Dear Patient,

Many thanks for agreeing to take this short survey to help our practice understand how our appointment system can be improved, if at all.

1. Information about you (please tick relevant boxes)

 
 

 
 
 
 
 
 
 
 
 

How would you describe how often you come to the practice?

 
 
 

2. If you need to be seen urgently we will give you an appointment on the same day. If you need a non-urgent appointment we aim to give you an appointment within a week of your call, although it may be longer if you specify a particular doctor. With this in mind, please tell us how much you agree with the following statements:

2a. If I need an urgent appointment I am usually seen on the same day or a doctor ring me:

 
 
 
 
 

2b. If I need a non-urgent appointment I am usually seen within one week by any doctor:

 
 
 
 
 

2c. I am happy with the current appointment system:

 
 
 
 
 

3. We are currently open from Monday to Friday 8.30am - 6.00pm and in addition we offer a late evening surgery to 9.00pm on Tuesdays. Considering our opening times please tell us how much you agree with the following statements:

3a. The practice is open at times when I can attend an appointment:

 
 
 
 
 

3b. I am happy with the current opening times:

 
 
 
 
 

4. We want to make your visit to the surgery as pleasant as possible. Please tell us how much you agree with the following statements:

4a. The practice is easy to get to:

 
 
 
 
 

4b. The staff are friendly and approachable:

 
 
 
 
 

4c. The practice is clean and tidy:

 
 
 
 
 

4d. Overall I think the practice is welcoming:

 
 
 
 
 

5. Providing excellent clinical care is our priority. Please tell us how satisfied generally you are with the clinic staff you see at your surgery:

THE PRACTICE DOCTORS

5a. I feel listened to by my doctor:

 
 
 
 
 

5b. My doctor treats me with dignity and respect:

 
 
 
 
 

5c. I am confident in the treatment I receive:

 
 
 
 
 

5d. I am happy with the clinical care I receive

 
 
 
 
 

THE PRACTICE NURSE & NURSE PRACTITIONER

5e. I feel listened to by the practice nurse:

 
 
 
 
 

5f. The nurse treats me with dignity and respect:

 
 
 
 
 

5g. I am confident in the treatment I receive:

 
 
 
 
 

5h. I am happy with the clinical care I receive:

 
 
 
 
 

6. Please tell us what your experience is when contacting us by telephone:

6a. The receptionist is polite and welcoming:

 
 
 
 
 

6b. The receptionist offers me a range of appointment options (where applicable):

 
 
 
 
 

6c. I am able to speak to a doctor on the telephone:

 
 
 
 
 

6d. I am able to speak to a nurse on the telephone:

 
 
 
 
 

6e. I can obtain my test results by telephone:

 
 
 
 
 

7. Please let us know if you are aware of the following services currently provided by the practice:

7a. Pre-bookable appointments with a doctor or nurse, up to three months in advance:

 
 

7b. Booking your GP appointment on0ine (24hour/7 day a week service):

 
 

7c. Ordering your prescription on-line (24hour/7 day a week service):

 
 

(if you would like information about any of the above services please ask at reception)

8. Your comments:

Thank you for taking the time to complete this patient survey - we will publish the results soon.