Julia Engwell Health Centre (F82025)
Julia Engwell Health Centre
Patient Reference Group (PRG)
A PRG give patients the opportunity to give and receive feedback on GP services.
If you are interested in joining your surgery PRG ask a member of staff for a leaflet and leave your contact details.
Your Local NHS
Have you Say
We want to know what you think…………..
We welcome your input to help us develop surveys, services, local priorities and take action.
By giving us your telephone number, mobile number and e-mail address, we will be able to contact you from time-to-time to as your views to help shape your local service.
Please fill the form and hand to the receptionist.
Name: ______
Phone: Home______Mobile: ______
Your e-mail: ______Postcode: ______
We won’t use your contact details for anything else.
SIGNING UP FOR OUR PATIENT REFERENCE GROUP
The information below will help to make sure that we receive feedback from a representative sample of the patients registered at this practice. Please circle the option.
1. Gender
Male Female
2.Your age18 – 24 25 - 34
35 - 44 45 - 54
55 – 64 65 – 74
75 – 84 Over 84
3. Ethnicity(this refers to your ethnic group not your nationality)
WhiteBritishIrishOther
AsianBangladeshiIndianPakistani Other
Black or Black BritishAfricanCaribbeanOther
Mixed RaceWhite/AsianWhite/Black AfricanWhite/CaribbeanOther
Other ethnic originChineseOther
Please tell us your main language is: ______
4. How would your describe how often you come to practice?
RegularlyOccasionallyVery rarely
5. Are your day activities limited because of a health problem or impairment which has lasted, or is expected to last at least 12 months?
YesNo
If you answered yes to 5, please note which of these problems you have? It would help us if you can tell us if you feel disability limits you a little or a lot.
Physical impairmentSensory impairmentlong standing illness
Mental health conditionsLearning disability/difficulty Other______
Thank you.
Please note that this information will be only used for PATIENT REFERENCE GROUP.
The information you supply us will be used lawfully, In accordance with the Data Protection Act 1998. The Data Protection Act 1998 gives you the right to know what information is held about you, and sets out rules to make sure that this information is handled properly.
Julia Engwell Health Centre
PATIENT SATISFACTION QUESTIONNAIRE
In order to continue to improve the quality of our services we need to monitor the requirements and expectations of our patients. We would be grateful therefore, if you could take a little time to fill in this short questionnaire, which as you will see, will remain anonymous. Please tick the appropriate box.
THE STAFF
If you telephones the surgery for an appointment was the telephone answered?
Promptly After a short wait After a long wait
How do you rate the way that you were spoken to on the phone by the reception staff?
Very good Good Neither good or poor Poor Very poor
How do you rate the way that you were greeted at reception by the staff?
Very good Good Neither good or poor Poor Very poor
WAITING TIMES
How long after your appointment time do you normally wait to be seen?
Less that 5 minutes 5 – 15 minutes More than 15 minutes Can’t remember
How do you feel about how long you have to wait before being seen?
I don’t normally have to wait too long I have to wait a bit too long
I have to wait far too long No opinion
OPENING HOURS
How satisfied are you with the hours that your GP surgery is open?
Very satisfied Fairly satisfiedNeither satisfied or dissatisfied
Very dissatisfied I’m not sure when my GP is open
If not satisfied which of the following additional opening hours would make it easier for you?
Before 8am At lunchtime Sunday None of these
THE GP/NURSE
Last time you saw or spoke to a GP/Nurse from your GP surgery, how good was that GP/Nurse at each of the following:
Listening to you:
Very good Good Neither good nor poor
Poor Very poor Doesn’t Apply
Explaining tests and treatment:
Very good Good Neither good nor poor
Overall how would you rate the service provided by your GP/Nurse:
Very good Good Neither good nor poor
Poor Very poor Doesn’t Apply
Please turn over
Julia Engwell Health Centre
PATIENT SATISFACTION QUESTIONNAIRE continued….
MAKING AN APPOINTMENT
Were you able to see doctor on the same day or next 2 days the surgery was open?
Yes No can’t remember
Were you able to get an appointment with a doctor more than 2 days in advance?
Yes No can’t remember
Did you get the appointment of your choice?
Yes No
If you did not get an appointment of your choice, why was that?
There weren’t any appointment for the day I wanted
There weren’t any appointment for the time I wanted
My preferred GP was already booked in advance
I couldn’t book ahead at my GP surgery.
Another reason______
Overall how would you describe your experience of making an appointment?
Very good Good Neither good or poor Poor Very poor
Overall, how would you describe your experience of your GP surgery?
Very good Good Neither good or poor Poor Very poor
If you have any other recommendation to improve the service please let us know:
______
______
______.
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