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You can help us improve the services we offer; the Patient Participation Group, Practice and Doctors at this surgery would welcome your honest feedback.
Please do not put your name on this survey.
Once complete please place in the envelope attached and return to the Reception Staff of your Surgery.
1. Who is your registered Doctor?
2. When was the last time you saw a Doctor or Nurse?
PRESCRIPTIONS & INTERACTIVE SERVICES
3 a) Do you have medication prescribed regularly?
b) Have you ordered your repeat prescription via email or the website?
i) If ‘no’ did you know this service was available?
ii) Do you think you would use this service in future?
c) Did this system work satisfactorily?
4 In the future would you be interested in booking advance appointments (more than 2 days ahead) on-line?
ACCESS TO APPOINTMENTS
5 a) In the past 6 months how easy have you found it to book an appointment in advance (more than 2 weekdays)?
b) If you had not tried were you aware you could book a doctors appointment in advance?
6 a) How long do you have to wait at your Appointment time?
b) How do you feel about how long you have to wait when you have attended your appointment?
c) If your appointment was delayed where you informed that there was a wait?
7 a) In the last 12 months have you used any of the following services?
b) If so was that because: (please tick one only)
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c) If it was outside surgery hours did you try ringing the surgery to obtain the emergency number?
PROMOTING HEALTH
8 a) If appropriate please tick the boxes that apply to you:
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b) Please list any personal health priorities not mentioned above:
c) Did you know you are entitled to a free NHS health check?
9 a) Do you have carer responsibilities for anyone with a long-standing health problem or disability? (The Department of Health defines a carer as someone who ‘provides unpaid support to family or friends who couldn’t manage without this help).
b) Who do you care for: (tick as appropriate)
| c) Is your carer role full-time or part-time?
d) Is the person you care for a patient at your surgery?
e) Is your GP aware of your carer responsibilities?
f) Do you feel that your caring responsibilities limit the time you have to focus on your own health?
OVERALL SERVICE
10 In general how satisfied are you with your overall care at the surgery?
11 Would you recommend this Surgery?
12 Do you have any constructive suggestions for the Surgery to improve the service to patients?
The following questions will help us to see how experiences vary between different groups of the population. We will keep your answers completely confidential
Are you male or female?
How old are you?
Which of these best describes your employment status? (tick one box only) | What is your ethnic group? (Chose one section from A to E below, and then select the appropriate option to indicate your ethnic group) | Thank you for taking the time to complete this survey. Your views are very much appreciated
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