Practice ID

Patient ID

Q1. Times seen doctor in past 12 months

Q2. Receptionists rating

Q3a. Rating of opening hours

Q3b. Additional hours requested For this question, more than one response can be ticked. Enter a value in the corresponding column if a box has been ticked. If it has not, leave the cell blank. Don't enter a zero for boxes that have not been ticked.

Q4a. How quickly you get seen (particular doctor)

Q4b. Rating

Q5a. How quickly you get seen (any doctor)

Q5b. Rating

Q6. Seeing a GP urgently

Q6B Website appointments

Q6c Rating website appts

Q7a. Waiting times in practice

Q7b. Rating

Q7c; Which dr normally seen

Q8a. Ability to get through to practice on phone

Q8b. Ability to speak to dr on phone

Q9a. How often you see your usual dr

Q9b. Rating

Q10a. How thoroughly dr asks about symptoms

Q10b. How well dr listens to what you say

Q10c. How well dr puts you at ease

Q10d. How much dr involves you in decisions about care

Q10e. How well dr explains problems/treatments

Q10f. The amount of time the dr spends with you

Q10g. Dr's patience with your questions or worries

Q10h. Dr's caring and concern for you

Q11. Seen nurse from practice in past 12 months

Q12a. How well nurse listens to what you say

Q12b. Quality of care nurse provides

Q12c. How well nurse explain problems/treatments

Q13. Sex

Q14. Age

Q15. Long standing illness, disability or infirmity

Q16. Ethnicity

Q17. Accommodation

Q18. Employment

list

list

list

list

list

earl morning

Lunchtime

Evenings

Weekends

None

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

list

4

5

5

1

2

5

2

5

1

6

3

2

1

4

4

3

4

4

4

5

5

4

5

5

5

1

6

6

6

1

72

2

1

1

6

5

6

6

1

1

6

1

6

1

1

4

0

5

1

4

4

1

6

4

4

6

5

4

5

5

6

1

4

4

4

2

50

2

1

1

1

4

5

5

1

2

6

1

6

1

2

2

4

1

4

2

5

6

5

5

5

5

5

5

6

1

4

4

5

2

61

2

1

1

1

3

6

6

1

1

6

1

6

1

2

1

5

1

6

6

1

6

6

6

6

6

6

6

6

6

1

6

6

6

2

54

1

1

1

1

3

5

6

1

7

1

5

1

2

3

3

4

3

4

5

5

5

5

5

5

5

5

2

1

38

2

1

1

1

2

6

4

1

2

5

2

4

2

2

3

3

4

4

2

5

5

6

5

4

4

4

2

5

4

1

81

1

1

1

6

2

4

6

1

6

3

2

4

2

2

3

1

5

2

4

5

4

5

4

5

5

5

5

2

1

47

1

1

1

1

2

5

6

1

2

4

1

1

2

2

3

1

4

1

5

4

5

4

4

4

3

4

4

1

4

4

4

1

62

1

1

1

6

3

5

6

1

3

5

7

2

3

2

2

3

1

6

6

5

5

5

4

6

6

5

1

1

2

2

2

32

1

1

2

1

2

6

6

1

3

6

2

6

2

2

5

1

6

2

6

6

6

6

6

6

6

6

6

2

1

39

1

1

1

1

2

4

5

1

5

3

5

3

2

3

2

3

5

3

4

4

4

4

5

3

4

4

2

1

39

1

1

1

1

2

5

4

1

3

4

2

2

3

2

4

1

5

4

5

4

4

5

1

5

5

6

2

30

2

1

2

1

2

6

6

1

2

6

1

6

1

1

5

2

4

2

6

5

1

6

6

6

6

6

6

5

6

6

1

6

6

6

1

62

1

1

1

1

2

6

6

1

2

6

2

6

1

2

2

5

1

6

2

6

6

6

6

6

6

6

6

6

2

1

39

1

1

1

1

4

5

5

1

2

5

1

5

3

2

2

5

2

2

5

5

5

5

5

5

5

5

5

1

5

5

5

2

35

2

1

1

1

2

6

6

2

6

7

1

1

6

1

4

1

5

1

6

6

6

6

6

6

6

6

6

2

6

6

2

53

1

1

1

1

4

6

6

1

1

6

1

1

6

0

5

1

6

6

1

6

6

6

6

6

6

6

6

6

1

6

6

6

5

6

6

1

3

5

1

6

1

2

1

5

2

6

3

2

5

6

5

6

5

6

6

6

6

1

5

6

5

2

46

1

2

2

1

2

6

6

1

7

5

7

5

2

1

4

2

6

1

6

6

6

6

4

6

6

4

4

1

6

6

6

1

35

1

1

2

2

3

5

5

1

4

5

3

5

2

2

3

2

4

1

5

5

5

5

5

5

5

5

5

1

5

5

5

2

59

1

1

1

1

3

6

6

1

1

6

1

6

1

2

3

4

3

5

2

5

6

6

6

6

6

6

6

6

1

6

6

6

2

40

2

1

2

1

2

5

4

1

2

4

7

1

1

3

2

3

1

4

5

1

6

5

6

6

5

6

5

6

5

1

4

4

5

1

65

1

1

1

6

3

6

5

1

4

5

7

1

1

2

4

2

6

1

6

6

6

6

6

6

6

6

6

1

5

5

4

3

6

5

1

3

5

3

5

1

6

2

4

1

3

1

5

5

6

5

5

5

5

5

6

1

5

6

6

2

48

2

1

1

1

5

4

5

1

2

5

7

1

1

3

2

2

3

5

4

1

6

6

6

6

6

6

6

6

6

1

5

5

5

1

49

1

1

2

4

2

6

5

1

2

6

2

6

2

3

3

5

1

6

6

6

6

6

6

6

6

6

1

6

6

6

1

89

1

1

1

3

5

5

1

2

6

1

6

2

6

1

4

1

4

1

5

4

3

5

3

4

3

4

5

2

1

59

1

1

1

1

2

3

3

1

3

3

3

3

1

2

3

2

6

5

2

5

5

5

5

6

3

6

6

1

5

4

4

2

32

1

1

2

1

3

5

5

1

2

6

1

6

2

5

1

5

1

4

1

6

4

3

5

4

4

3

4

5

2

1

59

1

1

1

1

2

6

6

1

1

6

1

6

1

1

6

2

4

1

5

4

2

5

4

4

4

4

4

4

5

5

1

4

4

4

2

1

1

1

1

3

5

4

1

4

3

3

3

1

2

3

3

1

3

3

1

6

5

5

5

5

5

5

5

5

2

1

41

2

1

2

1

2

5

5

3

5

1

6

2

4

3

2

5

5

3

6

6

6

6

6

6

6

6

6

1

6

6

5

2

36

1

1

3

3

1

3

5

1

3

3

7

2

2

2

4

1

5

4

2

5

6

6

6

6

6

6

6

6

2

6

6

6

1

2

5

6

6

1

2

6

1

6

1

1

3

2

4

4

6

6

2

6

6

6

6

6

6

6

6

6

1

5

5

5

2

36

2

1

1

5

2

5

5

1

3

4

7

2

2

3

1

5

1

5

5

5

5

5

5

5

5

1

5

5

5

1

60

2

1

1

1

2

3

5

1

6

3

3

3

2

3

3

4

1

5

5

5

2

25

2

1

2

1

2

6

6

1

3

6

3

6

2

1

5

1

6

6

1

6

6

6

6

6

6

6

6

6

1

6

6

6

2

1

2

1

3

5

5

1

2

6

1

6

1

1

4

2

3

4

5

2

6

6

5

6

6

6

6

6

6

1

6

6

6

1

52

1

1

2

4

2

6

6

1

1

6

2

6

2

2

4

1

5

1

6

5

5

5

5

5

5

5

5

1

5

5

5

1

65

2

1

1

6

2

6

5

1

3

5

3

5

2

3

4

1

5

4

2

5

5

5

5

5

5

4

5

5

1

6

6

6

1

55

2