Local Health Services Survey

1. Have you visited your GP practice in the past 12 months? (This may have been in a carer capacity, for example as a parent/carer of a young child, or a carer of an older person.)

 
 

2. Overall, how would you describe your experience of your GP practice?

 
 
 
 
 

3. The last time you needed to see or speak to a GP or nurse on the same day, were you able to get an appointment?

 
 
 
 

4. Did you have confidence and trust in the GP or health professional you saw or spoke to?

 
 
 
 
 

5. Please use the box to tell us what you LIKE about your GP practice.

6. Please use the box to tell us what you DISLIKE about your GP Practice.

7. Have you visited a pharmacy (chemist) to seek medical or health advise (i.e. more than simply collecting a prescription) in the last 12 months?

 
 

8. Was the pharmacist able to resolve your medical or health query?

 
 

9. Please use the box to tell us what you LIKE about your local pharmacy.

10. Please use the box below to tell us what you DISLIKE about your local pharmacy.

11. Have you needed urgent medical help during the evening and overnight (6.30pm to 8am) or at weekends in the past 12 months?

 
 

12. What did you do to meet your health need at this time? Think about your most recent experience. Tick all that apply.

 
 
 
 
 
 
 
 

13. Overall, how would you describe your experience of the service you used?

 
 
 
 
 

14. Did you have confidence and trust in the health professionals you saw or spoke to?

 
 
 
 
 

15. Please use the box below to expand on any of your previous answers and/or make any suggestions about what could be done to make things better.

16. Please use the box below if you wish to tell us about any other experiences you have had - good or bad of local NHS services, or make any suggestions about what could be done to make things better.

17. Have you HEARD of any of the following NHS services?

 
 
 
 
 
 
 

18. Have you USED any of the following NHS services locally in the last 12 months?

 
 
 
 
 
 

19. Where would you look for information about local health services?

20. Do you (or someone you care for) use any voluntary or charitable services, such as lunch clubs or meals on wheels, carer's groups, Age Concern, health-based meetings, or attend community events and initiatives that support and benefit your health, such as local parkrun or health walk?

 
 
 

21. Please tell us the name and location of the service(s), event(s), or initiative(s) that you (or your carer) use.

22. How often do you attend the service mentioned about, please state the name of the service followed by frequency (ie parkrun, weekly)

23. Please tell us why you, or the person you care for, attend or use these services.

24. Please provide the first three characters of your postcode (eg AL8)

25. Which GP Practice are you currently registered with?

26. What gender do you identify yourself as?

 
 
 

27. How old are you?

 
 
 
 
 
 
 

28. Do you consider yourself to have a disability?

 
 
 

29. Which of the following best describes your sexual orientation? Only answer this question if you are aged 16 years or over.

 
 
 
 
 

30. How would you describe your ethnic origin?

 
 
 
 
 
 
 
 
 

31. What is your religion or belief?

 
 
 
 
 
 
 
 
 

32. Do you, unpaid, look after someone who cannot manage without your support?

 
 
 

33. Are you currently pregnant, have you given birth within the last two weeks or are you on maternity?