Survey Questionnaire 2018

You can help the Practice to improve its service by completing this survey questionnaire and this has been developed in consultation with our Patient Participation Group.

If you are completing this after a recent appointment please provide the following information (this is optional):

Date of the appointment

Patients nameThis is optional

GP/Nurse seen

Opening Hours and appointments:

Do you know our opening hours Monday to Friday 08:00 am – 06:30 pm?

The Surgery is currently offering extended hour surgeries on Monday 7am to 8am and Wednesday and Thursday 18:30-19:30 pm. Are you aware of this service?

Making/Establishing the contact with the surgery?

How often do you telephone the practice?

If you answered 'Other' to the previous question please provide details here.

Generally, how easy is it to get through to someone at the surgery on the phone?

Making an appointments (working age Populations):

Do you know the practice is offering appointments up to four weeks ahead, are you aware of this?

The practice offers telephone consultations with the doctors (Daily), are you aware of this service?

Have you used these services (Tel consultations and or Ex-hours appts) before?

If you have used this service ((Tel consultations and or Ex-hours appts), how helpful do you find it?

The practice has a Patient online service, which allows you to book or cancel your appointment, change your address and request your repeat medication. Are you aware of this system?

If you have used the online booking service, how helpful do you find both?

Overall, how would you describe your experience for making an appointment?

Your last appointment:

Thinking about the GP or Nurse you last saw, how long did you have to wait for your consultation to begin?

Did your GP/Nurse give you enough time during your last GP appointment?

Did your GP/Nurse treat you with care and concern during your last GP/Nurse consultations?

How well did the nurse or GP involve you in decision making involving your care?

How helpful did you find the GP or Nurse you last saw?

Reception:

How helpful did you find the Receptionist you spoke to today?

Do you think the Receptionist could have done anything differently?

If you answered Yes to the previous question, please provide details here:

Your Health

Have you had enough support in the last 12 months from your local or GP to help manage your long term conditions?

Overall experience:

Please share your overall experience of this GP Practice with us?

Any other comments to help improve our appointment system?

The following questions provide us only with general information about the range of people who have responded to this survey. It will not be used to identify you, and will remain confidential.

How old are you?

Are you:

What is your ethnic group?

Which of the following best describes you?

Do you have a long standing health condition

How long have you been registered with this surgery?

Thank you very much for your time and assistance

Privacy Protection

Information entered into survey forms is used only for the purposes of processing your survey information and is stored and accessed securely by designated staff.

Issues raised in comments may be discussed between relevant members of staff. The information is used for quality monitoring purposes, in line with the expectations of those submitting the feedback.

Any personal information transmitted via survey forms may be anonymised when this is required to ensure compliance with General Data Protection Regulation.

This information is not shared with any external third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to Drs Arumugaraasah & Partners • Lister Primary Care Centre, 101 Peckham Road, London, SE15 5LJ.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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