## Report On The National Patient Choice Survey - December 2008 England

Report on the National Patient Choice Survey - December 2008 England 
 
Prepared by Sheila Dixon, Department of Health May 2009 

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Report on the National Patient Choice Survey - December 2008 England 
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Statistical publication of the results of the National Patient Choice survey for referrals made in December 2008. 
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 © Crown copyright 2009 First published May 2009 Published to DH website, in electronic PDF format only. http://www.dh.gov.uk/en/Publicationsandstatistics 
 

Table D.1  Percentage of patients aware of choice by age, sex and ethnic group, 
surveys to date .................................................................................................... 33 
Table D.2  Percentage of patients offered choice by age, sex and ethnic group, 
surveys to date .................................................................................................... 34 
Table D.3  Percentage of patients able to go where they wanted by age, sex and 
ethnic group, surveys to date............................................................................... 35 
 

## Results Of The National Patient Choice Survey - December 2008 England.

 
Introduction  
Since January 2006, all eligible1 patients referred by their GP should have 
been offered clinically appropriate choices for their elective care, initially from 
a list of four or more providers commissioned by their PCT.  Since April 2008, 
patients can choose any clinically appropriate hospital provider that meets 
NHS standards and costs in England.  As set out in the NHS Constitution, 
from April 2009 patients have a legal right to choose the organisation that 
provides their NHS care when referred for their first outpatient appointment. 
 
The Department of Health commissioned a series of national patient choice 
surveys to assess the implementation of choice at PCT level.  Previous 
reports gave the results of earlier surveys, for referrals made from May/June 
20062 to September3 2008, using an extended questionnaire from November 
2007.  This report gives summary results of around 76,000 responses to the 
sixteenth such survey, for referrals made in December 2008.  
 
Key findings  

- The percentage of patients recalling being offered a choice of hospital for their 
first outpatient appointment was 46% in December 2008, the same as in September and up from 30% in the first survey (May/June 2006). 
- 50% of patients were aware before they visited their GP that they had a choice 
of hospitals for their first appointment, up from 48% in September and 29% in the May/June 2006 survey. 
- 61% of patients who were aware of choice recalled being offered choice, 
whereas 32% of those not aware of choice recalled being offered it, similar to the 
September survey (61% and 33% respectively). 
- 68% of patients were able to go to the hospital they wanted, with a further 23% 
having no preference and 7% unable to go where they wanted, compared with 67%, 23% and 8% respectively in September. 
- 90% of patients offered choice were able to go to the hospital they wanted, with 
a further 4% having no preference.  This compares with 48% of patients not offered choice able to go where they wanted and 40% having no preference. 
- 80% 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. 
- Hospital cleanliness and low infection rates were selected most often (by 74% of 
patients) as an important factor when choosing a hospital. 
 
Choice of hospital  
The percentage of patients who recalled being offered a choice of hospital for their first outpatient appointment was 46% in December.  This compares with between 
43% and 47% doing so in surveys from May 2007 to September 2008 and 30% in the first (May/June 2006) survey.  The percentage of patients aware of choice has kept rising, see Figure 1 and Annex Table A.2.  In addition, 41% of patients in December said they discussed which hospital they might go to with their GP. 

  
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 50% in December 2008, up from 48% in September and 29% in the first (May/June 2006), see Figure 1 and Annex Table A.2. The 50% 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.  61% 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 61% and 33% respectively in September). 

Going to the hospital of choice 
68% of patients were able to go to the hospital they wanted, with a further 23% having no preference and 7% unable to go where they wanted.  This is similar to the September 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, 90% were able to go where they wanted whilst 5% were not and 4% had no preference.  This was different from patients not offered choice, 48% 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

Almost half the patients (48%) who were offered choice said they used the GP as a source of information to choose their hospital, with a third (33%) saying they used their own experience or that of friends and family.  A booklet about choice was used by 8% patients, whilst 5% used the NHS Choices website, see Figure 3 and Annex Table A.4.

 
Factors influencing choice Hospital cleanliness and low infection rates were given most often (by 74% of patients) as an important factor when choosing a hospital.  Of all the factors listed for patients to select (as many as apply), six were given by more than half the patients, see Figure 4 and Annex Table A.5.  The factors listed were all those that had been commonly identified in previous surveys.  Patients selected 5.4 factors on average.  The same six factors were selected most often in December as in the previous surveys.  The other five are quality of care (given by 64% of patients), waiting times (63%), the friendliness of staff (57%), the reputation of the hospital (55%) and location or transport considerations (54%).  

## Booking The First Appointment

37% of patients booked their first hospital appointment when the hospital contacted them following a letter from the GP, the same as in the September survey.  Of the others, 29% patients telephoned an appointments line, 20% were booked on screen 
(by the GP or other practice staff) and 4% used the internet, again similar to September.  Nearly half the patients (49%) who did not recall being offered choice booked their appointment when the hospital contacted them, whilst only a quarter 
(25%) of patients who were offered choice booked this way, see Annex Table A.3. 

Waiting for the first appointment 
80% 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 77% in September.  The level of satisfaction was higher amongst those who were offered choice (85%, with 12% dissatisfied) than amongst those who weren't (77%, with 
17% dissatisfied), see Annex Table A.3, which may indicate a benefit of offering choice. Results by type of provider The proportion of patients offered choice whose first outpatient appointment was in an Independent Sector (IS) provider was higher than for patients going to NHS organisations: 66% compared with 46%, see Figure 5 and Annex Table A.6.  This compares with 62% for those going to IS and 46% for NHS providers in the September survey.  However, only 792 (1%) patients taking part in the survey went to IS providers.  As before, the difference between the proportions of patients from IS and NHS providers who were aware of choice before visiting their GP was small. 

Variation by SHA  
The proportion of patients who recalled being offered a choice of hospital for their first outpatient appointment, 46% nationally, varied by SHA as shown in Figure 6 and Annex Table A.9.  Most SHAs showed an increase in the percentage of patients offered choice in December compared with the May 2008 survey, but did not show an increase compared with the September 2008 survey. 

The proportion of patients who were aware that they had a choice of hospital for their first outpatient appointment, 50% nationally, varied by SHA as shown in Figure 7 and Annex Table A.10.  Most SHAs continue to show a sustained increase in patient awareness of choice over the surveys to date. 

Variation by PCT  
In 16 out of 152 PCTs (11%), over 60% of patients were offered choice, see Figure 8 and Annex Table A.8.  This compares with 13 PCTs in the September survey with over 60% of patients offered choice.  The proportion of patients aware of choice was under 40% in 7 (5%) PCTs, down from 10 (7%) in the September survey and 33 (22%) in the March 2008 survey. 

The percentage of patients able to go to the hospital they wanted, 68% nationally, varied by PCT as shown in Figure 9 and Annex Table A.7.  Most of the remaining patients had no preference (23% nationally), although more than 10% patients said they were not able to go where they wanted in 33 (22%) 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 December and in September is illustrated in the PCT maps in Figure 10, see also Annex Table A.7.  However, some PCT figures are based on few responses, with the possibility of response bias, so results for individual PCTs should be treated with caution.  

60% or more 50 to <60% 40 to <50% 30 to <40%
20 to <30% Under 20% 

 

# Annex A: Tables Of Results Of The National Patient Choice Survey - December 2008 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 
 
75,878 
100% 
37,758 
50% 
37,625 
50% 
Q2 Did you discuss which hospital you might go to with your GP? 
Yes 
30,763 
41% 
20,674 
55% 
10,034 
27% 
No 
42,597 
56% 
16,300 
43% 
26,195 
70% 
Don't know 
1,864 
2% 
605 
2% 
1,249 
3% 
Not stated 
654 
1% 
179 
0% 
147 
0% 
Total 
75,878 
100% 
37,758 
100% 
37,625 
100% 
Q3 Were you offered a choice of hospital for your first hospital appointment? 
Yes 
35,209 
46% 
23,090 
61% 
12,052 
32% 
No 
37,416 
49% 
13,248 
35% 
24,065 
64% 
Don't know 
2,398 
3% 
1,092 
3% 
1,298 
3% 
Not stated 
855 
1% 
328 
1% 
210 
1% 
Total 
75,878 
100% 
37,758 
100% 
37,625 
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 495 (1%) responses. 

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% 

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 Q5 (introduced 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. 
 

Numbers and percentages1
  
Q3 Were you offered a choice of hospital for your first hospital 
appointment? 
 
Total2
Yes 
No 
  
Number 
Percent 
Number 
Percent 
Number 
Percent 
  
75,878 
100% 
35,209 
46% 
37,416 
49% 
Q5 Were you able to go to the hospital that you wanted to go to? 
Yes 
51,478 
68% 
31,664 
90% 
17,933 
48% 
No 
5,497 
7% 
1,851 
5% 
3,497 
9% 
I didn't have a preference 
17,140 
23% 
1,372 
4% 
14,951 
40% 
Not stated 
1,763 
2% 
323 
1% 
1,034 
3% 
Total 
75,878 
100% 
35,209 
100% 
37,416 
100% 
Q6 How did you book your first hospital appointment? 
GP wrote and hospital contacted me 
28,145 
37% 
8,726 
25% 
18,245 
49% 
Telephoned a call centre 
22,374 
29% 
15,074 
43% 
6,636 
18% 
On screen (with GP or practice staff) 
15,206 
20% 
7,310 
21% 
7,290 
19% 
Via internet 
3,404 
4% 
2,528 
7% 
817 
2% 
All other responses 
6,748 
9% 
1,572 
4% 
4,428 
12% 
Total 
75,878 
100% 
35,209 
100% 
37,416 
100% 
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? 
Very satisfied 
34,687 
46% 
17,724 
50% 
15,797 
42% 
Fairly satisfied 
26,193 
35% 
12,055 
34% 
13,071 
35% 
Not very satisfied 
6,959 
9% 
2,886 
8% 
3,789 
10% 
Not at all satisfied 
4,103 
5% 
1,419 
4% 
2,540 
7% 
No appointment date yet 
2,377 
3% 
758 
2% 
1,464 
4% 
Don't know / not stated 
1,560 
2% 
368 
1% 
753 
2% 
Total 
75,878 
100% 
35,209 
100% 
37,416 
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 3,253 (4%) responses. 

## 

Numbers and percentages 
Sources listed1
No. patients 
Percent of 
responses 
My GP 
      16,956  
48% 
Friends/family members/own experience 
      11,727  
33% 
A booklet or leaflet about my choices 
       2,841  
8% 
NHS Choices website 
       1,842  
5% 
Staff at Clinical Assessment or Referral Centre 
       1,485  
4% 
Someone at GP surgery 
       1,334  
4% 
Other internet site 
          350  
1% 
Local patient organisation 
          334  
1% 
Other 
       4,345  
12% 
None of these 
       2,920  
8% 
Don't know 
          276  
1% 

1. 

Patients who said they had been offered choice were invited to select, from a list of sources, those they used when choosing the hospital.  On average, patients selected 1.2 sources. 

Numbers and percentages 
Most important factors listed1
No. patients 
Percent of 
responses 
Cleanliness / Low levels of infection 
      55,961  
74% 
Quality of care 
      48,453  
64% 
Length of wait to appointment 
      47,596  
63% 
Friendliness of staff 
      42,952  
57% 
Reputation of hospital 
      41,394  
55% 
Location / Transport / Easy to get to 
      41,051  
54% 
Car parking 
      35,637  
47% 
Reputation of consultant 
      33,936  
45% 
Good personal experience 
      31,125  
41% 
Convenience of appointment time 
      28,808  
38% 
Other 
          884  
1% 
None of these 
          187  
0% 
Don't know 
          392  
1% 

1. 

Patients were invited to select, from a list of factors, those they considered most important to them when choosing a hospital (whether they were offered a choice on this occasion or not).  On average, patients selected 5.4 factors. 

## 

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 
37,758 
50% 
389 
54% 
37,369 
50% 
No 
37,625 
50% 
333 
46% 
37,292 
50% 
Not stated 
495 
1% 
2 
0% 
493 
1% 
Total1
75,878 
100% 
724 
100% 
75,154 
100% 
Q3 Were you offered a choice of hospital for your first hospital appointment? 
Yes 
35,209 
46% 
476 
66% 
34,733 
46% 
No 
37,416 
49% 
225 
31% 
37,191 
49% 
Don't know 
2,398 
3% 
18 
3% 
2,380 
3% 
Not stated 
855 
1% 
4 
1% 
850 
1% 
Total1
 75,878  
100% 
          724 
100% 
    75,154  
100% 
Q5 Were you able to go to the hospital that you wanted to go to? 
Yes 
51,478 
68% 
562 
78% 
50,917 
68% 
No 
5,497 
7% 
28 
4% 
5,469 
7% 
I didn't have a preference 
17,140 
23% 
125 
17% 
17,015 
23% 
Not stated 
1,763 
2% 
9 
1% 
1,754 
2% 
Total 
75,878 
100% 
724 
100% 
75,154 
100% 
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? 
Very satisfied 
34,687 
46% 
566 
78% 
34,121 
45% 
Fairly satisfied 
26,193 
35% 
118 
16% 
26,075 
35% 
Not very satisfied 
6,959 
9% 
18 
3% 
6,940 
9% 
Not at all satisfied 
4,103 
5% 
14 
2% 
4,089 
5% 
No appointment date yet 
2,377 
3% 
4 
1% 
2,373 
3% 
Don't know / not stated 
1,559 
2% 
4 
1% 
1,556 
2% 
Total 
75,878 
100% 
724 
100% 
75,154 
100% 

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. 

Percentages 
3   


Aware of 
choice
1
 
Offered 
 choice
2   
 
Able to go where wanted
 to go
PCT
4
SHA
5
Total
6
%Yes 
%No 
 
%Yes 
%No 
 
%Yes 
%No 
%No 
preference 
England 
 
75,878
50%
50%
46%
49% 
 
68% 
7%
23% 
Ashton, Leigh and Wigan 
NW 
354 
57%
43%  
59%
38%  
75% 
3%
19% 
Barking and Dagenham 
Lon 
203 
48%
52%  
54%
40%  
60% 19%
20% 
Barnet 
Lon 
420 
53%
45%  
51%
41%  
68% 11%
16% 
Barnsley 
YH 
159 
63%
37%  
60%
37%  
74% 
8%
17% 
Bassetlaw 
EM 
92 
65%
35%  
60%
38%  
80% 
5%
13% 
Bath and North East Somerset 
SW 
407 
57%
43%  
49%
48%  
75% 
4%
19% 
Bedfordshire 
EoE 
437 
50%
49%  
37%
58%  
67% 
4%
25% 
Berkshire East Teaching 
SC 
176 
45%
55%  
44%
50%  
61% 14%
22% 
Berkshire West 
SC 
134 
58%
41%  
68%
28%  
84% 
3%
10% 
Bexley Care Trust 
Lon 
256 
55%
45%  
49%
46%  
68% 
9%
20% 
Birmingham East and North 
WM 
84 
56%
43%  
56%
42%  
69% 11%
20% 
Blackburn with Darwen Teaching 
NW 
143 
62%
38%  
57%
40%  
76% 13%
10% 
Blackpool 
NW 
307 
56%
44%  
48%
48%  
73% 
5%
20% 
Bolton 
NW 
375 
59%
40%  
55%
42%  
78% 
5%
17% 
Bournemouth and Poole 
SW 
388 
54%
45%  
57%
39%  
84% 
4%
10% 
Bradford and Airedale Teaching YH 
628 
48%
52%  
36%
59%  
56% 
9%
31% 
Brent Teaching 
Lon 
239 
42%
56%  
44%
47%  
64% 
7%
25% 
Brighton and Hove City Teaching 
SEC 
246 
40%
59%  
26%
68%  
53% 
7%
37% 
Bristol Teaching 
SW 
403 
43%
57%  
49%
46%  
72% 
8%
18% 
Bromley 
Lon 
73 
48%
52%  
48%
47%  
64% 12%
22% 
Buckinghamshire 
SC 
873 
51%
48%  
48%
47%  
71% 
5%
22% 
Bury 
NW 
120 
56%
43%  
58%
42%  
77% 
4%
17% 
Calderdale 
YH 
427 
54%
45%  
48%
48%  
79% 
6%
13% 
Cambridgeshire 
EoE 
834 
48%
51%  
36%
59%  
75% 
6%
17% 
Camden 
Lon 
229 
55%
44%  
55%
39%  
79% 
3%
17% 
Central & Eastern Cheshire  
NW 
1,107 
55%
44%  
45%
51%  
71% 
6%
21% 
Central Lancashire 
NW 
216 
57%
42%  
56%
40%  
70% 13%
16% 
City and Hackney Teaching 
Lon 
235 
35%
64%  
37%
55%  
57% 
9%
32% 
Cornwall and Isles of Scilly 
SW 
702 
47%
51%  
46%
49%  
55% 19%
24% 
County Durham 
NE 
986 
67%
32%  
67%
31%  
77% 
8%
14% 
Coventry Teaching 
WM 
645 
60%
39%  
53%
42%  
78% 
3%
17% 
Croydon 
Lon 
88 
56%
43%  
50%
48%  
69% 
9%
22% 
Cumbria 
NW 
1,419 
61%
38%  
51%
44%  
72% 
8%
17% 
Darlington 
NE 
223 
59%
40%  
44%
52%  
76% 
6%
16% 
Derby City 
EM 
576 
49%
51%  
41%
54%  
66% 
7%
25% 
Derbyshire County 
EM 
1,208 
63%
36%  
58%
39%  
79% 
4%
15% 
Devon 
SW 
1,590 
54%
45%  
45%
51%  
75% 
6%
17% 
Doncaster 
YH 
317 
63%
36%  
46%
50%  
75% 
5%
17% 
Dorset 
SW 
825 
63%
36%  
61%
34%  
78% 
5%
14% 
Dudley 
WM 
255 
54%
45%  
29%
66%  
56% 
7%
34% 
Ealing 
Lon 
382 
56%
44%  
42%
52%  
64% 
9%
24% 
East and North Hertfordshire 
EoE 
320 
58%
41%  
49%
47%  
66% 10%
21% 
East Lancashire 
NW 
620 
61%
38%  
65%
32%  
72% 11%
15% 
East Riding of Yorkshire 
YH 
708 
45%
54%  
36%
60%  
57% 10%
30% 
East Sussex Downs and Weald SEC 
709 
50%
50%  
39%
57%  
70% 
5%
22% 
Eastern and Coastal Kent Teaching 
SEC 
1,115 
49%
50%  
49%
46%  
65% 
9%
22% 
Enfield 
Lon 
465 
55%
45%  
54%
41%  
70% 
9%
18% 
Gateshead 
NE 
542 
63%
36%  
57%
41%  
72% 
6%
19% 
Gloucestershire 
SW 
954 
48%
51%  
53%
44%  
72% 
7%
18% 
Great Yarmouth and Waveney 
EoE 
69 
67%
33%  
68%
32%  
78% 
6%
12% 
Greenwich Teaching 
Lon 
349 
52%
48%  
52%
44%  
69% 
9%
22% 
|                              |       |       | 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                          |       |       |             |
| preference                   |       |       |             |
| Halton and St Helens         | NW    | 723   | 55%         |
| Hammersmith and Fulham       | Lon   | 245   | 49%         |
| Hampshire                    | SC    | 2,021 | 51%         |
| Haringey Teaching            | Lon   | 198   | 41%         |
| Harrow                       | Lon   | 183   | 47%         |
| Hartlepool                   | NE    | 56    | 61%         |
| Hastings and Rother          | SEC   | 489   | 47%         |
| Havering                     | Lon   | 239   | 48%         |
| Heart of Birmingham Teaching | WM    | 110   | 45%         |
| Herefordshire                | WM    | 421   | 46%         |
| Hillingdon                   | Lon   | 557   | 40%         |
| Hounslow                     | Lon   | 181   | 44%         |
| Hull Teaching                | YH    | 487   | 46%         |
| Isle of Wight Healthcare     | SC    | 366   | 40%         |
| Islington                    | Lon   | 88    | 55%         |
| Kensington and Chelsea       | Lon   | 114   | 47%         |
| Kingston                     | Lon   | 58    | 43%         |
| Kirklees                     | YH    | 732   | 49%         |
| Knowsley                     | NW    | 184   | 47%         |
| Lambeth                      | Lon   | 174   | 47%         |
| Leeds                        | YH    | 1,439 | 48%         |
| Leicester City Teaching      | EM    | 566   | 40%         |
| Leicestershire County and    |       |       |             |
| Rutland                      | EM    | 974   | 48%         |
| Lewisham                     | Lon   | 289   | 46%         |
| Lincolnshire Teaching        | EM    | 2,066 | 60%         |
| Liverpool                    | NW    | 422   | 54%         |
| Luton Teaching               | EoE   | 15    | 40%         |
| Manchester                   | NW    | 728   | 48%         |
| Medway Teaching              | SEC   | 70    | 50%         |
| Mid Essex                    | EoE   | 677   | 43%         |
| Middlesbrough                | NE    | 232   | 72%         |
| Milton Keynes                | SC    | 647   | 39%         |
| Newcastle                    | NE    | 384   | 55%         |
| Newham                       | Lon   | 274   | 42%         |
| Norfolk                      | EoE   | 1,190 | 55%         |
| North East Essex             | EoE   | 887   | 46%         |
| North East Lincolnshire      | YH    | 290   | 60%         |
| North Lancashire             | NW    | 793   | 61%         |
| North Lincolnshire           | YH    | 332   | 62%         |
| North Somerset               | SW    | 558   | 47%         |
| North Staffordshire          | WM    | 503   | 57%         |
| North Tees                   | NE    | 144   | 56%         |
| North Tyneside               | NE    | 486   | 60%         |
| North Yorkshire and York     | YH    | 1,577 | 52%         |
| Northamptonshire Teaching    | EM    | 1,295 | 60%         |
| Northumberland Care Trust    | NE    | 624   | 58%         |
| Nottingham City              | EM    | 384   | 54%         |
| Nottinghamshire County       |       |       |             |
| Teaching                     |       |       |             |
| EM                           | 1,328 | 60%   | 40%         |
| Oldham                       | NW    | 51    | 59%         |
| Oxfordshire                  | SC    | 805   | 57%         |
| Peterborough                 | EoE   | 297   | 41%         |
| Plymouth Teaching            | SW    | 272   | 55%         |
| Portsmouth City Teaching     | SC    | 392   | 53%         |
| Redbridge                    | Lon   | 419   | 53%         |
| Redcar and Cleveland         | NE    | 267   | 66%         |
| Richmond and Twickenham      | Lon   | 42    | 31%         |
| Rochdale, Heywood and        |       |       |             |
| Middleton                    | NW    | 47    | 47%         |
3   


Aware of 
choice
1
 
Offered 
 choice
2   
 
Able to go where wanted
 to go
PCT
4
SHA
5
Total
6
%Yes 
%No 
 
%Yes 
%No 
 
%Yes 
%No 
%No 
preference 
Rotherham 
YH 
74 
70%
27%  
61%
34%  
80% 
4%
14% 
Salford Teaching 
NW 
344 
62%
38%  
50%
48%  
80% 
4%
15% 
Sandwell 
WM 
88 
50%
49%  
55%
41%  
75% 
9%
13% 
Sefton 
NW 
356 
46%
53%  
39%
58%  
62% 
4%
32% 
Sheffield 
YH 
1,156 
51%
48%  
39%
56%  
65% 
7%
25% 
Shropshire County 
WM 
84 
56%
43%  
58%
38%  
73% 
8%
15% 
Solihull 
WM 
33 
64%
33%  
73%
27%  
76% 12%
12% 
Somerset 
SW 
547 
62%
37%  
62%
35%  
73% 
8%
17% 
South Birmingham 
WM 
331 
39%
60%  
30%
64%  
61% 
2%
34% 
South East Essex 
EoE 
93 
48%
51%  
58%
39%  
73% 
4%
16% 
South Gloucestershire 
SW 
364 
46%
53%  
43%
53%  
67% 10%
21% 
South Staffordshire 
WM 
715 
60%
39%  
48%
47%  
70% 
6%
21% 
South Tyneside 
NE 
273 
72%
28%  
44%
52%  
72% 
5%
21% 
South West Essex Teaching 
EoE 
573 
50%
49%  
53%
45%  
70% 
8%
20% 
Southampton City 
SC 
342 
32%
67%  
20%
73%  
48% 
9%
39% 
Southwark 
Lon 
92 
40%
60%  
46%
48%  
68% 
7%
21% 
Stockport 
NW 
444 
54%
45%  
53%
42%  
77% 
4%
17% 
Stoke on Trent Teaching 
WM 
248 
60%
39%  
60%
36%  
75% 
5%
18% 
Suffolk 
EoE 
612 
48%
50%  
33%
62%  
66% 
5%
25% 
Sunderland Teaching 
NE 
741 
65%
34%  
45%
50%  
74% 
4%
19% 
Surrey 
SEC 
1,855 
50%
49%  
47%
49%  
70% 
7%
20% 
Sutton and Merton 
Lon 
502 
46%
54%  
42%
52%  
64% 11%
23% 
Swindon 
SW 
289 
48%
51%  
33%
64%  
72% 
1%
24% 
Tameside and Glossop 
NW 
459 
63%
37%  
62%
36%  
79% 
4%
17% 
Telford and Wrekin 
WM 
6 
50%
50%  
83%
17%  
67% 33%
0% 
Torbay Care Trust 
SW 
410 
54%
45%  
42%
55%  
77% 
5%
16% 
Tower Hamlets 
Lon 
41 
54%
46%  
56%
37%  
66% 12%
17% 
Trafford 
NW 
224 
45%
54%  
43%
51%  
68% 11%
19% 
Wakefield 
YH 
757 
52%
48%  
50%
47%  
65% 
9%
23% 
Walsall Teaching 
WM 
268 
59%
40%  
40%
52%  
70% 
5%
22% 
Waltham Forest 
Lon 
428 
47%
53%  
44%
50%  
65% 10%
23% 
Wandsworth 
Lon 
46 
52%
48%  
50%
46%  
70% 15%
11% 
Warrington 
NW 
433 
54%
46%  
39%
57%  
71% 
3%
24% 
Warwickshire 
WM 
490 
57%
43%  
63%
35%  
77% 
7%
15% 
West Cheshire 
NW 
386 
52%
47%  
44%
51%  
76% 
5%
17% 
West Essex 
EoE 
283 
57%
42%  
46%
52%  
72% 
4%
21% 
West Hertfordshire 
EoE 
965 
41%
58%  
39%
57%  
61% 
9%
26% 
West Kent 
SEC 
509 
42%
56%  
39%
55%  
67% 
6%
24% 
West Sussex Teaching 
SEC 
957 
51%
48%  
50%
45%  
74% 
8%
16% 
Westminster 
Lon 
115 
37%
63%  
33%
57%  
65% 10%
23% 
Wiltshire 
SW 
688 
56%
43%  
50%
46%  
76% 
4%
17% 
Wirral 
NW 
192 
57%
42%  
52%
44%  
69% 
6%
22% 
Wolverhampton City 
WM 
436 
45%
54%  
32%
65%  
70% 
3%
25% 
Worcestershire 
WM 
123 
55%
43%  
50%
44%  
63% 11%
24% 

 
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 Q5 'Were you able to go to the hospital that you wanted to go to?' 
4. 
Responsible Care Trusts and Primary Care Trusts based on reconfigured (post 1 October 2006) organisations, see 
Annex B.  PCT results are not weighted for any age or sex bias among respondents. 
5. 
SHA is based on a mapping of responsible PCTs to Strategic Health Authorities: 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 3,482 (5%) weighted cases not listed by responsible PCT because the PCT was not clear. Results for PCTs with fewer than 50 responses should be treated with some caution (see Annex B Issues for PCT results). 

Numbers and percentages 

 
May/June
2006
  
November
2007 
1
January  
2008 
March  
2008 
May  
2008 
July  
2008 
September  
2008 
December  
2008 
No. of 
PCTs2
% of 
PCTs 
No. of 
PCTs
% of 
PCTs
No. of 
PCTs
% of 
PCTs 
No. of 
PCTs
% of 
PCTs
No. of 
PCTs 
% of 
PCTs 
No. of 
PCTs
No. of 
PCTs
No. of 
PCTs
No. of 
PCTs
No. of 
PCTs 
% of 
PCTs 
Percentage of patients offered a choice of hospital3
60% and over 
14
5% 
10
7%
18
12%
11
7%
7 
5%
14
9%
13
9%
16 
11% 
50% to <60% 
17
6% 
39
26%
39
26%
49
32%
50 
33%
50
33%
52
34%
48 
32% 
40% to <50% 
34
11% 
53
35%
60
39%
61
40%
58 
38%
52
34%
51
34%
53 
35% 
30% to <40% 
71
23% 
39
26%
27
18%
28
18%
31 
20%
28
18%
29
19%
26 
17% 
20% to <30% 
104
34% 
10
7%
8
5%
3
2%
6 
4%
8
5%
7
5%
7 
5% 
10% to < 20% 
 
59
19% 
1
1%
0
0%
0
0%
0 
0%
0
0%
0
0%
2 
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%
152 
100%

 1. 

For results of the July 2006 to September 2007 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. 
Percentage of patients who said Yes to: 'Were you offered a choice of hospital for your first hospital appointment?' 

Numbers and percentages 


May/June
2006
  
November 
2007 
1
January 
2008 
March 
2008 
May
2008 
July 
2008 
September 
2008 
December 
2008 
Total2
%Yes3
Total2 %Yes3
Total2
%Yes3
Total2
%Yes3
Total2 %Yes3
Total2
%Yes3
Total2
%Yes3
Total2
%Yes3
England  
78,773 


30%
77,804
44%
72,153
46%
109,331
47%
89,903
45%
93,528
46%
93,003
46%
75,878
46%
North East 
4,238 
28% 
5,141
44% 
   4,225 
44% 
     6,824 
51% 
5,587
47% 
3,922
52% 
     5,577 
50% 
4,958
50% 
North West  
11,252 
39% 
11,774
49% 
   9,865 
52% 
   14,117 
 
 
52%
12,751
51%
13,139
52% 
   13,084 
52% 
10,447
51% 
Yorks & Humber 
9,321 
26% 
10,203
39% 
   9,235 
42% 
   12,486 
44% 
9,831
41% 
10,699
41% 
   12,165 
43% 
9,083
42% 
East Midlands  
7,240 
38% 
7,518
52% 
   7,168 
54% 
   10,269 
56% 
8,514
52% 
9,701
52% 
   10,113 
52% 
8,489
51% 
West Midlands  
7,355 
30% 
5,531
44% 
   6,333 
46% 
     8,605 
45% 
8,208
43% 
8,002
43% 
     7,119 
44% 
4,840
46% 
East of England 
8,580 
24% 
7,597
37% 
   7,663 
39% 
   11,442 
40% 
8,976
37% 
8,295
39% 
     8,764 
40% 
7,252
42% 
London  
9,350 
30% 
8,071
43% 
   7,857 
45% 
   11,563 
45% 
10,433
45% 
10,318
45% 
     8,634 
43% 
7,224
45% 
South East Coast  
7,490 
20% 
4,962
40% 
   5,005 
43% 
     8,642 
44% 
7,530
44% 
6,880
43% 
     7,797 
44% 
5,950
44% 
South Central 
5,204 
34% 
5,011
44% 
   4,305 
45% 
     6,486 
47% 
6,051
44% 
7,001
46% 
     6,150 
45% 
5,756
42% 
South West 
8,747 
27% 
6,278
46% 
   5,629 
50% 
   10,690 
49% 
8,455
48% 
11,177
50% 
     8,274 
49% 
8,397
49% 

1. 

For results of the July 2006 to September 2007 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
2006
  
November 
2007 
1
January 
2008 
March 
2008 
May
2008 
July 
2008 
September 
2008 
December 
2008 
Total2
%Yes3
Total2 %Yes3
Total2
%Yes3
Total2
%Yes3
Total2 %Yes3
Total2
%Yes3
Total2
%Yes3
Total2
%Yes3
England  
78,773 


29%
77,804
41%
72,153
43%
109,331
43%
89,903
45%
93,528
47%
93,003
48%
75,878
50%
North East 
4,238 
30% 
5,141
45% 
   4,225 
46% 
     6,824 
47% 
5,587
49% 
3,922
55% 
     5,577 
58% 
4,958
63% 
North West  
11,252 
34% 
11,774
46% 
   9,865 
48% 
   14,117 
 
 
47%
12,751
50%
13,139
53% 
   13,084 
54% 
10,447
56% 
Yorks & Humber 
9,321 
30% 
10,203
42% 
   9,235 
43% 
   12,486 
45% 
9,831
46% 
10,699
49% 
   12,165 
51% 
9,083
51% 
East Midlands  
7,240 
36% 
7,518
51% 
   7,168 
51% 
   10,269 
51% 
8,514
53% 
9,701
53% 
   10,113 
56% 
8,489
57% 
West Midlands  
7,355 
31% 
5,531
45% 
   6,333 
48% 
     8,605 
47% 
8,208
48% 
8,002
51% 
     7,119 
52% 
4,840
54% 
East of England 
8,580 
31% 
7,597
42% 
   7,663 
41% 
   11,442 
43% 
8,976
43% 
8,295
45% 
     8,764 
47% 
7,252
48% 
London  
9,350 
32% 
8,071
40% 
   7,857 
42% 
   11,563 
43% 
10,433
46% 
10,318
46% 
     8,634 
46% 
7,224
48% 
South East Coast  
7,490 
28% 
4,962
38% 
   5,005 
39% 
     8,642 
41% 
7,530
43% 
6,880
45% 
     7,797 
46% 
5,950
48% 
South Central 
5,204 
32% 
5,011
43% 
   4,305 
41% 
     6,486 
43% 
6,051
46% 
7,001
48% 
     6,150 
48% 
5,756
49% 
South West 
8,747 
31% 
6,278
44% 
   5,629 
46% 
   10,690 
47% 
8,455
50% 
11,177
49% 
     8,274 
51% 
8,397
53% 

1. 
For results of the July 2006 to September 2007 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 sixteenth National Patient Choice Survey conducted by Ipsos MORI on behalf of the Department of Health, in a series of surveys planned to monitor patient awareness of choice and recall of having been offered a choice of hospital for their first outpatient appointment.  The surveys are designed to provide a national overview of choice and summary results at PCT level.  After piloting the methodology with six NHS hospital trusts in February 2006, national surveys have been 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 now December 2008. 

Methodology Patients who had been referred by a GP for a first outpatient appointment in any of 141 major acute NHS trusts or 14 Independent Sector (IS) organisations during the two-week period 15 to 28 December 2008 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 6). These providers of care together account for over 95% of NHS GP referrals to first outpatient appointments.  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 218,000 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. The questionnaire for the December 2008 survey was the same as that used for the previous six surveys, following questionnaire redesign in November 2007 (see Annex C for the questionnaire). 

Response A total 75,916 patients responded to the survey, a response rate of 35%.  Of these, 
38 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, 3,335 (4%) responses did not clearly indicate the responsible PCT.  Such cases have been included in national analysis since the November 2006 survey, as they have a valid provider code.  This resulted in an effective national response rate of 35% (75,878 valid responses).  This compares with valid response rates of between 25% and 33% in all surveys to January 2008 except 40% in September 2007, 50% in March 2008 and between 37% and 38% in May to September 2008. 

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 8.9 million first attendance outpatient appointments in 2006-07 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 for the majority of patients.  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 was not universally complete enough to provide a robust comparison. 

Analysis by age, sex and ethnic group Results of the survey by age, sex and ethnic group were last presented in the report for referrals made in March 20081.  The report compiled results for the first twelve surveys, 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 analysis has been updated to include the subsequent four surveys and is presented in Annex D. 

Issues for PCT results Survey forms were marked with the commissioning organisation (Care Trust or Primary Care Trust, PCT) prior to issue.  In most cases, issuing organisations identified the responsible PCT on the basis of contemporary PCTs, ie those following reconfiguration from 303 to 152 commissioning organisations on 1 October 2006.  In the December survey, 97% of responses were marked with either new PCT codes (67%) or PCTs unaffected by reconfiguration (30%).  The remaining 3% of responses had a discontinued PCT code.  These were mapped to their new codes (where generally two or more of the 303 PCTs aggregated into one of the 152 reconfigured PCTs) for inclusion in the PCT level results of the survey.  SHA results were aggregated from the PCT data (also unweighted). The number of valid responses received varied by PCT, from fewer than 60 patients in ten PCTs (where there were local problems with the survey process) to more than 1,000 in 14 PCTs, as shown in Annex Table A.7.  If responses were unbiased, the average confidence interval2 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 ± 32%.  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. 

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

 
Background Results of the survey by the age, sex and ethnic group of respondents were last presented in the report for referrals made in March 20081.  That report compiled results for the first twelve 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 all sixteen surveys to date, combining these into groups of four successive surveys2. 

 
Age and sex results The proportion of patients recalling being offered a choice of hospital for their first outpatient appointment was nearly 2% higher for women than for men, see Figure D.1 and Table D.2.  The proportion also varied by age, although this became less marked as the general level of recall of choice rose.  The highest proportion of patients offered choice was 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. 

Combined results of surveys 10 to 12                 Combined results of surveys 13 to 16
 
                                            
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.  
The Asian or Asian British and Black or Black British ethnic groups were on average 12% below the overall proportion of patients offered choice in the latest four surveys, as was the Other group (based on less than 0.5% of responses, see Table D.2).  Those with Mixed ethnicity were slightly closer to average, whilst the Chinese group showed most variability and was not always below average (but also based on less than 0.5% of responses and omitted from Figure D.4).  The variation by ethnic group lessened in the latest four surveys. 

## 

 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 has risen over time across all groups.  
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). 

                                            

Numbers and percentages 
 
Surveys 1 to 4 
20061
  Surveys 5 to 8
20071
 
Surveys 9 to 12
2007-081
Surveys 13 to 16
20081
  
May  
2008 (13) 
 
  


July
2008 (14) 
September
2008 (15) 
December
2008 (16) 
Total2 %Yes3
Total2
%Yes3
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%
89,903
45%
93,528
47%
93,003
48%
75,878
50%
By age and sex: 


Male 
16-34  
18,601 
23%
19,237
27%
22,851
31%
20,237
36%
5,162
36%
5,371
35%
5,335
35%
4,368
37%
 
35-54 
31,699 
26%
32,784
31%
40,461
34%
39,431
39%
10,050
37%
10,468
38%
10,399
40%
8,514
42%
 
55-64 
19,124 
34%
19,779
38%
24,479
43%
24,004
50%
6,120
47%
6,371
50%
6,330
50%
5,183
53%
 
65+ 
35,105 
40%
36,306
45%
44,885
50%
43,896
56%
11,193
53%
11,651
55%
11,575
57%
9,477
58%
 
Total4
107,761
32%
111,677
37%
134,298
41%
128,169
46%
32,694
44%
34,028
46%
33,790
47%
27,658
49%
Female 16-34  
36,415 
25% 
37,661
29%
50,405
34%
57,961
38%
14,780
36%
15,386
38%
15,282
39%
12,512
41%
 
35-54 
51,872 
32%
53,647
36%
68,115
41%
70,646
47%
18,015
45%
18,751
47%
18,628
48%
15,252
50%
 
55-64 
24,102 
35%
24,927
41%
30,932
47%
30,519
54%
7,780
52%
8,102
53%
8,048
55%
6,589
57%
 
65+ 
45,060 
37%
46,602
43%
57,584
48%
56,242
55%
14,340
52%
14,929
54%
14,830
55%
12,142
58%
 
Total4
160,152
32%
165,791
37%
208,456
42%
216,041
48%
55,114
45%
57,342
47%
56,968
49%
46,617
51%
 
By ethnic group:  
 
White
244,948
33% 
251,765
38%
312,955
42%
311,425
48%
 79,095 
46%
82,511 
48%
 82,256 
49%
 67,563  
51% 
All BME 
24,138 
26% 
26,237
30%
30,925
34%
33,661
39%
   8,841 
38%
  9,270 
38%
   8,670 
39%
   6,881  
40% 
Mixed 
   3,430  28% 
   3,605 
31%
   7,648 
36%
 10,373 
42%
   2,747 
41%
  2,737 
41%
   2,856 
42%
   2,034  
44% 
Asian or Asian British 
 10,655  26% 
 12,049 
32%
 12,489 
35%
 12,555 
39%
   3,281 
37%
  3,567 
39%
   3,084 
39%
   2,622  
40% 
Black or Black British 
   5,986  25% 
   6,236 
27%
   7,297 
32%
   7,732 
35%
   1,998 
34%
  2,177 
35%
   1,967 
34%
   1,591  
39% 
Chinese 
   1,192  26% 
   1,309 
30%
   1,340 
31%
   1,323 
36%
       365 
39%
      343 
33%
       333 
36%
       282  
36% 
Other 
   2,874  29% 
   3,038 
31%
   2,151 
31%
   1,678 
37%
       450 
36%
      446 
37%
       430 
39%
       351  
35% 

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.  Surveys 13 to 16 are for referrals made in May, July, September and December 2008.  For a breakdown by survey for surveys 1 to 12, see the *Report on the National Patient Choice Survey - July 2007 England* and the *Report on the National Patient Choice Survey - March 2008 England.* 
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. 

Numbers and percentages 
 
Surveys 1 to 4 
20061
  Surveys 5 to 8
20071
 
Surveys 9 to 12
2007-081
Surveys 13 to 16
20081
  
May  
2008 (13) 
 
  


July
2008 (14) 
September
2008 (15) 
December
2008 (16) 
Total2 %Yes3
Total2
%Yes3
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%
89,903
45%
93,528
46%
93,003
46%
75,878 
46%
By age and sex: 


Male 
16-34  
18,601 
32%
19,237
41%
22,851
44%
20,237
43%
5,162
42%
5,371
43%
5,335
45%
4,368
43%
 
35-54 
31,699 
36%
32,784
46%
40,461
45%
39,431
45%
10,050
45%
10,468
44%
10,399
45%
8,514
46%
 
55-64 
19,124 
36%
19,779
46%
24,479
46%
24,004
47%
6,120
47%
6,371
47%
6,330
47%
5,183
48%
 
65+ 
35,105 
34%
36,306
44%
44,885
44%
43,896
44%
11,193
43%
11,651
44%
11,575
45%
9,477
45%
 
Total4
107,761
35%
111,677
45%
134,298
45%
128,169
45%
32,694
44%
34,028
45%
33,790
45%
27,658
45%
Female 16-34  
36,415 
34% 
37,661
43%
50,405
45%
57,961
45%
14,780
44%
15,386
45%
15,282
44%
12,512
45%
 
35-54 
51,872 
39%
53,647
49%
68,115
49%
70,646
49%
18,015
48%
18,751
49%
18,628
49%
15,252
49%
 
55-64 
24,102 
38%
24,927
48%
30,932
49%
30,519
50%
7,780
49%
8,102
51%
8,048
49%
6,589
49%
 
65+ 
45,060 
35%
46,602
44%
57,584
44%
56,242
45%
14,340
44%
14,929
45%
14,830
46%
12,142
46%
 
Total4
160,152
36%
165,791
46%
208,456
47%
216,041
47%
55,114
46%
57,342
47%
56,968
47%
46,617
47%
 
By ethnic group:  
 
White
244,948
36% 
251,765
46%
312,955
46%
311,425
47%
 79,095 
46%
82,511 
47%
 82,256 
47%
 67,563  
47% 
All BME 
24,138 
30% 
26,237
37%
30,925
40%
33,661
41%
   8,841 
42%
  9,270 
42%
   8,670 
41%
   6,881  
41% 
Mixed 
   3,430  33% 
   3,605 
39%
   7,648 
42%
 10,373 
42%
   2,747 
43%
  2,737 
42%
   2,856 
42%
   2,034  
39% 
Asian or Asian British 
 10,655  30% 
 12,049 
37%
 12,489 
39%
 12,555 
41%
   3,281 
41%
  3,567 
41%
   3,084 
40%
   2,622  
40% 
Black or Black British 
   5,986  29% 
   6,236 
38%
   7,297 
40%
   7,732 
41%
   1,998 
41%
  2,177 
41%
   1,967 
39%
   1,591  
41% 
Chinese 
   1,192  32% 
   1,309 
36%
   1,340 
43%
   1,323 
47%
       365 
45%
      343 
44%
       333 
47%
       282  
54% 
Other 
   2,874  30% 
   3,038 
37%
   2,151 
39%
   1,678 
40%
       450 
38%
      446 
41%
       430 
44%
       351  
39% 

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.  Surveys 13 to 16 are for referrals made in May, July, September and December 2008.  For a breakdown by survey for surveys 1 to 12, see the *Report on the National Patient Choice Survey - July 2007 England* and the *Report on the National Patient Choice Survey - March 2008 England.* 
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. 

Numbers and percentages 
 
Surveys 10 to 12 
2007-081
 
Surveys 13 to 16 
20081
 
  
 
  
May
2008 (13)  
July
2008 (14) 
September  
2008 (15) 
December 
2008 (16) 
Total2 %Yes
Total2 %Yes
Total2 %Yes
Total2 %Yes
Total2 %Yes
Total2 %Yes
3
% No3 
pref. 
3
% No3 
pref. 
3
% No3 
pref. 
3
% No3 
pref. 
3
% No3 
pref. 
3
% No3 
pref. 
Total  
259,289 
 
 
66%
24% 
352,316
67%
23%
89,903
66%
24%
93,528
66%
23%
93,003
67%
23%
75,878
68% 23% 
By age and sex: 


Male 
16-34  
16,632 
61% 30%
20,237
62%
28%
5,162
61%
28%
5,371
62%
28%
5,335
62%
27%
4,368
62% 29%
 
35-54 
29,861 
63% 27%
39,431
63%
27%
10,050
62%
28%
10,468
62%
27%
10,399
63%
26%
8,514
65% 26%
 
55-64 
18,084 
67% 23%
24,004
67%
23%
6,120
66%
24%
6,371
67%
22%
6,330
67%
23%
5,183
69% 21%
 
65+ 
33,147 
70% 21%
43,896
70%
21%
11,193
70%
21%
11,651
69%
21%
11,575
71%
21%
9,477
71% 20%
 
Total3
98,165
66%
25% 
128,169
66%
24%
32,694
65%
25%
34,028
65%
24%
33,790
66%
24%
27,658
67% 23% 
Female 16-34  
38,228 
63% 28% 
57,961
63%
28%
14,780
62%
29%
15,386
62%
28%
15,282
63%
28%
12,512
65% 26%
 
35-54 
50,771 
67% 23%
70,646
67%
23%
18,015
66%
23%
18,751
67%
23%
18,628
67%
23%
15,252
67% 23%
 
55-64 
22,873 
69% 21%
30,519
69%
20%
7,780
68%
21%
8,102
69%
19%
8,048
69%
20%
6,589
71% 19%
 
65+ 
42,517 
70% 20%
56,242
71%
19%
14,340
70%
20%
14,929
70%
19%
14,830
71%
19%
12,142
72% 19%
 
Total3
154,877
67%
 
67%
23%
56,968
68%
23%
46,617
68% 22% 
 
By ethnic group:  
 
White
231,024 
23%
67%
 
311,425
68%
23%
79,095
67%
24%
82,511
67%
23%
82,256
68%
23%
67,563
69% 22%
23% 
 
216,041
67%
23%
55,114
66%
24%
57,342
 
All BME 
22,825 
60% 27% 
33,661
61%
26%
8,841
61%
26%
9,270
61%
26%
8,670
61%
27%
6,881
62% 26%
Mixed 
   6,605  62% 26% 
 10,373 
63%
25%
   2,747 
63%
24% 
   2,737 
62%
24%
   2,856 
62%
25%
   2,034 
63% 26% 
Asian or Asian British
   8,834  60% 28% 
 12,555 
62%
26%
   3,281 
61%
26% 
   3,567 
61%
26%
   3,084 
62%
26%
   2,622 
63% 25% 
Black or Black British
   5,308  59% 28% 
   7,732 
59%
28%
   1,998 
59%
28% 
   2,177 
59%
27%
   1,967 
57%
29%
   1,591 
60% 28% 
Chinese 
       834  62% 29% 
   1,323 
63%
28%
       365 
62%
26% 
       343 
60%
32%
       333 
64%
28%
       282 
68% 28% 
Other 
   1,244  58% 28% 
   1,678 
60%
26%
       450 
59%
28% 
       446 
62%
23%
       430 
63%
25%
       351 
58% 27% 

1. 

The question was introduced from Survey 10 (November 2007).  For a breakdown by survey for surveys 10 to 12, see the *Report on the National Patient Choice Survey - March 2008 England.* 
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 Q5 '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.