Please could you take time to complete this survey form and place it in the box provided at reception, or return it by email or via the website.
The aim of the survey is to find out what you think about our service to you, and get feedback from you about how you think we could improve our service.
The outcome of this survey will be published within the practice, on the website, and can be emailed to you if we have permission to use your email. ( a newsletter in the surgery or on the website gives you the opportunity to complete this with your email address.)
This survey has been developed with the help of our practice Patient participation Group who are contributing to, and supporting the practice on your behalf.
Please rate each of the following areas
INFORMATION
1. As a patient do you feel you want more information about the practice and/or not sure where to find it, please rate our level of available information
Please comment
2. Did you know the practice has a website www.mannamameadsurgery.co.uk
If yes, please rate your level of satisfaction with the website
Have you found it useful, or how can it be improved, your comments will be useful
Please comment
3. If you don’t use the website, how would you like to receive information about the practice
Please comment
CLINICAL CARE
4. Clinical care given at the surgery by the doctors
Please comment
5. Seeing the doctor of your choice
Please comment
6. Making routine appointments to see your doctor
Please comment
7. Level of satisfaction about seeing a doctor more urgently
Please comment
8. Clinical care given at the surgery by the practice nurses
Please comment
MANAGEMENT AND ADMINISTRATION
Are you satisfied with the management/ administrative care given at the surgery with the following points
9. Making Routine Appointments
Please comment
10. Making Urgent Appointments
Please comment
11. Requesting Repeat Prescriptions
Please comment
12. Telephoning for Results
Please comment
13. Telephoning the surgery
Please comment
14. Contacting out of hours assistance
Please comment
15. Making complaints
Please comment
WE WANT TO REACH OUT TO GET VIEWS FROM A WIDE RANGE OF OUR PATIENTS
16. Have you suggestions about how we do this, please place your comments in the boxes provided
Please comment
17. Is there something more we can do to improve the experience for our young people
Please comment
18. Is there something more we can do to improve the experience for our older people
Please comment
19. Is there something more we can do to improve the experience for our working people
Please comment
20. Did you know we do have appointments on Monday evenings from 6.30pm to help those patients unable to get to the surgery during the day
If you have experienced these appointments did you find them useful
Please comment
21. Is there something more we can do to improve the experience for other sections of our patient groups, or patients with certain health problems, we would welcome your ideas
Please comment
The following additional information will help to make sure we try to speak to a representative sample of the patients that are registered at this practice, and enable us to feedback to you.
This information is entirely voluntary
Name:
Tel No:
Mobile No:
Email address:
Postcode:
Are You
Age Group
To help us ensure our contact list is representative of our local community please indicate which of the following ethnic background you would most closely identify with? These are the current ONS classification used for classifying ethnicity in the title 2001 UK Census
England and Wales
White
Mixed
Asian or Asian British
Black or Black British
Chinese or other ethnic group
Not Stated
How would you describe how often you come to the practice
Any other representation/interest/comment you would like to make
Thank you for taking the time to complete this survey. Your views will help us look at how we may be able to make improvements. If there are reasons why we may be unable to make any changes we will also feed this back to you with the reasons.
Please note that no medical information or questions will be responded to. The information you supply us will be used lawfully, in accordance with the Data Protection Act 1998. The Data Protection Act 1998 gives you the right to know what information is held about you, and sets out rules to make sure that this information is handled properly.