Q1. Which Doctor/ANP did you see most recently?
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Dr AUGUST (f) Dr CRAWFORD (m) Dr DOOLDENIYA (m) Dr FRANCIS (f) Dr GILLIBRAND (f) Dr GREEN (m) Dr HOXLEY (f) Dr JAVANSHIR (f) Dr JONES (m) Dr LYALL (f) Dr PARDO (f) Dr WILTSHER (m) Advanced Nurse Practitioner MARRIOTT (m)
Q1. Which Doctor/ANP did you see most recently?
About the Practice: How satisfied are you with the following…?
Q2. Practice’s opening hours
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q3. Ease of getting through on the phone
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q4. Day and time arranged for your most recent doctor appoinment
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q5. Chances of seeing an unspecified (unnamed) doctor within 48 hours
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q6. How would you describe your experience of making an appointment?
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q7. Comfort level of waiting room
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
About the Doctor/ANP: How good was your doctor/ANP at each of the following…?
Q8. Being polite
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q9. Making you feel at ease
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q10. Listening to you
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q11. Assessing your medical condition
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q12. Explaining your condition and treatment
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q13. Involving you in decisions about your treatment
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q14. Providing or arranging treatment for you
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q15. Confidence in this doctor/ANPs ability
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q16. Amount of time waiting to be seen/called (after your scheduled appointment time)
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q17. Overall satisfaction with the doctor/ANP you saw
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
General: How satisfied are you with the following…?
Q18. Manner in which you are treated by the reception staff
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q19. Respect shown by reception for your privacy and confidentiality
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q20. Information provided by the practice about its services (eg repeat prescriptions, test results, costs for private work)
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q21. The opportunity for making compliments or complaints to this practice about its service and quality of care
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q22. The information provided by this practice about how to prevent illness and stay healthy (eg alcohol use, smoking, diet habit etc) is…
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q23. The website www.umsuea.co.uk is clear, concise and easy to use
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q24. How do you find our online services to book/cancel/manage appointments and repeat medications online
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q25. Did you register online with us via www.campusdoctor.co.uk/umsuea? If so – how do you rate this
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor) Not applicable
Q26. Overall satisfaction/experience with this GP practice
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5 (excellent) 4 (very good) 3 (good) 2 (fair) 1 (poor)
Please add any addition comments you wish to make…
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