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1.
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In the past 12 months, how many times have you seen a doctor from
your practice?
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2.
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How do you rate the way you are treated by receptionists at your
practice?
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3 a)
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How do you rate the hours that your practice is open for appointments?
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3 b)
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What additional hours would you like the practice to be open?
(please tick all that apply)
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4.
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Thinking of times when you want to see a particular doctor:
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a)
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How quickly do you usually get to see that doctor?
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b)
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How do you rate this?
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5.
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Thinking of times when you are willing to see any doctor:
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a)
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How quickly do you usually get seen?
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b)
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How do you rate this?
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6.
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If you need to see a GP urgently, can you normally get seen on
the same day?
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7. a)
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How long do you usually have to wait at the practice for your consultations
to begin?
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7 b)
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How do rate this?
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8.
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Thinking of times you have phoned the practice, how do you rate
the following:
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a)
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Ability to get through to the practice on the phone?
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b)
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Ability to speak to a doctor on the phone when you have a question
or need medical advice?
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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.
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9. a)
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In general, how often do you see your usual doctor?
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9. b)
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How do you rate this?
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10.
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Thinking about when you consult your doctor, how do you rate the
following:
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a)
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How thoroughly the doctor asked about your symptoms and how you
are feeling?
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b)
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How well the doctor listens to what you had to say?
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c)
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How well the doctor puts you at ease during your physical examination?
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d)
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How much the doctor involves you in decisions about your care?
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e)
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How well the doctor explains your problems or any treatment that
you need?
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f)
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The amount of time your doctor spends with you?
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g)
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The doctor's patience with your questions or worries?
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h)
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The doctor's caring and concern for you?
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11.
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Have you seen a nurse from your practice in the past 12 months?
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12.
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Thinking about the nurse(s) you have seen, how do you rate the
following:
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a)
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How well they listen to what you say?
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b)
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The quality of care they provide?
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c)
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How well they explain your health problems or any treatment that
you need?
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Finally, it will help us to understand your answers if you could tell us a little
about yourself:
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13.
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Are you:
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14.
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How are old are you?
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15.
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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.
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16.
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Which ethnic group do you belong to?
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17.
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Is your accommodation?
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18.
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Which of the following best describes you?
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19.
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We are interested in any other comments you may have. Please enter them below.
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