Q1. When did you last see a doctor or nurse at the GP Surgery?
Q2. How do you normally book your appointments to see a doctor or nurse at the surgery?Please tick all the circles that apply
Q3. Which of the following methods would you prefer to use to book an appointment at the surgery? Please tick all the circles that apply
Q4. Thinking about your last visit did you see a GP, nurse or nurse practitioner?
Q5. If you contacted us by telephone in the past 6 months, how was your experience in getting through?
Getting through on the phone |
Speaking to a doctor on the phone |
Speaking to a nurse on the phone |
Getting test results on the phone Q6.Think about the last time you tried to see a doctor urgently. Were you able to see a doctor on the same day or in the next 2 weekdays the GP surgery or health centre was open?
Q7.How satisfied are you with the opening hours of the practice?
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Q8. How do you feel about your wait after registering at reception to be seen by a health care professional?
Q9. Did you have confidence and trust in the person you saw?
Q10. Were you treated with dignity and respect?
Q11.Were you given helpful information about the different options, choices or treatments available to you?
Q12. Were you involved as much as you wanted to be in decisions about your care and treatment?
Q13.We are continuously looking at ways to improve our services. As well regularly asking for your experiences of being at patient at the practice, we would like to know what your priorities are for the future and your views on how we are currently performing.
Thinking about the GP practice, which of these listed below are the most important to you? Please tick up to FIVE boxes only in the left hand column.
Which are the areas where improvements could be made? Please tick up to FIVE boxes only in the right hand column
(Tick up to 5)
(Tick up to 5)
Q14. Would you recommend this service to your friends or colleagues? Please answer on a scale of 0 to 10, where 0 is not at all likely and 10 is extremely likely.
Q15. Overall, how satisfied were you with the service you received?
Q16.Please use this space to tell us what about your experience affected your answers.
(This might include what we are doing well or areas we could improve on).
| Providing Fair and Accessible Services |
We are committed to providing high quality services that meet your needs. To enable us to find out whether we are carrying out our duties fairly we need to monitor particular data. The following questions will help us to see how experiences vary between different groups of the population. The information that you provide will remain confidential but if you prefer not to answer, please leave the question blank. Q17. Are you? Q18. What is your age (years)? Q19. To which of these groups do you consider you belong? To which of these groups do you consider you belong? | White | | Black or Black British | | | | | | ;Irish; | | Caribbean; | | ;Gypsy or Irish traveller; | | Any other Black/African/Caribbean; background; | | ;Any other White background; | | | | | | Asian or Asian British | | Mixed or multiple ethnic groups | | | | | | Pakistani; | | White and Black African; | | Bangladeshi; | | White and Asian; | | Chinese; | | Other mixed/multiple-ethnic; background | | Any other Asian background; | | | | | | Other ethnic group | | | | | | | |
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Q20. Do you consider yourself to have a disability or a long-term limiting illness?
Under the Disability Discrimination Act 1995, a disabled person is someone who has, or has had, a physical or mental impairment, which has a substantial or long-term adverse effect to his/her ability to carry out normal day-to-day activities. Please tick (ü) all that apply
Q21.What is your religion or beliefs? Please tick (ü) one box only
Q22. What is your sexual orientation? Please tick (ü) one box only
Bank Questions – optional questions offered to practices and their PRGs
Accessing the practice
Q1.
If you travelled by car, how satisfied were you with availability of car parking?
Please tick ü one box only.
Q.2 How easy did you find getting into the building?
If you didn't find it easy, please tell us why
Q3. How satisfied or dissatisfied are you with the general condition of the practice building? Please tick ü one box only.
Q4. How helpful were the receptionists?
Q5.How would you rate the comfort of the waiting area (e.g. temperature, seating etc)?
[OR] Very good;Fairly good;Neither good nor poor;Fairly poor;Very poor
Q6.How would you rate the cleanliness of the health centre?
Q7.Did the person you saw on your last visit know about any previous care or treatment you had received?
Q8.Were you given enough time to discuss your health or medical condition?
Q9. Did the person you saw explain the reasons for any treatment or action in a way that you could understand?
Q10. Overall, how do you feel about the length of time your health professional spent with you?
Q11. How much confidence and trust do you have in the health care professional that treated you today? Please rate on a scale of 1 to 10 with 1 being no confidence at all and 10 being completely confidence.
Q12. If you needed any interpreting support to communicate i.e. language or British Sign Language (BSL), was this provided / offered for you by the practice?
If yes, please indicate whether it was British sign language or foreign language.
Thank you!