Organisation Logo
English

Patient Feedback Survey

You recently sought health advice using the 111 telephone service. This questionnaire asks you about your experience of the 111 service on this occasion. Any information you give will remain confidential; this questionnaire is anonymous.

If you require this survey in another language, large print or another format, please ask the service or contact the PALS Team, telephone 01983 534850, who will assist you.

1. Overall, how was your experience of our service?

Section A: The 111 call

2. How quickly did you get through to a 111 health adviser?

Section B: Once connected

3. When you got through to a 111 health adviser, what happened?

4. At the end of the call what did 111 advise you to do or would organise?

5. How helpful was the advice given by the 111 service?

Section C: After the call

6. How satisfied or dissatisfied were you with the way the 111 service handled the whole process?

7. If the NHS111 service had not been available, would you have contacted another service about your health problem? (please select one) Yes, I would have contacted:

8. If you would like to provide additional feedback to the 111 service or the call advisers that dealt with your call, please add your details below:

4000 characters remaining
Next

About you

Thank you for providing feedback on your experience. We want to make sure everyone in our community has safe, kind and excellent patient experience. The personal details you give below help us identify any inequalities or gaps in the service we provide you and data is not patient identifiable.

The Equality Act 2010 also requires us and all other public services to ask you for this information. If you do not wish to provide this information you can simply leave it blank.

9. I am:

10. Does your gender identity match the sex you were assigned at birth?

11. In which age group are you?

12. I identify as:

13. Which of the following options best describes how you think of yourself?

14. What is your religion?

15. Do you consider yourself to have a disability or impairment? (select 'Other' and use the text box if you would like to specify)

Thank you

We will use your feedback to improve the service we provide.