We would be grateful if you would complete this survey about your general practice.

The nurses at your practice want to provide the highest standard of care. Feedback from this survey will enable them to identify areas that may need improvement. Your opinions are very valuable.

Please answer ALL the questions you can. There are no right or wrong answers and your doctor will NOT be able to identify your individual answers.

Thank you.

Please write the name of the nurse you saw below:

1 In the past 12 months how many times have you seen a nurse from your pratice?

 
 
 
 
 

2 How do you rate the way you are treated by receptionists at your pratice?

 
 
 
 
 
 
 

3 a) How do you rate the hours that your practice is open for appointments?

 
 
 
 
 
 
 

3 b) What additional hours would you like the practice to be open? (Please tick all that apply)

 
 
 
 
 

The Following Questions are about the Nurse at your Practice:

4 Thinking of times you want to see a nurse: (please tick one box)

a) How quickly do you usually get to see the nurse?

 
 
 
 
 
 
 

b) How do you rate this?

 
 
 
 
 
 
 

5 a) How long do you usually have to wait at the practice for your consultations with a nurse tpo begin? (please tick one box only)

 
 
 
 
 

5 b) How do you rate this

 
 
 
 
 
 
 

6 Thinking of times you have phoned the practice, how do you rate the following:

a) Ability to get through on the telephone?

 
 
 
 
 
 
 

b) Ability to speak to a nurse on the phone when you have a question or need advice?

 
 
 
 
 
 
 

7 This question asks about your usual nurse. If you dont have a 'usual nurse' answer the question about the one nurse at the practice you know best. If you don't know any of the nurses please go to question 8.

a) In general, how often do you see your usual nurse?

 
 
 
 
 
 

b) How do you rate this?

 
 
 
 
 
 
 

8 Thinking abou tyour consultation with the nurse, how do you rate the following?

a) How thouroughly the nurse asked about your symptoms and how you are feeling?

 
 
 
 
 
 
 

b) How well the nurse listened to what you had to say?

 
 
 
 
 
 
 

c) How well did the nurse put you at ease during your physical examination?

 
 
 
 
 
 
 

d) How well the nurse involved you in decisions about your care?

 
 
 
 
 
 
 

e) How well the nurse explained your problems or any treatment you need?

 
 
 
 
 
 
 

f) The amount of time the nurse spent with you today?

 
 
 
 
 
 
 

g) The nurse's patience with your questions or worries?

 
 
 
 
 
 
 

h) The nurs'e caring and concern for you?

 
 
 
 
 
 
 

9 After seeing the nurse do you feel...

a) able to understand your problem(s) or illness?

 
 
 
 

b) able to cope with your problem(s) or illness?

 
 
 
 

c) able to keep yourself healthy?

 
 
 
 

Finally it will help us to understand your answers if you could tell us a little about yourself...

10 Are you..

 
 
 

11 How old are you?

 
 
 
 
 

12 What is your ethnic group?

 
 
 
 
 
 

13 Which of the following best describes you?

 
 
 
 
 
 
 

Finally, please add any other comments you would like to make about your GP practice:

Thank you for completing this questionnaire.

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