1. Patients receive the best care from the staff working at this practice (General satisfaction) | □ | □ | □ | □ | □ |
2. I feel it is easy to speak to my doctor by telephone (Access) | □ | □ | □ | □ | □ |
3. The doctor clearly explains what is wrong before giving any treatment (Doctors) | □ | □ | □ | □ | □ |
4. Getting an appointment at a convenient time is easy (Appointments) | □ | □ | □ | □ | □ |
5. The practice nurses do not take care to explain things carefully (Nurses) | □ | □ | □ | □ | □ |
6. The doctor does enough tests to find out what is wrong (Doctors) | □ | □ | □ | □ | □ |
7. I have absolute faith and confidence in the doctors (General satisfaction) | □ | □ | □ | □ | □ |
8. The doctor is always available to give advice over the telephone (Access) | □ | □ | □ | □ | □ |
9. The doctor does not tell me enough about the treatment (Doctors) | □ | □ | □ | □ | □ |
10. The surgery building could do with some improvements (Facilities) | □ | □ | □ | □ | □ |
11. The doctor fully explains how the illness will affect my future health (Doctors) | □ | □ | □ | □ | □ |
12. It is easy to get advice over the telephone (Access) | □ | □ | □ | □ | □ |
13. The doctor is very careful to check everything when examining me (Doctors) | □ | □ | □ | □ | □ |
14. I am satisfied with the out of hours service (Access) | □ | □ | □ | □ | □ |
15. The doctor is always interested (Doctors) | □ | □ | □ | □ | □ |
16. The practice has good facilities for dealing with emergencies which occur when the surgery is closed (Access) | □ | □ | □ | □ | □ |
17. The doctor always asks about how my illness affects everyday life (Doctors) | □ | □ | □ | □ | □ |
18. I sometimes feel I have not been given enough information by the doctor (Doctors) | □ | □ | □ | □ | □ |
19. I am not satisfied with my doctor (General satisfaction) | □ | □ | □ | □ | □ |
20. The practice nurse does not always listen carefully when I talk about my problems (Nurses) | □ | □ | □ | □ | □ |
21. There are one or two things about this surgery I am not happy about (General satisfaction) | □ | □ | □ | □ | □ |
22. The waiting room is uncomfortable (Facilities) | □ | □ | □ | □ | □ |
23. The receptionists explain things clearly to me (Access) | □ | □ | □ | □ | □ |
24. Sometimes the doctor makes me feel I am wasting his/her time (Doctors) | □ | □ | □ | □ | □ |
25. I don't feel confident discussing my problems with the doctor (Doctors) | □ | □ | □ | □ | □ |
26. Appointments are easy to make whenever I need them (Appointments) | □ | □ | □ | □ | □ |
27. The doctor seems to want to get rid of me as soon as possible (Doctors) | □ | □ | □ | □ | □ |
28. The doctor gives me every chance to talk about all my problems (Doctors) | □ | □ | □ | □ | □ |
29. I feel perfectly satisfied with the way I am treated at the surgery (General satisfaction) | □ | □ | □ | □ | □ |
30. It is often difficult to get an appointment with a doctor (Appointments) | □ | □ | □ | □ | □ |
31. The doctor sometimes fails to appreciate how ill I am (Doctors) | □ | □ | □ | □ | □ |
32. The doctor shows a genuine interest in my problems (Doctors) | □ | □ | □ | □ | □ |
33. The receptionists ask patients the right questions (Access) | □ | □ | □ | □ | □ |
34. There are not enough seats in the waiting room (Facilities) | □ | □ | □ | □ | □ |
35. The doctor does everything needed to arrive at a diagnosis (Doctors) | □ | □ | □ | □ | □ |
36. The practice nurse is always very reassuring. (Nurses) | □ | □ | □ | □ | □ |
37. The doctor always puts me at ease (Doctors) | □ | □ | □ | □ | □ |
38. The waiting room seats are uncomfortable (Facilities) | □ | □ | □ | □ | □ |
39. It is easy to see the doctor of my choice (Appointments) | □ | □ | □ | □ | □ |
40. The doctor is very understanding (Doctors) | □ | □ | □ | □ | □ |
41. I have thought of changing to another practice (General satisfaction) | □ | □ | □ | □ | □ |
42. Even when the doctor is busy I am examined properly (Doctors) | □ | □ | □ | □ | □ |
43. I can speak to a receptionist privately if I wish (Access) | □ | □ | □ | □ | □ |
44. The doctor knows when tests are necessary (Doctors) | □ | □ | □ | □ | □ |
45. The practice nurse makes me feel that I'm wasting his/her time (Nurse) | □ | □ | □ | □ | □ |
46. I do not feel rushed when I am with the doctor (Doctors) | □ | □ | □ | □ | □ |
Finally, we would ask you a few questions about yourself so that we can see how different groups of people (e.g. men/women) feel about the services offered by their General Practice. |
1. Are you: | □ Male | □ Female | (Please tick) | | |
2. Are you disabled? | □ Yes | □ No | (Please tick) | | |
3. How old are you? | ________ years | | | | |
4. How many children, under the age of 16, do you have in your home? | ________ | | | | |
5. How many times have you seen the doctor in the last year? | ________ | | | | |
6. How many times has the doctor come to see you at home in the past year? | ________ | | | | |
7. How many times have you tried to contact the doctor when the surgery was closed in the past year | ________ | | | | |
8. Do you have a telephone at home? | ________ | | | | |
Thank you for your help. Now please return the questionnaire. |