We would be grateful if you would complete this survey about our Practice. We want to provide the highest standard of care. A summary from this survey will be fed back to members of the Practice and to patients, to help identify areas for improvement. Your opinions are very valuable. Please answer ALL the questions you can. There are no right or wrong answers and your doctor or nurse will NOT be able to identify your individual answers. Thank you.
About Your Visit to the Surgery
How good was the Clinician at:
Q1 Putting you at ease?
Q2 Being polite and considerate?
Q3 Listening to you?
Q4 Giving you enough time?
Q5 Assessing your medical condition?
How good was the Clinician at:
Q6 Explaining your condition and treatment?
Q7 Involving you in decisions about your care?
Q8 Providing or arranging treatment for you?
Q9 Did you have confidence that the Clinician is honest and trustworthy?
Q10 Did you have confidence that the Clinician will keep your information confidential?
Q11 Would you be completely happy to see this Clinician again?
Please enter the name of the Clinician you recently saw and add any additional comments:
About Receptionists and Appointments
Q12 How helpful do you find the Receptionists at our practice?
Q13 How easy is it to speak to a doctor or nurse on the phone at our practice?
Q14 If you need to see a Clinician urgently, can you normally get seen on the same day?
Q15 How do you normally book your appointments at your practice? (please X all boxes that apply)
Q16 Which of the following methods would you prefer to use to book appointments at your practice? (please X all boxes that apply)
How quickly do you get to see a specific doctor:
Q17 How quickly do you usually get seen?
Q18 How do you rate how quickly you were seen?
Thinking of times when you are willing to see any doctor:
Q19 How quickly do you usually get seen?
Q20 How do you rate how quickly you were seen?
Thinking about the care you get from your doctors and nurses overall, how well does the practice help you to:
Q21 Understand your health problems?
Q22 Cope with your health problems
Q23 Keep yourself healthy
Q24 Overall, how would you describe your experience of our surgery?
Q25 Would you recommend our surgery to someone who has just moved to your local area?
It will help us to understand your answers if you could tell us a little about yourself
Q26 Are you ?
Q27 How old are you?
Q28 Do you have a long-standing health condition?
Q29 What is your ethnic group?
Q30 Which of the following best describes you?
Finally, please add any other comments you would like to make about our Practice:
GPAQ-R © 2013 is reproduced with the kind permission of the University of Manchester & University of Cambridge. GPAQ incorporates the Primary Care Assessment Survey (PCAS); with permission from Dr Dana Gelb Safran creator of PCAS. www.gpaq.info