Proposal to change the provider holding the contract at City Road Medical Centre to The Islington GP Group Limited

Patient Feedback

City Road Medical Centre would like your views about a proposal to change how the practice is run, with a change of provider holding the contract from Dr Sauvage and Dr O’Riordan to The Islington GP Group Ltd. The important thing you need to know as a patient is that the care you receive will stay the same. You will still be able to see the same health care professionals e.g. doctors, nurses, pharmacists etc, we will be open for the same hours and the appointment booking system will continue as it is with a mixture of telephone calls, online consultations and face to face appointment etc. Before we proceed, we would like to know what you think about the proposal and what impact it may have on you. Please take the time to feed your thoughts back about this proposal.

We will collate all the responses, and this will inform our application to change the ownership of the contract.

Hard copies of the form are also available at the practice reception.

All responses will be confidential.

Please tick the boxes that apply to you.

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* 1. Are you a

Patient

Carer

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* 2. Do you consider yourself to have a disability or a long-term health condition?

Yes

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* 3. What is your gender?

Male

Female

Other

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* 4. What is your age bracket?

Under 24

25-50

51-74

Over 75

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* 5. Ethnic Group: please tick the boxes that apply to you

White - English, Welsh, Scottish, Northern Irish or British

White - Irish

White - Gypsy or Irish Traveller

White - Polish

White - Other

Mixed or Multiple ethnic groups - White and Black Caribbean

Mixed or Multiple ethnic groups - White and Black African

Mixed or Multiple ethnic groups - White and Asian

Mixed or Multiple ethnic groups - Other

Asian or Asian British - Indian

Asian or Asian British - Pakistani

Asian or Asian British - Bangladeshi

Asian or Asian British - Other

Black, African, Caribbean or Black British - African

Black, African, Caribbean or Black British - Caribbean

Black, African, Caribbean or Black British - Other

Chinese

Arab

Other

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* 6. What comments do you have regarding the proposal for Islington GP Federation to lead the running of City Road Medical Centre, along with the existing team?

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* 7. What do you like about City Road Medical Centre that you would like to see continue if the proposed change takes place?

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* 8. What do you think could be better or improved at City Road Medical Centre?

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* 9. What is your full postcode?

Thank you for completing this survey. Your feedback will help us make the best decisions for our patients.