Dr Milner & Partners

1. When did you last see a doctor or practice nurse at the surgery?

• Within the past 3 months
• Between 3 and 6 months ago
• More than 6 months ago
• I have never been seen by a GP or practice nurse at the surgery

2. How do you normally book your appointments?

• In person
• By telephone
• Online
• Not applicable

3. When do you normally wish to book your appointment?

• Same day
• Advanced booking (within 7 days)
• Advanced booking (7-14 days)
• Advanced booking (over 14 days)

4. Do you ever require appointments outside of normal surgery hours (8:00am to 6:00pm, Mon - Fri)?

• Yes
• No

5. If yes, which of the following extended hours surgeries would you / do you find most helpful?

• Tuesday evenings
• Saturday mornings
• Both

5. How would you describe the access to the following services:

Space Cell	Very Easy	Easy	Average	Difficult	Very Difficult
Doctors	Doctors: Very Easy	Doctors: Easy	Doctors: Average	Doctors: Difficult	Doctors: Very Difficult
Practice Nurses	Practice Nurses: Very Easy	Practice Nurses: Easy	Practice Nurses: Average	Practice Nurses: Difficult	Practice Nurses: Very Difficult
Health Care Assistants	Health Care Assistants: Very Easy	Health Care Assistants: Easy	Health Care Assistants: Average	Health Care Assistants: Difficult	Health Care Assistants: Very Difficult

6. If you need advice from a GP urgently can you normally see or speak to someone on the same day?

• Yes
• No
• Not applicable

7. If no, were you offered any of the following (please tick all applicable):

• A call back from a GP
• Advice on how to access NHS 111
• Advice on how to access the NHS Walk-in Centre
• Advice on how to access the A&E services if appropriate

7. When you wish to see ANY GP, how quickly do you usually get seen?

• Same or next day
• Between 2-4 days
• Between 5 days or more
• I don't usually need to be seen quickly

8. When you wish to see a particular NAMED GP, how quickly do you usually get seen?

• Same or next day
• Between 2-4 days
• Between 5 days or more
• I don't usually need to be seen quickly

9. How would you rate your most recent consultation with a GP?

• Very satisfied
• Fairly satisfied
• Neither satisfied or dissatisfied
• Fairly dissatisfied
• Very dissatisfied

10. Are you aware that you can register at the Practice for online services?

• Yes
• No

11. How helpful do you find the Receptionists at the Practice?

• Very helpful
• Fairly helpful
• Neither helpful or unhelpful
• Fairly unhelpful
• Very unhelpful

12. How would you rate the cleanliness of the Practice?

Space Cell	Very Good	Good	Average	Poor	Very Poor
Tramways	Tramways: Very Good	Tramways: Good	Tramways: Average	Tramways: Poor	Tramways: Very Poor
Middlewood	Middlewood: Very Good	Middlewood: Good	Middlewood: Average	Middlewood: Poor	Middlewood: Very Poor

13. How would you rate the site and grounds at the Practice (i.e inside the buildings, car parks, gardens)?

Space Cell	Very Good	Good	Average	Poor	Very Poor
Tramways	Tramways: Very Good	Tramways: Good	Tramways: Average	Tramways: Poor	Tramways: Very Poor
Middlewood	Middlewood: Very Good	Middlewood: Good	Middlewood: Average	Middlewood: Poor	Middlewood: Very Poor

16. How would you rate your most recent visit to the Practice?

• Very positive
• Fairly positive
• Neither positive or negative
• Fairly negative
• Very negative

17. Are you:

• Male
• Female
• Other
• Prefer not to say

18. Your age is:

• Under 16
• 16 - 44
• 45 - 64
• 65 - 74
• 75 or over

19. Do you have any long standing medical conditions?

• Yes
• No
• Don't know/can't say

20. How long have you been registered with the practice?

• 0- 5 Years
• 6- 10 Years
• 11- 20 Years
• 21- 30 Years
• 31- 50 Years
• More than 50 years

21. Which of these best describes you at present?

• Employed
• Unemployed/looking for work
• Retired or doing something else
• Disabled/long-term sickness
• In full or part time education (school, college, university)
• Carer/looking after your family
• Other