CCA Care Partnership

We value all our patient feedback and would like to ask you to take 5 minutes to complete the questionnaire below. Results from this survey will be used to formulate a Surgery Action Plan to help us improve the service we provide to our patients.The results will be published in the three surgeries and on our website. If you want to be involved in the changes taking place at our surgery and be part of the Patient Voices Team then please ask a member of staff for details.

If you would prefer to complete the questionnaire online, please go to http://www.ccacarepartnership.co.uk/.

DATE OF VISIT:

MAKING YOUR APPOINTMENT

Q1:Which surgery have you attended?

Q2:How easy is it to get through on the telephone?

PLEASE STATE YOUR DIFFICULTY

Q3:How helpful is the receptionist on the telephone?

IF NOT VERY HELPFUL PLEASE STATE YOUR REASONS

Q4.How easy is it to make an appointment on the day you required?

IF DIFFICULT PLEASE STATE WHY.

Q5:How easy is it to make an appointment with the Doctor/Nurse or Health Care Assistant of your choice?

IF DIFFICULT WHAT WAS THE REASON GIVEN

Q6:If you requested a telephone appointment did the Doctor/Nurse ring you back on the same day?

AT THE SURGERY

Q7:On arrival at the surgery was the automatic booking system on the wall computer working?

Q8:On arrival is the receptionist helpful?

IF NO PLEASE STATE PROBLEM AND THE NAME OF THE RECEPTIONIST

Q9:What is your preferred method of making an appointment?

STATE ANY OTHER METHOD YOU PREFER

Q10:Are the opening times of the surgery suitable for you?

IF NO, PLEASE STATE THE TIMES YOU CONSIDER IDEAL

Q11:What other medical services would you like to see available at the surgery?

Q12:Have you signed up to receive a Text Message reminding you of your appointment?

IF NO AND YOU WOULD LIKE TO PLEASE SEE RECEPTIONIST

Q13:How often do you visit the surgery to see a Doctor/Nurse/Health Care Assistant?

[OR}Regulary;Occasionally;Not Very Often

Q14:Repeat Prescriptions; are you happy with the service provided?

IF NO PLEASE STATE YOUR REASON

Q15: Do you use the following prescription service?

Q16:Have you registered for the on-line repeat prescription service?

IF NO AND YOU WOULD LIKE TO PLEASE SEE RECEPTIONIST

Q17. If your disabled, is it easy to get into the surgery?

STATE THE DIFFICULTY YOU HAD

Q18. On arrival, how long did you wait for your consultation with the

STATE HOW LONG YOU WAITED

Q19. On arrival did the receptionist inform you of a delay in your appointment?

Q20. How satisfied were you with your consultation with

PLEASE STATE NAME OF DOCTOR/NURSE/HEALTHCARE ASSISTANT

PLEASE STATE REASONS FOR BOTH

Q21. If you were referred for tests i.e. Blood tests/Scan did the Doctor/Nurse/Healthcare Assistant tell you the procedure in a matter that you understood?

IF NO PLEASE STATE WHY

Q22. Are you happy with the overall appearance of the surgery? i.e. Is it clean and tidy?

IF NO PLEASE STATE YOUR REASONS

SO THAT WE CAN ANALYSE YOUR REPLYS TO THE ABOVE QUESTIONS, PLEASE TELL US A LITTLE ABOUT YOURSELF.

Are you?

What age are you?

What is the ethnic background that you most identify with yourself?

FINALLY

Would you recommend this surgery to family and friends?

PLEASE STATE THE REASON FOR YOUR ANSWERS

SURVEY TO BE ISSUED ON:

SURGERY WEBSITE
PPG WEBSITE
PPG NOTICEBOARD
SURGERY NOTICEBOARD
VIRTUAL MEMBERS
IN SURGERY AT RECEPTION AND HANDED OUT FOR COMPLETION

SURVEY TO BE PUBLISHED ON: 27/10/14 to 5/11/14

THIS SURVEY RESULTS WILL BE PUBLISHED ON: THE ABOVE

Many thanks for your time in answering the questions on this survey.