The Border Practice Patient Reference Group Survey

Firstly we would like to thank you for agreeing to complete this on-line survey. It is very important for us to know what you would like from us, especially in light of all the changes within the NHS.

You will see that the first few questions cover such things as age, ethnicity etc. We need to ask this as patient needs differ depending on various factors. By answering these questions, you are helping us to ensure that we can better tailor our services to our patients.

You will see that some questions simply need a click on the appropriate circle and others have boxes for you to type in your comments.

Please note that the information you supply us with will be used lawfully in accordance with the Data Protection Act 1998. Personal data from this survey will never be passed on to anyone else.

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* 1. Are you male or female?

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* 2. Which age group do you fall into?

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* 3. Which of the following categories best describes your employment status?

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* 4. What is your ethnic group?

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* 5. What is your Religion?

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* 6. When did you last visit the surgery?

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* 7. What do you think works well at the surgery?

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* 8. What do you think does not work so well at the surgery?

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* 9. We would like to produce an Action Plan which lists things we would like to do to enhance our services. What do you think should be on that list? (Please feel free to list multiple suggestions.).

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* 10. What do you think NHS prorities should be?

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* 11. To help improve patient access, we run extended hours surgeries early mornings, late evenings and Saturdays. How satisfied are you with our opening hours?

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* 12. We run special clinics such as Asthma, COPD (Chronic Obstructive Pulmonary Disease), Diabetes, Immunisations, Maternity, Minor Surgery etc. What other clinics or services do you think we should offer our patients?

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* 13. What sort of questions do you think we should ask on our next survey?

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* 14. Do you have any other comments?

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* 15. If you are happy for us to contact you to further discuss your ideas, comments and suggestions, please note your name and address/email address below. Completing this section is entirely voluntary.

Thank you for taking time to complete our survey. Understanding our patient needs and wishes will help us develop our surgery service in the future.

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