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Dear Patient
We are keen to try and improve the service we offer to you our patients.
Your comments are very important because they will be used to help us develop a better service for all of you.
We would therefore be grateful if you could spare 10 minutes to tell us what you think of our service and what changes you would like to see.
Please answer the questions on the following pages by ticking the appropriate box or use the space provided to give us your comments. Any information you provide will be kept confidential.
Thank you very much for helping us to help you.
Section One: Access to our services
In this section we’re trying to get an idea of how people feel about accessing this practice’s services.
How often do you use the practice?
Other(please state)
Non Urgent Appointments
How easy do you find it to book a non-urgent appointment with a doctor?
How easy do you find it to book a non-urgent appointment with a nurse?
How do you normally book an appointment to see a doctor or nurse?
Other (please state)
How could we make it easier to book an appointment?
Comment
Urgent Appointments
When you last wanted to book an urgent appointment with the doctor/nurse were you able to do so?
If you couldn’t get an urgent appointment why do you think this was?
There was another reason (please state)
How easy do you find it to cancel or rearrange an appointment?
How could we make it easier for you to cancel an appointment?
Comment
If you have been cared for by any of the following healthcare professionals in the last year please tell us what you thought of the overall care you received.
District nurse
Community midwife
Health visitors
Health care assistant/worker
Specialist nurses
Specialist nurses
Specialist GP service (e.g. diabetes or dermatology)
Community physiotherapist
Occupational therapist
Intermediate care team
Do you find the premises easy to access?
Section Two: Information and Advice
The information that people have access to is really important in helping them to manage their health. We want to find out what you think of the information we provide to patients and what we should do differently.
How do you feel about the information we currently provide to you?
How do you feel about the methods we use to provide this information?
Information from the doctor or nurse
Television screen
Health leaflets
Check in screen
Notice board
Website
Other (please state)
What kind of information and advice would you like to be able to access in this practice?
Other (please state)
Do you feel that you have enough opportunity to give feedback, raise concerns and complaints or make suggestions?
Section Three: Quality of service
We believe that providing high quality services is vitally important to our patients. Please tell us what you think of our services.
Please tell us how much to agree or disagree with the following statements. Please tick ONE box for each statement.
I am treated with dignity and respect at my GP practice
My personal values and beliefs are respected by my GP practice
The receptionist/administrator was polite and helpful
I was worried because other people could overhear me talking to the receptionist
I felt bothered or threatened by other patients
The doctor or nurse listens to me
I feel that the doctor or nurse has all the information they need to treat me
The doctor or nurse talks in a way that helps me understand my condition and treatment
I am confident in the doctor or nurse’s ability to treat me
I have enough time with the doctor or nurse
I am treated with dignity and respect by the receptionist
How do you feel about being involved in decisions about your care?
Regular/Acute Medicines
Have you been prescribed any medicines by your GP in the past 12 months?
Were these medications
If you have been prescribed medicines within the last 12 months please answer the following statements.
I know enough about what my medicines are for
I know enough about how and when to take my medicines
I know enough about possible side effects of my medicines
I would know what to do if I had any problems with my medicines
What/How could we improve the information with regards to your personal medication?
Section Four: About you
We need a little bit of information about you so we can work out where things are working and for whom. We also need to know where there are areas for improvement.
Are you:
What is your age?
You do not have to answer the next few questions but your responses will help us to identify any specific needs some patients may have. All data will be kept strictly confidential.
Do you have a long-term health condition? These are sometimes called chronic diseases and include asthma, COPD, heart diseases, liver and kidney diseases or any other ongoing illness.
Do you consider yourself to be disabled?
If “yes”, what type of impairment?
Ethnic origin:
Other ethnic groups (Please specify – e.g. Chinese,)
Thank you once again for your help