Patient Survey

English

Patient Survey

Your answers are confidential. We do not ask for your name or NHS number.

1. Thinking about your recent appointment, overall how was your experience of our service?

Very good Good Neither good nor poor Poor Very poor Don't know

Notes

2. What was good about your experience of care? and what could be improved?

4000 characters remaining

Can we share your comment publicly (for example, on our website or printed material such as posters)?

Yes No

Notes

3. Did your treatment, test or appointment happen when it was supposed to?

Yes, on time Yes, but I waited longer than expected My treatment, test or appointment was changed No Not sure

Notes

4. Do you feel staff treated you with kindness?

Yes, always Yes, sometimes No

Notes

5. Did staff act when you asked for help or information?

Yes, always Yes, sometimes No I did not ask for help or information I am not sure

Notes

6. Did staff explain things clearly?

Yes, always Yes, sometimes No I am not sure Not applicable

Notes

7. Did we meet your communication and/or accessibility needs in a way that worked for you?

Yes, completely Yes, mostly No Not applicable Not sure

Notes

8. Were your family and/or carer involved in decisions as much as you wanted?

Yes, as much as I wanted Yes, but I wanted more involvement No I did not want my family or carer involved I do not have a family member or carer Not sure

Notes

Thank you for your valuable feedback. We have a few final, optional questions about you.

Answering them helps us to understand who is responding to our surveys. All information you provide is completely confidential, and you can skip any questions you don't wish to answer.

9. Is your gender the same as your sex registered at birth?

Yes No Prefer not to say

Notes

10. What is your gender?

Man (including trans man) Woman (including trans woman) Prefer to self-describe Prefer not to say

Notes

11. What age are you?

0-7 8-11 12-15 16-24 25-34 35-44 45-54 55- 64 65-74 75-84 85+ Prefer not to say

Notes

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

Yes No Prefer not to say

Notes

13. What is your ethnic group?

White Mixed ethnic group Asian or Asian British Black or Black British Other ethnic group Prefer not to say

Notes

Patient Survey

Your answers are confidential. We do not ask for your name or NHS number.

1. Thinking about your recent appointment, overall how was your experience of our service?

2. What was good about your experience of care? and what could be improved?

Can we share your comment publicly (for example, on our website or printed material such as posters)?

3. Did your treatment, test or appointment happen when it was supposed to?

4. Do you feel staff treated you with kindness?

5. Did staff act when you asked for help or information?

6. Did staff explain things clearly?

7. Did we meet your communication and/or accessibility needs in a way that worked for you?

8. Were your family and/or carer involved in decisions as much as you wanted?

Thank you for your valuable feedback. We have a few final, optional questions about you.

9. Is your gender the same as your sex registered at birth?

10. What is your gender?

11. What age are you?

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

13. What is your ethnic group?

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