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?
4. Thinking of times when you want to see a particular doctor: a) How quickly do you usually get to see that doctor?
5. a) Thinking of times when you are willing to see any doctor: a) How quickly do you usually get seen?
6. If you need to see a GP urgently, can you normally get seen on the same day [this is with any GP]?
7. a) How long do you usually have to wait at the practice for your consultations to begin?
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?
These 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?
10. Thinking about when you consult your doctor, how do you rate the following: a) How thoroughly the doctor asked about your symptoms and how you are feeling?
b) How well the doctor listens to what you had 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 quaility 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:
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?