Sixteenth Citizens’ Panel report

The sixteenth Citizens’ Panel survey was carried out between June and August 2025.

The survey sought views and experiences on the following topics:

• Local GP or Medical Practice
• Personal Continuity of Care
• Duty of Candour
• The Charter of Patient Rights and Responsibilities

A total of 659 survey responses were received, equivalent to a response rate of 60%. This is sufficient to support robust analysis with overall results accurate to ± 3.8%. Key findings are summarised over the following pages. The body of this report sets out findings in more detail, and a profile of survey responses is appended.

Experience of GP or Medical Practice and Personal Continuity of Care

Local GP or Medical Practice – Key findings

The first part of the survey asked about experiences of care through local GP or medical practices over the past 12 months.

In relation to local GP or medical practices, most respondents agreed that they can access the care they need when they need it, that the care they have received from their practice over the last 12 months has met their needs, and that it is important for them to see the same healthcare professional(s). Key findings are summarised below:

• Just over half of respondents (56%) agreed that they are able to access the care they need from their practice when they need it, while three in ten (30%) disagreed.
• Just over six in ten (61%) agreed that the care they have received from their practice over the last 12 months has met their needs, and around a fifth (21%) disagreed.
• Just over four in ten (43%) agreed that there is a ‘joined-up’ approach to the care they receive from different staff at their practice. A quarter of respondents (25%) disagreed.
• Almost seven in ten (68%) agreed that it is important for them to see the same health care professional(s) in their practice appointments, while 12% disagreed.

Personal Continuity of Care – Key findings

Personal continuity of care means that a patient consistently sees the same health care professional or group of professionals over time, while having fast access to care means quick access to care regardless of which individual the patient sees.

A little less than half of the respondents were aware of the difference between fast access to care and personal continuity of care. A large majority felt that both are important to them, with the main benefits of personal continuity of care seen as healthcare professionals knowing their medical history and having an ongoing relationship with the same person. Key findings are summarised below:

• Just over half of the respondents (52%) were not aware of the difference between fast access to care and personal continuity of care. 45% were aware of this distinction, although most of these understood the distinction only ‘to some extent.’
• Respondents were most likely to say that personal continuity of care is more important than fast access to care when referring to long-term conditions and ongoing care (53%). Fast access to care was seen as more important for emergency, acute or time-critical cases (55%).
• A large majority (89%) agreed that fast access to care is important for them, and few (3%) disagreed. Most respondents (79%) also agreed that personal continuity of care is important to them, while 8% disagreed.
• On the benefits of personal continuity of care, respondents rated the most important as healthcare professionals knowing their medical history and having an ongoing, trusting relationship with the same person.
• More than half of the respondents (53%) were unsure of whether they can request personal continuity of care in the healthcare services they use, while nearly a third (31%) knew they can request personal continuity of care at least sometimes.

Insights

The Primary Care Phased Investment Programme (PCPIP) evaluation is drawing on a range of expert input and public evidence to make recommendations. Findings from this Citizens’ Panel will be shared with the PCPIP team to support and inform that broader evaluation process. Based on these conclusions we offer the following insights for the PCIPP to consider:

• GP and medical practices should continue efforts to improve access and ensure patients’ needs are consistently met.
• GP and medical practices should explore mechanisms to strengthen personal continuity of care including how to make it clearer for patients to request personal continuity of care, if appropriate.
• GP and medical practices should continue to improve joined-up care among the different health and care professionals working in a practice.

Duty of Candour

Key findings

The Duty of Candour is a legal process that health, care, and social work services must follow when something goes wrong and causes harm or could have caused harm. The Scottish Government are conducting a review of the organisational duty of candour and the findings will inform part of the final report on the review.

Most respondents had not heard of the Duty of Candour, and most were not aware of the process that services should take if something goes wrong. More than half felt that there is not enough information available on the Duty of Candour. A significant number of respondents reported that they or someone they care for had experienced an adverse event while using a health, care or social work service. Key findings are summarised below:

• Most respondents (65%) had not heard of the Duty of Candour, while around a third (33%) had heard of this.
• Most (61%) were not aware of the process that health, care, or social work services should take if something goes wrong, while around a third (34%) were aware of this.
• Two in five respondents (40%) reported that they or someone they care for had experienced an adverse event while using a health, care, or social work service.
• For information about their rights if something went wrong, respondents would be most likely to go to the NHS Inform website (67%), online search engines (52%), their GP or healthcare provider (44%), or Citizens Advice Scotland (40%).
• Three quarters (75%) had visited the NHS Inform website. A little less than a tenth of these respondents (8%) had seen information about the Duty of Candour on the website.
• More than half of respondents (55%) felt that there is not enough information available to the public about the Duty of Candour.

Recommendations

Based on these findings Healthcare Improvement Scotland makes the following recommendations to the Scottish Government, NHS Inform and NHS Boards and Health and Social Care Partnerships: 

1. NHSScotland should strengthen public-facing communication about the Duty of Candour, including clearer guidance on rights and procedures. There may also be the need to explain in more plain language what is meant by the ‘Duty of Candour.’ This could be supported by the development of a strapline to improve public understanding of ‘candour.’
2. NHSScotland should review and enhance its content and visibility on the Duty of Candour across both digital and non-digital formats ensuring that relevant information is easy to find and understand for all audiences.
3. Health and social care services should take active responsibility for informing patients and families about the Duty of Candour following adverse events. This should include timely, compassionate communication, and consider using plain language, and clear explanations of what the Duty entails, what steps will be taken, and what support is available.

4. In order to implement recommendation 3, training and support for staff should emphasise the importance of transparency, empathy, and procedural clarity in implementing the Duty of Candour. NHS Boards and Health and Social Care Partnerships should utilise existing training on offer such as NES e-learning module, Healthcare Improvement Scotland adverse events toolkit and compassionate communication training.
5. Further public engagement should be considered to better understand expectations, experiences, and barriers related to the Duty of Candour–particularly among those directly affected by adverse events. This engagement should actively involve third sector and advocacy organisations, whose trusted relationships and community reach can help ensure that diverse voices are heard, and that future improvements are informed by lived experience.

The Charter of Patient Rights and Responsibilities

Key findings

The Patients’ Charter sets out patients’ rights and responsibilities when using the NHS in Scotland including what they are entitled to, what they can do if they feel their rights have not been respected, and what is expected of them.

More than half were aware of the Patients’ Charter, although most respondents did not know where to find the Charter. Key findings are summarised below:

• More than half of respondents (54%) were aware of the Patients’ Charter, although a small minority of these (10%) said they were “fully aware,” and 40% had not heard of the Charter.
• Most respondents (65%) did not know where to find the Patients’ Charter, while around a fifth (18%) felt they did know this. A tenth of respondents (10%) had seen or used the Charter.

Recommendations

Based on these findings Healthcare Improvement Scotland makes the following recommendations to the Scottish Government and relevant stakeholders:

1. The Charter of Patient Rights and Responsibilities should be more actively promoted across NHS Scotland and on a local level through GP or medical practices, hospitals, and digital platforms. 
2. NHS Inform and other public-facing services should ensure that the Charter is prominently featured, with accessible summaries and guidance on how to use it. 
3. Healthcare providers should incorporate the Charter into patient communications, induction materials, and feedback processes and embedding it more consistently within everyday service interactions (eg appointment/discharge letters, feedback forms, welcome packs). 
4. Evaluation of the Charter’s reach and impact should be undertaken to inform future revisions and implementation strategies, including a review of NHS Inform website data and memorandum of understanding.