We are undertaking a formal consultation about the possibility of merging the patient lists of New Coningsby Surgery, Newmarket Medical Practice and The Wolds Practice to create one practice.  The new practice would continue to operate from its current three sites.

Frequently asked questions and details of the road show events we will be holding are available from your Practice on the websites. After reading the relevant information and / or attending one of the events, we are asking for your views on this proposal and would like you to complete this short survey. Please share your views by the closing date of 25th September 2017.

* 1. Please tell us which GP Practice you are currently registered with?

* 2. Approximately how far do you live from your practice?

* 3. What form of transport do you currently use to visit your GP surgery?

* 4. To what extent do you understand the reasons for the merger of these practices?

* 5. If you do not have a good understanding of this proposal, please tell us what other information you need:

* 6. What is most important to you when accessing a GP Practice? (please tick only 2):

* 7. Please tell us below what you feel the advantages of this merger could be:

* 8. Please tell us below if there is anything about this merger that would cause you concern and, if so, please give us your suggestions of how we could address this:

* 9. Please tell us below if you have any other comments:

Equalities Monitoring

Under the provisions of the Equality Act 2010, all NHS organisations are required to demonstrate that their processes are fair, and that they are not discriminating or disadvantaging anyone because of their age, disability, gender reassignment status, marriage or civil partnership status, pregnancy or maternity, race, religion or belief, sex or sexual orientation. Please help us to monitor how well we engage with the population we serve, by completing the monitoring section below.  Your answers will be kept strictly confidential in line with the Data Protection Act 1998 and you will not be personally identifiable through your answers.

* 10. Gender

* 11. Age:

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

* 13. If yes, what is your disability or long term health condition?

* 14. How do you describe your ethnic origin?

* 15. What is your employment status?

This document is available in other languages and formats on request. To request alternative formats, or if you require the services of an interpreter, please contact us.