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This questionnaire has been designed to capture your views and experiences of the Community Equipment Service provided by Medequip.  

A summary of responses and any quotes you provide may be included anonymously in a report to recommend any future changes to the Community Equipment service. 

Please complete the questionnaire by using the “tick” boxes or by writing in the spaces provided and return in the free post envelope by Friday 22nd January 2021.

All the information you provide will be kept anonymous therefore please be as honest as possible when completing the questionnaire as the information you provide will be valuable to the review of the current service. Alternatively you can complete the questionnaire electronically via the survey monkey link www.surveymonkey.com/r/communityequipmentservicesreview-children

If you require this survey in a different format, such as large print, easy read, audio recording or braille, or a different language, please email judith.mcguinness@nhs.net

As a parent/guardian, we would like to know about your experience of the current community equipment service for you and your child, please complete the section below:

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* 1. How were you referred to the Community Equipment Service?

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* 2. Can you remember when you first had contact with the Community Equipment Service?

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* 3. What was your impression of the Community Equipment Service, from your first contact with them?

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* 4. Following your assessment for equipment, how long did you wait for the equipment to be delivered?

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* 5. Were you informed of the date of delivery?

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* 6. If you answered yes to Q5, was a time slot given?

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* 7. Would the option of morning or afternoon slots be beneficial to you?

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* 8. If you were waiting for multiple items of equipment were all items delivered at the same time?

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* 9. Have you, a friend or relative collected the equipment from Medequip?

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* 10. Did you know this option is available?

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* 11. Was the equipment delivered clean and in good working order?

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* 12. Did someone demonstrate how to use the equipment?

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* 13. If you answer to Q12 was yes, was this the delivery driver?

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* 14. Were you provided with any instructions and/or information on how to:

  Yes No
Use the equipment
Care for the equipment

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* 15. Would you know who to contact if there was a problem with the equipment?

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* 16. Items of equipment with a plug, battery or lifting mechanism require regular servicing . If your child has any of these items are they serviced regularly?

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* 17. Do you still have all of the equipment that has been delivered to you?

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* 18. Does your child still use all of the equipment?

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* 19. Do you know what to do with the equipment when it is no longer required?

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* 20. Is the collection/return process clear and easy to understand?

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* 21. Have you requested equipment to be returned to the Community Equipment Service and not had it collected?

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* 22. Is the equipment helpful to you and your child?

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* 23. Has the equipment made a difference to your child's quality of life?

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* 24. On a scale of 1 - 10 (one being poor and ten being excellent) please rate your overall experience of the Community Equipment Service?

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