Patient Survey

1.

50% of survey complete.

Understanding what patients and their families think about the service we provide is very important to gtd healthcare. If you have any comments or suggestions, please take a few minutes to complete this questionnaire. Any information you provide will be treated in confidence and with sensitivity. This questionnaire is anonymous and you are under no obligation to provide your contact details.

The questionnaire is separated into different sections depending on the type of care you have received for example homecare advice or a home visit. The fields are optional so you can leave any of them blank if you feel they do not apply to you.

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

Very good

Good

Neither good or poor

Poor

Very poor

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* 2. Are you:

The patient

A relative of the patient

A carer of the patient

Other (please specify)

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* 3. What area do you live in?

Southport and Formby

South Sefton

North Manchester

South Manchester

Central Manchester

Tameside & Glossop

Oldham

Greater Preston

Chorley & South Ribble

Other (please specify)

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* 4. If contacted NHS111 was the patient:

Given advice over the telephone from a doctor or nurse?

Given an appointment to see a GP at a treatment centre?

Given a home visit

This survey is separated into different sections depending on the type of care the patient received. Please complete the sections that apply to the patient.

Section 1 - Telephone Advice

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* 5. Telephone advice

	Yes	Partly	No
Did you feel the time you waited for a call back was acceptable?	Did you feel the time you waited for a call back was acceptable? Yes	Did you feel the time you waited for a call back was acceptable? Partly	Did you feel the time you waited for a call back was acceptable? No
Did the doctor/nurse introduce themselves?	Did the doctor/nurse introduce themselves? Yes	Did the doctor/nurse introduce themselves? Partly	Did the doctor/nurse introduce themselves? No
Was the doctor/nurse you spoke to polite and courteous?	Was the doctor/nurse you spoke to polite and courteous? Yes	Was the doctor/nurse you spoke to polite and courteous? Partly	Was the doctor/nurse you spoke to polite and courteous? No
Did you feel the doctor/nurse listened to you?	Did you feel the doctor/nurse listened to you? Yes	Did you feel the doctor/nurse listened to you? Partly	Did you feel the doctor/nurse listened to you? No
In your opinion did the doctor/nurse understand your problem?	In your opinion did the doctor/nurse understand your problem? Yes	In your opinion did the doctor/nurse understand your problem? Partly	In your opinion did the doctor/nurse understand your problem? No
Did you feel reassured by the doctor/nurse?	Did you feel reassured by the doctor/nurse? Yes	Did you feel reassured by the doctor/nurse? Partly	Did you feel reassured by the doctor/nurse? No
Were you happy with the advice you received?	Were you happy with the advice you received? Yes	Were you happy with the advice you received? Partly	Were you happy with the advice you received? No

If you answered no to any of the above questions please, provide details:

Section 2 - Treatment Centre

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* 6. Which treatment centre did you attend?

Ashton Treatment Centre

Royal Oldham Hospital

Manchester Royal Infirmary

North Manchester General Hospital

Wythenshawe Hospital

Southport and Formby District General Hospital

Litherland Health Centre

Royal Preston Hospital

Chorley & South Ribble Hospital

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* 7. Was the treatment centre environment clean and tidy?

Yes

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* 8. If you travelled to the treatment centre by car were you satisfied with the car parks?

Yes

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* 9. If given an appointment time, how long did you have to wait to be seen by a doctor?

Less than 30 minutes

30 minutes - 1 hour

1 hour - 2 hours

Longer than 2 hours

If longer than 2 hours please state how long you waited:

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* 10. Treatment centre appointment

	Yes	Partly	No	N/A
Did you feel the distance you had to travel to the treatment centre was acceptable?	Did you feel the distance you had to travel to the treatment centre was acceptable? Yes	Did you feel the distance you had to travel to the treatment centre was acceptable? Partly	Did you feel the distance you had to travel to the treatment centre was acceptable? No	Did you feel the distance you had to travel to the treatment centre was acceptable? N/A
Did the receptionist greet you on arrival?	Did the receptionist greet you on arrival? Yes	Did the receptionist greet you on arrival? Partly	Did the receptionist greet you on arrival? No	Did the receptionist greet you on arrival? N/A
Was the receptionist polite and courteous?	Was the receptionist polite and courteous? Yes	Was the receptionist polite and courteous? Partly	Was the receptionist polite and courteous? No	Was the receptionist polite and courteous? N/A
If there was a delay did the receptionist keep you updated on the waiting times?	If there was a delay did the receptionist keep you updated on the waiting times? Yes	If there was a delay did the receptionist keep you updated on the waiting times? Partly	If there was a delay did the receptionist keep you updated on the waiting times? No	If there was a delay did the receptionist keep you updated on the waiting times? N/A
Did the doctor/nurse you saw introduce themselves?	Did the doctor/nurse you saw introduce themselves? Yes	Did the doctor/nurse you saw introduce themselves? Partly	Did the doctor/nurse you saw introduce themselves? No	Did the doctor/nurse you saw introduce themselves? N/A
Was the doctor/nurse you saw polite and courteous?	Was the doctor/nurse you saw polite and courteous? Yes	Was the doctor/nurse you saw polite and courteous? Partly	Was the doctor/nurse you saw polite and courteous? No	Was the doctor/nurse you saw polite and courteous? N/A
Did you feel the doctor/nurse listened to you?	Did you feel the doctor/nurse listened to you? Yes	Did you feel the doctor/nurse listened to you? Partly	Did you feel the doctor/nurse listened to you? No	Did you feel the doctor/nurse listened to you? N/A
In your opinion did the doctor/nurse understand your problem?	In your opinion did the doctor/nurse understand your problem? Yes	In your opinion did the doctor/nurse understand your problem? Partly	In your opinion did the doctor/nurse understand your problem? No	In your opinion did the doctor/nurse understand your problem? N/A
Did you feel reassured by the doctor/nurse?	Did you feel reassured by the doctor/nurse? Yes	Did you feel reassured by the doctor/nurse? Partly	Did you feel reassured by the doctor/nurse? No	Did you feel reassured by the doctor/nurse? N/A
Were you happy with the advice you received?	Were you happy with the advice you received? Yes	Were you happy with the advice you received? Partly	Were you happy with the advice you received? No	Were you happy with the advice you received? N/A

If you answered no to any of the above questions, please provide details:

Section 3 - Home visit

Question Title

* 11. Home visit

	Yes	No
Were you told how long it would be before a doctor could visit you at home?	Were you told how long it would be before a doctor could visit you at home? Yes	Were you told how long it would be before a doctor could visit you at home? No
If the home visit took longer than you were initially told, were you kept informed by a member of gtd healthcare's staff?	If the home visit took longer than you were initially told, were you kept informed by a member of gtd healthcare's staff? Yes	If the home visit took longer than you were initially told, were you kept informed by a member of gtd healthcare's staff? No

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* 12. Approximately how long did you have to wait for the doctor to arrive?

Less than 1 hour

Between 1 - 2 hours

Between 2 - 6 hours

If longer than 6 hours please state how long:

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* 13. Home visit

	Yes	Partly	No
Were you satisfied with the time you waited for the home visit?	Were you satisfied with the time you waited for the home visit? Yes	Were you satisfied with the time you waited for the home visit? Partly	Were you satisfied with the time you waited for the home visit? No
Did the doctor you saw introduce themselves?	Did the doctor you saw introduce themselves? Yes	Did the doctor you saw introduce themselves? Partly	Did the doctor you saw introduce themselves? No
Was the doctor you saw polite and courteous?	Was the doctor you saw polite and courteous? Yes	Was the doctor you saw polite and courteous? Partly	Was the doctor you saw polite and courteous? No
Did you feel the doctor listened to you?	Did you feel the doctor listened to you? Yes	Did you feel the doctor listened to you? Partly	Did you feel the doctor listened to you? No
In your opinion did the doctor understand your problem?	In your opinion did the doctor understand your problem? Yes	In your opinion did the doctor understand your problem? Partly	In your opinion did the doctor understand your problem? No
Did you feel reassured by the doctor?	Did you feel reassured by the doctor? Yes	Did you feel reassured by the doctor? Partly	Did you feel reassured by the doctor? No
Were you happy with the advice you received?	Were you happy with the advice you received? Yes	Were you happy with the advice you received? Partly	Were you happy with the advice you received? No

If you answered no to any of the above questions, please provide details:

Section 4 - Overall service

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* 14. Overall service

	Yes	Partly	No
Were you treated with dignity and respect from all our employees?	Were you treated with dignity and respect from all our employees? Yes	Were you treated with dignity and respect from all our employees? Partly	Were you treated with dignity and respect from all our employees? No
Were you satisfied with the overall care you received?	Were you satisfied with the overall care you received? Yes	Were you satisfied with the overall care you received? Partly	Were you satisfied with the overall care you received? No

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* 15. What do you feel gtd healthcare did well?

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* 16. What do you feel gtd healthcare could do better?

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* 17. Please enter any additional comments:

Section 5 - Equality & Diversity Monitoring

We want to make sure that the services we provide are fair to all who need them. Your feedback will help us get a picture of the people who access our services. It also identifies those who do not access our services; completing these questions will help us reduce potential barriers to accessing healthcare.

We would be grateful if you could take a little time to complete this form. Please go through it and tick all the categories that most accurately describe you. Some questions may feel personal, but the information we collect will be kept confidential and secure.

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* 18. Patient's Age (please tick one box)

Under 16

16-30

31-45

46-60

61-74

Over 75

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* 19. What best describes your gender?

Woman (including trans woman)

Man (including trans man)

Non-binary

Prefer to self-describe

Comments

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* 20. Is your gender identity the same as the one you were assigned at birth?

Yes

Disability

Under the Equality Act 2010, a person is considered to have a disability if they have a physical or mental impairment which has a substantial or long-term adverse effect on their ability to carry out normal day-to-day activities. In order to be able to identify and respond to a patient's specific needs, it is important that we know what disability you have.

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* 21. Do you consider yourself to be disabled/have an impairment?

Yes

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* 22. If you have answered yes please tick the box/es below that best describe your disability/impairment.

Hearing eg. profound to mild deafness

Communication

Visual eg. blind or partial sighted

Learning Disability eg. Downs Syndrome, Asperger's, Autism etc.

Mobility or Physical

Developmental

Mental ill health

Long term illness or condition

Other (please specify)

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* 23. Are you a carer?

Yes

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* 24. Ethnicity

White British

Irish

Any other white background

African

Caribbean

Any other black blackground

White & Black Caribbean

White & Black African

White & Asian

Any other mixed background

Indian

Pakistani

Bangladeshi

Any other Asian background

Chinese

Any other ethnic group

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* 25. Belief/Religion

Atheism

Christianity

Judaism

Buddhism

Islam

Sikhism

Other (please state below)

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* 26. Language

Main language spoken

Additional language spoken

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* 27. Sexual Orientation
Which of the following best describes how you think of yourself?

Lesbian/Gay

Bisexual

Heterosexual/Straight

Pregnancy & Maternity

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* 28. Are you pregnant?

Yes

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* 29. Have you had a baby in the last 12 months?

Yes

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* 30. Marriage & Civil Partnership

Single

Married

Co-habiting

Same Sex relationship

Separated

Divorced

Widowed

Refugees & Asylum Seekers

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* 31. Are you a Refugee?

Yes

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* 32. Are you an Asylum Seeker?

Yes

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* 33. Which country or region are you a refugee/asylum seeker from?

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* 34. From time to time, we like to publish anonymous feedback from people who use our services to help promote the benefits of gtd healthcare and celebrate the work of our team. As such, please let us know if you give permission for gtd healthcare to publish your anonymous feedback in our internal and external communications such as website, social media, newsletters, patient information and leaflets?

Yes

None of the above

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* 35. If you would like us to contact you in relation to this feedback, please complete the below:

Name

Address

Address 2

City/Town

ZIP/Postal Code

Date of Birth

Email Address

Daytime Contact Telephone Number

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

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* 2. Are you:

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* 3. What area do you live in?

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* 4. If contacted NHS111 was the patient:

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* 5. Telephone advice

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* 6. Which treatment centre did you attend?

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* 7. Was the treatment centre environment clean and tidy?

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* 8. If you travelled to the treatment centre by car were you satisfied with the car parks?

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* 9. If given an appointment time, how long did you have to wait to be seen by a doctor?

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* 10. Treatment centre appointment

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* 11. Home visit

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* 12. Approximately how long did you have to wait for the doctor to arrive?

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* 13. Home visit

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* 14. Overall service

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* 15. What do you feel gtd healthcare did well?

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* 16. What do you feel gtd healthcare could do better?

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* 17. Please enter any additional comments:

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* 18. Patient's Age (please tick one box)

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* 19. What best describes your gender?

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* 20. Is your gender identity the same as the one you were assigned at birth?

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* 21. Do you consider yourself to be disabled/have an impairment?

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* 22. If you have answered yes please tick the box/es below that best describe your disability/impairment.

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* 23. Are you a carer?

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* 24. Ethnicity

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* 25. Belief/Religion

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* 26. Language

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* 27. Sexual OrientationWhich of the following best describes how you think of yourself?

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* 28. Are you pregnant?

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* 29. Have you had a baby in the last 12 months?

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* 30. Marriage & Civil Partnership

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* 31. Are you a Refugee?

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* 32. Are you an Asylum Seeker?

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* 33. Which country or region are you a refugee/asylum seeker from?

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* 35. If you would like us to contact you in relation to this feedback, please complete the below:

* 27. Sexual Orientation
Which of the following best describes how you think of yourself?