54% 
10,447 
56% 
13,002 
57% 
11,805 
60% 
9,321 
30% 
12,486 
45% 
9,831 
46% 
10,699 
49% 
12,165 
51% 
9,083 
51% 
12,253 
54% 
9,340 
57% 
7,240 
36% 
10,269 
51% 
8,514 
53% 
9,701 
53% 
10,113 
56% 
8,489 
57% 
8,937 
56% 
6,181 
58% 
7,355 
31% 
8,605 
47% 
8,208 
48% 
8,002 
51% 
7,119 
52% 
4,840 
54% 
6,964 
55% 
5,747 
59% 
8,580 
31% 
11,442 
43% 
8,976 
43% 
8,295 
45% 
8,764 
47% 
7,252 
48% 
8,959 
49% 
5,951 
53% 
9,350 
32% 
11,563 
43% 
10,433 
46% 
10,318 
46% 
8,634 
46% 
7,224 
48% 
9,180 
49% 
5,864 
53% 
7,490 
28% 
8,642 
41% 
7,530 
43% 
6,880 
45% 
7,797 
46% 
5,950 
48% 
7,712 
47% 
5,601 
52% 
5,204 
32% 
 6,486 
43% 
6,051 
46% 
7,001 
48% 
6,150 
48% 
5,756 
49% 
7,326 
48% 
5,841 
50% 
8,747 
31% 
10,690 
47% 
8,455 
50% 
11,177 
49% 
 8,274 
51% 
8,397 
53% 
10,690 
53% 
8,366 
58% 

1. 

For results of the July 2006 to January 2008 surveys, see previous reports. 

2. 
Total valid responses. From November 2006, total includes cases not identifiable by SHA (see Annex B). 
3. 
Percentage of patients who said Yes to: '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?' 
4. 
SHA results are not weighted for any age or sex bias among respondents. 

## Annex B: Notes On The Survey Methodology

Background This is the eighteenth National Patient Choice Survey conducted by Ipsos MORI on behalf of the Department of Health, as a follow-up to the series of surveys used to monitor patient awareness of choice and recall of having been offered a choice of hospital for their first outpatient appointment.  The surveys provide a national overview of choice and summary results at PCT level.  National surveys were conducted for referrals in May/June, July, September and November 2006, January, March, May, July, September and November 2007, January, March, May, July, September and December 2008, March 2009 and now February 2010. 

Methodology The methodology of the February 2010 survey was similar to the previous series of surveys. Patients who had been referred by a GP for a first outpatient appointment in any of 123 major acute NHS trusts or 12 Independent Sector (IS) organisations during the two-week period 15 to 28 February 2010 were invited to take part in the survey. Patients aged under 16 or referred for specialties exempted from choice were omitted from the survey (including urgent referrals, two week wait cancer patients, antenatal patients and those referred to rapid access chest pain clinics or mental health specialties - see footnote on Page 7). 

These providers of care together account for three quarters of NHS GP referrals to first outpatient appointments.  This is a lower share than for previous surveys, because more providers did not take part in the survey, but still gives a reasonable sample in most areas (see 'Issues for PCT results' below).  Although the Independent Sector units receive relatively few referrals, their inclusion in the survey (from November 2006) helps to ensure representation of these patients, who might have a different experience of choice. The providers were asked to issue the survey questionnaire within a week of the two-week period. Around 205,000 questionnaires were issued.  Patients were invited to complete the questionnaire and return it using the pre-paid Ipsos MORI reply envelope. The questionnaires were anonymous except for the information pre-completed regarding the issuing Trust and the responsible PCT of the patient (see below for issues regarding the PCT information).  All responses were treated as completely confidential. 

Questionnaire redesign 
Following a review of the questionnaire design, changes were implemented for the 
February 2010 follow-up survey (see Annex C for the questionnaire).  
ƒ New questions about whether the patient had enough information to make their 
choice, choice of date and time and awareness of how to complain were added. 
ƒ Patients offered choice were asked to select the single most important source of 
information, instead of all that apply, since this gives a more powerful indication of which were most important. 
ƒ Patients offered choice were asked to select the single most important factor 
when they chose their hospital, instead of all patients being invited to select factors that would be important to them, since this gives a more powerful 
indication of which were most applicable. 
ƒ New questions about long-standing illness and the first part of the patient 
postcode were added, to improve analysis of the extent to which PCT results are affected by underlying health or socio-economic inequalities. 
Owing to a lack of redesigned questionnaires in a few providers, some patients were sent copies of the previous survey questionnaire.  1,776 responses were received to the previous questionnaire, 3% of the total (equivalent to 1,886 weighted responses, see below). These were included in the analysis of all questions common to both questionnaires, but omitted from analysis of the new or revised questions. 

Response A total 69,075 patients responded to the survey, a response rate of 34%.  Of these, 
35 responses did not clearly indicate the code of the issuing Trust or IS provider (despite pre-printing of the organisation code) and were omitted as invalid.  In addition, 1,010 (1.5%) responses did not indicate the responsible PCT, fewer than in previous surveys as it was often possible to impute the PCT code from the postcode district entered by the patient. Such cases were included in national analysis since they had a valid provider code. This resulted in an effective national response rate of 34% (69,040 valid responses). This compares with valid response rates of between 25% and 33% in surveys to January 2008 (except 40% in September 2007), 50% in March 2008 and between 35% and 38% in May 2008 to March 2009.  
Although the survey results were weighted for age and sex bias among respondents 
(see below), they may be subject to other response bias for which no adjustment can be made. 

Weighting for non-response The age and sex of respondents to the survey was compared with Hospital Episodes Statistics (HES) Outpatients data sourced from the Information Centre for Health and Social Care (IC)1. The HES data related to 9.8 million first attendance outpatient appointments in 2008-091 for patients with known sex and age 16 and over where the source of referral was a General Medical Practitioner and the specialty was not one of those excluded from choice (cancer, obstetrics and mental health). There was a lower proportion of younger patients among the survey respondents than in the overall HES distribution, for both males and females, see Figure B.1. 

Although many of the survey results differed only slightly by age and sex, this sample difference is sufficiently marked that the decision was made to weight the national data to adjust for this response bias.  No weighting was done by ethnic group since the HES outpatient data did not have an ethnic group recorded.  The national weighting was not applied to PCT or SHA results because the age and sex distribution differs by PCT and the HES outpatient data may not provide a sufficiently robust comparison. 

Issues for PCT results Survey forms were marked with the commissioning organisation (Care Trust or Primary Care Trust, PCT) prior to issue.  In some cases, PCT codes were invalid or illegible and these were imputed where possible using the PCT entry, Provider code or first part of the patient postcode.  SHA results were aggregated from the PCT data, which were not weighted for any age, sex or ethnicity bias among respondents. The number of valid responses received varied by PCT, from fewer than 60 patients in 20 PCTs to more than 1,000 in 16 PCTs, as shown in Annex Table A.8.  For seven PCTs where there were significant local problems with the survey process, only between 2 and 19 responses were received (see Annex Table A.8).  Results for these PCTs are likely to be misleading and so were omitted from the PCT analysis. If responses were unbiased for the other 145 PCTs, the average confidence interval1 around the percentage of patients offered choice in each PCT would be ± 
6%, but in some cases this is as low as ± 2% or, in the worst case, as high as ± 
20%. The variable response, possibility of response bias and lack of weighting for age and sex bias at a local level means that PCT results should be treated with some caution. This is particularly the case for PCTs where fewer than 100 patients have responded to the survey. 

## Annex C: Survey Questionnaire Annex D: Combined Survey Results By Age, Sex, Ethnic Group And Long-Standing Illness

Background Results of the survey by the age, sex and ethnic group of respondents were last presented in the report for referrals made in December 20081. That report compiled results for the first sixteen surveys. These were aggregated for comparison, since the differences observed by age, sex and ethnic group were generally consistent over all the surveys and otherwise small samples for some groups made comparisons inconclusive. This annex updates that analysis by presenting the analysis of the seventeenth and eighteenth surveys against the combined results of the first sixteen surveys2. In addition, results of the latest survey are presented by whether or not the patient had a long-standing illness or disability. 

Age and sex results The proportion of patients recalling being offered a choice of hospital for their first outpatient appointment was over 2% higher for women than for men in February 
2010, a similar difference to that seen in previous surveys.  The proportion also varied by age (see Figure D.1 and Table D.2), with the highest proportion of patients offered choice being for 35-54 year olds and 55 to 64 year olds whilst there were lower proportions for 16-34 year olds and those aged over 65. 

The proportion of patients aware before visiting their GP that they had a choice of hospital for their first outpatient appointment increased with age, see Figure D.2 and Table D.1. This trend was maintained across all the surveys to date, despite the general increase in awareness.  Women generally had a greater awareness of choice, except in the over 65 age band where men had a greater awareness. 

The proportion of patients who were able to go to the hospital they wanted increased with age, whilst the proportion who had no preference decreased with age, see Figure D.3 and Table D.31. Men were somewhat less inclined to have a preference than women, slightly more of whom said they went to their hospital of choice. 

Ethnic group results The proportion of patients recalling being offered a choice of hospital for their first outpatient appointment was higher for patients in the White ethnic group than for Black and Minority Ethnic group (BME) patients1, see Figure D.4 and Table D.2. 

This difference reduced over the series of surveys but was relatively consistent over the latest surveys, with more variation for uncombined survey results due to smaller numbers. The Asian or Asian British ethnic group was up to 12% below the overall proportion of patients offered choice in the latest surveys, as was the Other group2 
(see Table D.2). The Black or Black British group and those of Mixed ethnicity were slightly closer to average.  The Chinese group showed most variability and was not always below average (but based on less than 0.4% of responses and omitted from Figure D.4). 

The proportion of patients aware before visiting their GP that they had a choice of hospital for their first outpatient appointment was higher for patients in the White ethnic group than for Black and Minority Ethnic group (BME) patients, see Figure D.5 and Table D.1. Of all BME patients, those considering themselves in the Mixed and Asian or Asian British groups had the highest awareness of choice.  
Nevertheless, awareness continued to rise over time across all groups.  
1 The results are weighted to adjust for age and sex bias amongst respondents to the surveys, but not to adjust for the differences in the distribution of patients by age and sex between ethnic groups.  In particular, the most common age group for BME respondents in February 2010 was 35-54 years old, compared to 65 or over in the White group.  In addition, no adjustment has been made for other factors that might affect the comparison by ethnic group, such as any correlation between the proportion of patients in different ethnic groups and geographic or deprivation effects.  Separate study indicates that if we control for these effects, the main results are broadly consistent with those presented here. 

The proportion of patients who were able to go to the hospital they wanted was higher for patients in the White ethnic group than for Black and Minority Ethnic group (BME) patients, see Figure D.6 and Table D.31. All BME groups were less likely to have a preference of hospital than White patients (even when offered a choice). 

Long-standing illness results The proportion of patients aware before visiting their GP that they had a choice of hospital for their first outpatient appointment was higher for patients with a longstanding illness or disability1 (57%) than for those without (51%), see Figure D.7 and Table D.1. However, most of this difference is explained by the proportion of patients with a long-standing illness or disability rising with age, since awareness increases with age, so these factors may be related.  The proportion of patients recalling being offered choice varied less by whether or not the patient had an illness or disability (see Table D.2), as did the proportion going to the hospital they wanted (see Table D.3). 

Numbers and percentages 
Surveys 1 to 4 
20061 
Surveys 5 to 8 
20071 
Surveys 9 to 12 
2007-081 
Surveys 13 to 16 
20081 
Survey 17 
March 2009 
 
Survey 18 
February 2010 
Total2 %Yes3 
Total2 %Yes3 
Total2 
%Yes3 
Total2 %Yes3 
Total2 %Yes3 
Total2 %Yes3 
Total 
276,369 
32% 
285,736 
37% 
351,834 
42% 
352,316 
47% 
93,217 
50% 
69,040 
54% 
By age and sex: 
Male 
16-34 
18,601 
23% 
19,237 
27% 
22,851 
31% 
20,237 
36% 
5,705 
36% 
4,251 
39%
 
35-54 
31,699 
26% 
32,784 
31% 
40,461 
34% 
39,431 
39% 
10,436 
42% 
7,814 
45%
 
55-64 
19,124 
34% 
19,779 
38% 
24,479 
43% 
24,004 
50% 
6,680 
52% 
4,967 
55%
 
65+ 
 
Total4
35,105 
 
107,761 
40% 
32% 
36,306 
111,677 
45% 
37% 
44,885 
134,298 
50% 
41% 
43,896 
128,169 
56% 46% 
12,443 35,395 
60% 49% 
9,302 
26,462 
62%
52% 
Female 16-34 
36,415 
25% 
37,661 
29% 
50,405 
34% 
57,961 
38% 
13,831 
40% 
10,346 
43%
 
35-54 
51,872 
32% 
53,647 
36% 
68,115 
41% 
70,646 
47% 
17,937 
50% 
13,452 
55%
 
55-64 
24,102 
35% 
24,927 
41% 
30,932 
47% 
30,519 
54% 
8,278 
57% 
6,121 
61%
 
65+ 
 
Total4
45,060 
 
160,152 
37% 
32% 
46,602 
165,791 
43% 
37% 
57,584 
208,456 
48% 
42% 
56,242 
216,041 
55% 
48% 
15,461 
55,679 
58% 
51% 
11,500 
41,661 
61%
55% 
By ethnic group:  
White 
244,948 
33% 
251,765 
38% 
312,955 
42% 
311,425 
48%
 82,694 
51% 
61,985 
55% 
All BME 
24,138 
26% 
26,237 
30% 
30,925 
34% 
33,661 
39%
 8,458 
41% 
5,738 
44% 
Mixed 
3,430 
28% 
3,605 
31%
 7,648 
36%
 10,373 
42%
 2,697 
45% 
964 
47% 
Asian or Asian British 
10,655 
26% 
 12,049 
32%
 12,489 
35%
 12,555 
39%
 3,044 
41% 
2,315 
45% 
Black or Black British 
5,986 
25% 
   6,236 
27%
 7,297 
32%
 7,732 
35%
 1,966 
40% 
1,536 
41% 
Chinese 
1,192 
26% 
1,309 
30%
 1,340 
31%
 1,323 
36%
 301 
31% 
219 
34% 
Other 
2,874 
29% 
3,038 
31%
 2,151 
31%
 1,678 
37%
 450 
37% 
705 
48% 
By long-standing illness:5 
Long-standing illness 
22,689 
57% 
Disability 
 
9,262 
57% 
Neither 
 
31,627 
51% 

1.  
Surveys 1 to 4 are for referrals made in May/June, July, September and November 2006; surveys 5 to 8 are for referrals made in January, March, May and July 2007; surveys 9 to 12 are for referrals made in September and November 2007 and January and March 2008 and surveys 13 to 16 are for referrals made in May, July, September and December 2008.  For a breakdown by survey for surveys 1 to 16, see previous reports. 

2.  
Total valid responses. All figures are weighted, ie adjusted for national age and sex bias in the responding sample. 

3.  
Percentage of patients who said Yes to 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?' 
4.  
Male and Female totals include those of unknown age.  Overall totals also include those of unknown sex or ethnic group. 

5.  
The question on long-standing illness was introduced this survey, defined as "anything that has troubled you over a period of time or that is likely to affect you over a period of time".   
1,847 (3%) responses had both a long-standing illness and a disability. 

Numbers and percentages 
Surveys 1 to 4 
20061 
Surveys 5 to 8 
20071 
Surveys 9 to 12 
2007-081 
Surveys 13 to 16 
20081 
Survey 17 
March 2009 
 
Survey 18 
February 2010 
Total2 %Yes3 
Total2 %Yes3 
Total2 
%Yes3 
Total2 %Yes3 
Total2 %Yes3 
Total2 %Yes3 
Total 
276,369 
35% 
285,736 
45% 
351,834 
46% 
352,316 
46% 
93,217 
47% 
69,040 
49% 
By age and sex: 
Male 
16-34 
18,601 
32% 
19,237 
41% 
22,851 
44% 
20,237 
43% 
5,705 
46% 
4,251 
46%
 
35-54 
31,699 
36% 
32,784 
46% 
40,461 
45% 
39,431 
45% 
10,436 
46% 
7,814 
47%
 
55-64 
19,124 
36% 
19,779 
46% 
24,479 
46% 
24,004 
47% 
6,680 
48% 
4,967 
50%
 
65+ 
 
Total4
35,105 
 
107,761 
34% 
35% 
36,306 
111,677 
44% 
45% 
44,885 
134,298 
44% 
45% 
43,896 
128,169 
44% 45% 
12,443 35,395 
45% 46% 
9,302 
26,462 
47%
47% 
Female 16-34 
36,415 
34% 
37,661 
43% 
50,405 
45% 
57,961 
45% 
13,831 
45% 
10,346 
47%
 
35-54 
51,872 
39% 
53,647 
49% 
68,115 
49% 
70,646 
49% 
17,937 
50% 
13,452 
51%
 
55-64 
24,102 
38% 
24,927 
48% 
30,932 
49% 
30,519 
50% 
8,278 
50% 
6,121 
52%
 
65+ 
 
Total4
45,060 
 
160,152 
35% 
36% 
46,602 
165,791 
44% 
46% 
57,584 
208,456 
44% 
47% 
56,242 
216,041 
45% 
47% 
15,461 
55,679 
46% 
48% 
11,500 
41,661 
48%
50% 
By ethnic group:  
White 
244,948 
36% 
251,765 
46% 
312,955 
46% 
311,425 
47%
 82,694 
48% 
61,985 
49% 
All BME 
24,138 
30% 
26,237 
37% 
30,925 
40% 
33,661 
41%
 8,458 
42% 
5,738 
43% 
Mixed 
3,430 
33% 
3,605 
39%
 7,648 
42%
 10,373 
42%
 2,697 
43% 
964 
44% 
Asian or Asian British 
10,655 
30% 
 12,049 
37%
 12,489 
39%
 12,555 
41%
 3,044 
41% 
2,315 
43% 
Black or Black British 
5,986 
29% 
   6,236 
38%
 7,297 
40%
 7,732 
41%
 1,966 
43% 
1,536 
44% 
Chinese 
1,192 
32% 
1,309 
36%
 1,340 
43%
 1,323 
47%
 301 
42% 
219 
45% 
Other 
2,874 
30% 
3,038 
37%
 2,151 
39%
 1,678 
40%
 450 
41% 
705 
43% 
By long-standing illness:5 
Long-standing illness 
22,689 
47% 
Disability 
 
9,262 
46% 
Neither 
 
31,627 
50% 

1.  
Surveys 1 to 4 are for referrals made in May/June, July, September and November 2006; surveys 5 to 8 are for referrals made in January, March, May and July 2007; surveys 9 to 12 are for referrals made in September and November 2007 and January and March 2008 and surveys 13 to 16 are for referrals made in May, July, September and December 2008.  For a breakdown by survey for surveys 1 to 16, see previous reports. 

2.  
Total valid responses. All figures are weighted, ie adjusted for national age and sex bias in the responding sample. 

3.  
Percentage of patients who said Yes to the question: 'Were you offered a choice of hospital for your first hospital appointment?' 
4.  
Male and Female totals include those of unknown age.  Overall totals also include those of unknown sex or ethnic group.  
5.  
The question on long-standing illness was introduced this survey, defined as "anything that has troubled you over a period of time or that is likely to affect you over a period of time".  1,847 
(3%) responses had both a long-standing illness and a disability. 

Numbers and percentages 
Surveys 10 to 12 
2007-081 
Surveys 13 to 16 
20081
 
Survey 17 
March 2009 
 
Survey 18 
February 2010 
Total2 %Yes3 % No3 
Total2 %Yes3 
% No3 
Total2 %Yes3 
% No3 
Total2 %Yes3 
% No3 
pref. 
pref. 
pref. 
pref. 
Total 
259,289 
66% 24% 
352,316 
67% 
23% 
93,217 
67% 
23% 
69,040 
67% 
22% 
By age and sex: 
Male 
16-34 
16,632 
61% 30% 
20,237 
62% 
28% 
5,705 
64% 
26% 
4,251 
61% 
27%
 
35-54 
29,861 
63% 27% 
39,431 
63% 
27% 
10,436 
63% 
26% 
7,814 
63% 
25%
 
55-64 
18,084 
67% 23% 
24,004 
67% 
23% 
6,680 
67% 
23% 
4,967 
69% 
22%
 
65+ 
 
Total3
33,147 
 
98,165 
70% 
66% 
21% 
25% 
43,896 
128,169 
70% 
66% 
21% 
24% 
12,443 
35,395 
71% 
67% 
20% 
23% 
9,302 
26,462 
71% 
66% 
20%
23% 
Female 16-34 
38,228 
63% 28% 
57,961 
63% 
28% 
13,831 
63% 
28% 
10,346 
64% 
27%
 
35-54 
50,771 
67% 23% 
70,646 
67% 
23% 
17,937 
67% 
23% 
13,452 
67% 
22%
 
55-64 
22,873 
69% 21% 
30,519 
69% 
20% 
8,278 
69% 
20% 
6,121 
70% 
19%
 
65+ 
 
Total3
42,517 
 
154,877 
70% 
67% 
20% 
23% 
56,242 
216,041 
71% 
67% 
19% 
23% 
15,461 
55,679 
71% 
67% 
19% 
23% 
11,500 
41,661 
71% 
68% 
19%
22% 
By ethnic group:  
White 
231,024 
67% 23% 
311,425 
68% 
23%
 82,694 
68% 
23% 
61,985 
68% 
22% 
All BME 
22,825 
60% 27% 
33,661 
61% 
26%
 8,458 
62% 
27% 
5,738 
61% 
26% 
Mixed 
6,605 
62% 26% 
10,373 
63% 
25%
 2,697 
64% 
24% 
964 
60% 
25% 
Asian or Asian British
 8,834 
60% 28% 
12,555 
62% 
26%
 3,044 
61% 
27% 
2,315 
63% 
25% 
Black or Black British
 5,308 
59% 28%
 7,732 
59% 
28%
 1,966 
59% 
29% 
1,536 
59% 
28% 
Chinese 
834 
62% 29% 
1,323 
63% 
28%
 301 
64% 
28% 
219 
64% 
25% 
Other 
1,244 
58% 28% 
1,678 
60% 
26%
 450 
62% 
24% 
705 
60% 
26% 
By long-standing illness:5 
Long-standing illness 
22,689 
68% 
21% 
Disability 
9,262 
67% 
21% 
Neither 
 
31,627 
68% 
23% 

1.  
The question was introduced from Survey 10 (November 2007).  For a breakdown by survey for surveys 10 to 16, see previous reports. 

2.  
Total valid responses. All figures are weighted, ie adjusted for national age and sex bias in the responding sample. 

3.  
Percentage of patients who said Yes or that they had No preference respectively to the question 'Were you able to go to the hospital that you wanted to go to? 

4.  
Male and Female totals include those of unknown age.  Overall totals also include those of unknown sex or ethnic group. 

5.  
The question on long-standing illness was introduced this survey, defined as "anything that has troubled you over a period of time or that is likely to affect you over a period of time".   
1,847 (3%) responses had both a long-standing illness and a disability.