Well the good news is that this big patch has meant some noticeable improvements over the previous hotfix.
1: The game loads quicker now, the launch game loaded a save in 43 seconds, the last hotfix increased save loads to over 1 minute, now the load time has gone back down to 43 seconds.
2: The shader compilation was weird, first load after this big patch and nvidia hotfix driver re-install the main screen showed 98% compiled within 20 seconds and I thought it was done. Loaded the game and played all fine, circa 100fps. running nicely and CPU usage was not high as if shader comp was happening in the background. Just loaded it up now and it's looking like it's resuming compilation and started at 25%, I walked away to use the loo, came back within 5 mins and the compilation was done, so looks like this has been massively improved although I can't say exactly how long it took but must have been ~10 minutes - Weird but fine.
3: I also installed the hotfix Nvidia driver as mentioned above to see if the performance degrade seen in the pre-patch version of the game was sorted. It largely is. In the menus it seems to drop the fps to a bit over 60 it seems but when you go back into the game it's ~100. It's still lower than the non hotfix driver, but not by the 20 odd fps I was seeing before. Also no more crash with this patch + driver combo.
4: Mouse camera judder remains, we will be waiting a while for that I can feel it......
At least everything appears stable now, just that mouse jitter before I put a New game+ session on Survivor mode into play.