1
In the past 12 months, how
many times have you seen a doctor
from your practice?
2 How do you rate the way you are treated
by receptionists at your practice?
3 a) How do you rate the hours that
your practice is open for appointments?
b)
What
additional hours would you like the practice to be open?(our
current hours are Monday to Thursday 0800 to 2000 and 0800 to 1830 on
Fridays)
4 Thinking of times when you want to see a
particular doctor:
a) How quickly do you
usually get to see that
doctor?
b)
How do you rate
this?
5 Thinking of times when you are willing to
see any doctor:
a) How quickly do you
usually get seen?
b) How do you rate this?
6 a)If you need to see a GP urgently, can
you normally get seen on the same day?
b)Have you tried to make appointments
through our website?
c) if so, how do you rate the facility?
7 a) How long do you usually have to
wait at the practice for your consultations to begin?
b) How do you rate this?
c) Which
doctor do you normally see?
8 Thinking of times you have phoned
the practice, how do you rate the following:
a) Ability to get through to the
practice on the phone?
b) Ability to speak to a doctor
on the phone when you have a question or
need medical advice?
The next questions ask about your usual
doctor. If you don’t have a ‘usual doctor’, answer about the one doctor
at your practice who you know best. If you don’t know any of the doctors, go
straight to question 11.
9 a) In general, how often do
you see your usual doctor?
b) How do you rate this?
10 Thinking about when you consult
your usual doctor, how do you rate the following:
a) How thoroughly the doctor asks about
your symptoms and how you are feeling?
b) How well the doctor listens to what
you have to say?
c) How well the doctor puts you
at ease during your physical
examination?
d) How much the doctor involves you
in decisions about your care?
e) How well the doctor explains your
problems or any treatment that you need?
f) The amount of time
your doctor spends with you?
g) The doctor’s patience with your
questions or worries?
h) The doctor’s caring and
concern for you?
11: Have you seen a nurse from your practice in
the past 12 months?
12 Thinking about the nurse(s) you have
seen, how do you rate the following:
a) How well they listen to what you say?
b) The quality of care they provide?
c) How well they explain your health
problems or any treatment that you need?
Finally, it will help us to understand your
answers if you could tell us a little about yourself:
13 Are you:
14 How old are you?
years
15 Do you have any long-standing
illness, disability or infirmity? By long-standing we mean anything
that has troubled you over a period of
time or that is likely to affect you over a period of time.
16 Which ethnic group do you belong
to?
17 Is your accommodation:
18 Which of the following best describes
you?
19 We are interested in any other comments you
may have. Please write them here.
Is there anything
particularly good about the services that we provide for your health care?
Is there anything that could be improved?
Any other comments?
To submit the questionnaire to us, please press
the submit button; if you wish to restart, press the Reset button
OUR SINCERE THANKS TO YOU FOR YOUR HELP WITH
THIS
