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The General Practice Assessment Questionnaire
1
The General Practice Assessment Questionnaire
In the past 12 months, how many times have you seen a doctor from your practice?
Please Choose...
None
Once or twice
Three or four times
Five or six times
Seven times or more
Ability to get through to the practice on the phone?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
How do you rate the hours that your practice is open for appointments?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
2
What additional hours would you like the practice to be open? (Please tick all that apply)
Early Morning
Lunchtime
Evenings
Weekends
Non I am satisified
3
Thinking of times when you want to see a particular doctor
How quickly do you usually get to see that doctor?
Please Choose...
Same day
Next working day
Within 2 working days
Within 3 working days
Within 4 working days
5 or more working days
Does not apply
How do you rate this?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
Does not apply
4
Thinking of times when you are willing to see any doctor
How quickly do you usually get seen?
Please Choose...
Same day
Next working day
Within 2 working days
Within 3 working days
Within 4 working days
5 or more working days
Does not apply
How do you rate this?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
Does not apply
If you need to see a GP urgently, can you normally get seen on the same day?
Please Choose...
Yes
No
Don’t know
Never needed to
How long do you usually have to wait at the practice for your consultations to begin?
Please Choose...
5 mins or less
6-10 mins
11-20 mins
21-30 mins
More than 30 min
How do you rate this wait?
Please Choose...
Very poor
Poor
Fair
Good
Very poor
Excellent
How do you rate the way you are treated by the receptionists at your practice?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
Don’t know
How helpful do you find the receptionist at the surgery?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
Don’t know
5
The next questions ask about your usual doctor, if you don’t have a ‘usual doctor’, answer about the one doctor at your practice whom you know best. If you don’t know any of the doctors, go straight to the question about Home Visits
How clean/comfortable do you find the waiting room?
Please Choose...
Always
Almost always
A lot of the time
Some of the time
Almost never
Never
How do you rate the leaflets/posters available in the waiting area?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
How thoroughly the doctor asks about your symptoms and how you are feeling?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
Does not apply
How well the doctor listens to what you have to say?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
Does not apply
How well the doctor puts you are ease during your physical examination?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
Does not apply
How much the doctor involves you in decisions about your care?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
Does not apply
How well the doctor explains your problems or any treatment that you need?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
Does not apply
The amount of time your doctor spends with you?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
Does not apply
The doctor’s patience with your questions or worries?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
Does not apply
The doctor’s caring and concern for you?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
Does not apply
6
Home Visits
Have you requested a home visit in the past 12 months?
Please Choose...
Yes
No
Do you have any comments about the visit?
7
Thinking about the nurse(s) you have seen, how do you rate the following
How well they listen to what you say?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
The quality of care they provide?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
How well they explain your health problems or any treatment that you need?
Please Choose...
Very poor
Poor
Fair
Good
Very good
Excellent
8
General Information
All things considered, how satisfied are you with your practice?
Please Choose...
Completely satisfied
Very satisfied
Fairly satisfied
Neutral
Fairly dissatisfied
Very dissatisfied
Completely dissatisfied
Are You?
Please Choose...
Male
Female
How old are you?
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?
Please Choose...
Yes
No
Which ethnic group do you belong to?
Please Choose...
White
Black or Black British
Asian or Asian British
Mixed
Chinese
Other ethnic group
Is your accommodation:
Please Choose...
Owner-occupied/mortgaged
Rented or other arrangements
Which of the following best describes you?
Please Choose...
Employed (full or part-time, including self-employed)
Unemployed and looking for work
At school or in full time education
Unable to work due to long term sickness
Looking after a your home/family
Retired from paid work
Other
9
We are interested in any other comments you may have
Is there anything particularly good about your health care?
is there anything that could be improved?
Any other comments?
Submit Survey Response
© Moseley Avenue Surgery 2012
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109 Moseley Avenue, Coundon, Coventry, CV6 1HS
Telephone 024 7659 2201
Email
thelma.briggs@nhs.net
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