Ive recently started thinking about starting up a new game since i last played in june. Ive read alot of negativity and im wondering if the latest patch really messed gameplay up so badly. Any input appreciated

Luck of your draw, alot of people in this section are here to report their problems, some of which are the exact same as other threads.
You might get good and have a copy without many bugs/crashes.
But just save at regular points, like maybe every 15 mins for a good while just to be safe your game isn't unstable, and keep autosave on.
If I play a marathon run I don't usually need to worry about crashes for like 2 hours when my xbox becomes a toaster.
There are faction armour bug (don't know if they've been patched) so try avoid wearing any faction armour for safeties sake.

Thats all you need to be wary of and your good to go
Enjoy

Thanks. Im thinking of just installing ot to hdd. Maybe thatll help too

You could try that too, from what I've heard about installing to HDD just makes the game run smoother/xbox is quieter.
I don't know how true any of that is.