Implementing the survey; the practicalities

1. Setting up a freepost address

A freepost address allows patients to return completed questionnaires at no cost to themselves. After you have paid for the licence you will only pay for the responses you receive. The freepost address can be printed on the envelopes you send out with the questionnaires. Printed envelopes must comply with Royal Mail guidelines. If you have hired a contractor, your contractor will set this up for you.

2. Setting up a PO Box

The mail out envelope(s) must not include any indication of the sender address.

If using a contractor
Your contractor will set up the freepost address and the PO address for you.

If conducting the survey in-house
You will need to set up a freepost address, as well as a PO address for the surveys.

3. Freephone line

The covering letter to patients should include a telephone number for patients to call if they have any questions or complaints about the survey. All staff who are likely to take calls should be properly briefed about the details of the survey, and be aware of the questions or complaints they are likely to receive. You should consider setting up a freephone line for this purpose.

Managing calls to the freephone line
Where appropriate, ask the patient to tell you the Patient Record Number (PRN) which should be on the address label of the envelope they received and on the questionnaire. You can then check this number against the numbers in the mailing file and log the appropriate code to record the nature of the call.

The Patient Record Number (PRN) or Service User Record Number (SURN) (for the Community Mental Health Survey only) is a unique number allocated to all patients at the time of preparing the sample that allows matching up of the response data with the sample data. It also allows patients to identify themselves if they contact the trust.

Below are some questions and comments commonly asked and some advice on how they can be managed. Even if you are using a contractor to run the survey on your behalf, you may get patients calling your trust directly about the survey.

I have a specific comment, complaint or question about my care or treatment. Who can I contact?

Patients can be referred to the trust’s Patient Advice and Liaison Service (PALs), the complaints manager or patient services manager.

The person to whom the questionnaire is addressed is unable to understand it.

Relatives or carers may call to pass on this information. In some cases, they may offer to complete the questionnaire for the patient, but this is only advisable if the responses will still be a true reflection of the patient’s views.

The person to whom the questionnaire is addressed has died.

Even with the use of a deceased patients tracing service, it may not be possible to identify all deceased patients, particularly those who have died most recently. It is very important that staff who take the calls are aware of this possibility and are prepared to respond sensitively to such calls.

I would like to take part but English is not my first language.

If a patient’s spoken English is better than their written English, they may be willing to have someone, such as a family member, fill in a form on their behalf. It is also strongly recommended that you offer access to an interpretation service, where the questionnaire can be filled in over the telephone.

I do not wish to participate in this survey.

A few patients might call to say that they do not want to be involved in the survey and fewer still may object to being sent the questionnaire in the first place. Staff should apologise to the patient and reiterate the statement in the covering letter – that taking part in the survey is voluntary and that the patient’s care will not be affected in any way if they do not respond.

  • You are required to record any objection immediately, and to check whether a mailing is underway. If a mailing is underway, the caller will need to be advised that it might not be possible to prevent this mailing but assured that they will receive no future mailings.
  • People who do not want to receive any further questionnaires should be logged on the mailing file.
  • When speaking to callers wishing to opt-out of future survey mailings, it is not appropriate to try and dissuade them from their intent.
  • Keep a record of the reasons patients called by logging these in the Weekly Monitoring template that is submitted to the Survey Coordination Centre.

4. Printing the survey materials

If you intend to copy the questionnaire into your own format you must be careful to replicate it exactly. This includes:

  • Question and response option wording and numbering
  • Routing instructions
  • Any other instructions to respondents.

Questions should be formatted as two columns and set out across the page as per the original. Questionnaires must be printed in A4 booklet style and centre-stapled.

Covering letters
Covering letters should be printed on the trust’s letterhead paper. There is a different covering letter for each mailing.

You may not make any modifications to the covering letters. This is because they are submitted for ethics approval to the NHS Research Ethics Service. Once ethics approval has been granted, changes to the covering letters are not permissible.

If the patient name is included in the letter, take great care that these are matched to the corresponding questionnaire (identified by the PRN/SURN) and envelope.

5. Sending out Survey packs

Address labels
Three address labels are needed for each patient. One set of labels will be used for the first mailing, one for the first reminder and one for the second reminder. It is essential that the PRN is on each address label, as this has to be matched with the number on the front of the questionnaire. The label should not include any information other than the patient’s name, address and postcode details.

For results to be representative, it is essential to get a good response rate. To achieve a good response rate, you must send out up to two reminders to non-responders. Depending on the time that has elapsed since you first checked your patient list for deaths, it might be necessary to send your list back to the Demographic Batch Service (DBS) for a further check before you send out reminders. At the very least the trust’s own records should be checked.

First mailing
Survey packs in the first mailing will include:

  • Questionnaire
  • First mailing covering letter
  • Multi-language sheet
  • Freepost return envelope

These items should be packed into an envelope that has a return address on the outside (PO Box recommended for in-house trusts).

Second mailing (first reminder)
The first reminder only consists of the first reminder covering letter. This may be printed on A5 paper and should be sent to patients who have not responded after one to two weeks.

Third mailing (second reminder)
Second reminders should be sent out approximately two to three weeks after the first reminder to patients who have not yet responded. These packs will contain:

  • Questionnaire
  • Second reminder covering letter
  • Multi-language sheet
  • Freepost return envelope

6. Booking in questionnaires

If using a contractor
Your contractor will book the questionnaires in for you.

If conducting the survey in-house
When questionnaires are received, match up the PRN’s against the list of patients so that you can record (in the outcome column of your ‘sample file’) which patients have returned questionnaires and will not therefore need to be sent reminders.

Keep paper copies (or scanned pictures of all the pages of the questionnaires, including the front page) of any questionnaires that are returned to you until further notice – but do not send these to the Survey Coordination Centre unless requested.

If a questionnaire is returned with the PRN removed, please enter the response information in an additional row at the bottom of the data file when submitting it to the Survey Coordination Centre.