Sorsby Health Centre Feedback Question Title * 1. We propose that the surgery will be open from 8am to 6.30pm Monday to Friday. On a scale of 1-5, where 1 is not at all and 5 is completely, how do these opening hours meet your needs? 1 2 3 4 5 Don't know Please provide further details if you wish OK Question Title * 2. Please rank the following in order of importance (with 5 being the most important and 1 being the least important). 1 2 3 4 5 that you can book an appointment the first time that you speak to the receptionist, without having to call back 1 2 3 4 5 that you can book an appointment online 1 2 3 4 5 that you can book an appointment at short notice (i.e. the same or next day) 1 2 3 4 5 That you can plan your routine visits by being able to book several weeks in advance 1 2 3 4 5 that you are seen on time when you have booked an appointment OK Question Title * 3. On a scale of 1 to 5, where 1 is not important at all and 5 is very important, how important is it to be able to request to see either a male or female GP? 1 2 3 4 5 Please use this scale Please use this scale 1 Please use this scale 2 Please use this scale 3 Please use this scale 4 Please use this scale 5 OK Question Title * 4. On a scale of 1 to 5, where 1 is not important at all and 5 is very important, how important is it that you are able to choose which doctor you see for a routine appointment, even if you have to wait a little longer to see your chosen doctor? 1 2 3 4 5 Please use this scale Please use this scale 1 Please use this scale 2 Please use this scale 3 Please use this scale 4 Please use this scale 5 OK Question Title * 5. Have you ever gone to a hospital Accident and Emergency department or a walk-in centre, or called NHS 111 rather than trying to see a GP? Yes No Don't Know OK Question Title * 6. If you answered yes to the above, why? I couldn’t get an appointment with my GP The appointment I was offered was not soon enough My GP practice was closed I couldn’t get through on the phone to speak to my GP surgery I felt I needed emergency treatment Other reason - please specify below Please provide further details if you wish OK Question Title * 7. What is important to you when talking to or visiting your GP reception? OK Question Title * 8. Do you feel that you have enough support and information to help you manage common ailments - such as coughs and colds, mild skin conditions, and vomiting and diarrhoea - yourself, without needing to visit or get advice from your GP? Yes No Don't know Provide further details if you wish OK Question Title * 9. Do you consider yourself, or someone you care for, to have a long term condition? Yes No Don't know OK Question Title * 10. If you answered yes to the above question, do you feel you have enough support and information to help you manage your long term condition(s)? Yes No Don't know Provide further details if you wish OK Question Title * 11. Do you feel you have enough information about the following NHS services? GP hubs Community pharmacies NHS 111 Walk-in centres Patient online services Use the drop down Yes No Don't know Use the drop down GP hubs menu Yes No Don't know Use the drop down Community pharmacies menu Yes No Don't know Use the drop down NHS 111 menu Yes No Don't know Use the drop down Walk-in centres menu Yes No Don't know Use the drop down Patient online services menu Please provide further details if you wish OK Question Title * 12. Apart from being able to see a GP or nurse when you are ill, are there any other services currently provided at your GP surgery that you particularly value? Yes No Don't know Please provide details if you wish OK Question Title * 13. Are there any other services that you would like to see provided at the surgery? Yes No Don't know Please provide further details if you wish OK Question Title * 14. On a scale of 1 to 5, where 1 is not important at all and 5 is very important, how important is it that the practice involves the PPG in appropriate and relevant decisions about services and standards at your practice? 1 2 3 4 5 Use the scale provided Use the scale provided 1 Use the scale provided 2 Use the scale provided 3 Use the scale provided 4 Use the scale provided 5 Provide further details if you wish OK Question Title * 15. On a scale of 1 to 5, where 1 is not important at all and 5 is very important, how important is it that your surgery has a website from which you can order repeat prescriptions, book appointments and view your medical record? 1 2 3 4 5 Use the scale provided Use the scale provided 1 Use the scale provided 2 Use the scale provided 3 Use the scale provided 4 Use the scale provided 5 OK Question Title * 16. Tell us what you value about your surgery’s website? OK Question Title * 17. Tell us what else you would like from your surgery’s website OK Question Title * 18. Does your GP practice send you appointment reminders by text message? Yes No Don't know OK Question Title * 19. If you answered yes to the above question, how useful do you find these text messages and is there any other information you would like to receive in this way? OK Question Title * 20. Do you consider yourself or someone you care for to have a disability? Yes No OK Question Title * 21. If you or someone you care for has a disability, what aspects of your practice do you find helpful and what could be improved? Yes No OK Question Title * 22. If you or someone you care for have difficulty speaking, reading or understanding English, what facilities at your practice do you find helpful and what could be improved? OK Question Title * 23. Is there anything else that you would like us to take into account when making a decision about appointing a new GP services provider to run your GP practice? OK Question Title * 24. Are you male or female? Male Female Prefer not to answer OK Question Title * 25. How old are you? 0 - 14 15 - 29 30 - 44 45 - 64 65 - 74 85+ Prefer not to answer OK Question Title * 26. Which of the following best describes your sexual orientation? (Tick ONE box only) Heterosexual Bisexual (both sexes) Gay or Lesbian (same sex) Other Prefer not to answer OK Question Title * 27. What is your ethnic group? English, Welsh, Scottish, Northern Irish or British Gypsy or Irish Traveller Any other White background White and Black Caribbean White and Black African White and Asian White and Asian Any other Mixed/Multiple ethnic background Indian Chinese Pakistani Bangladeshi Any other Asian backgroun African Caribbean Any other Black, African or Caribbean background Arab Any other ethnic group If you answered other, please specify if you wish OK DONE