Respiratory Services, Patient Engagement Survey.

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* 1. Do you have a diagnosis for your breathing complaint.

Yes

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* 2. What is your diagnosis? (please tick all that apply)

COPD

Asthma

Pulmonary Fibrosis

Bronchiectasis

Lung Cancer

Obstructive Sleep Apnoea

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* 3. Who diagnosed your breathing condition?

Practice Nurse

Breathlessness Service

Respiratory Nurse (Hospital)

Respiratory Nurse (Community)

Respiratory Consultant (Hospital)

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* 4. How long did it take to get diagnosis from when you first visited a clinic?

years

months

weeks

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* 5. When you were given the diagnosis, was it explained to you in a way that you understood?

Yes

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* 6. When you were given your diagnosis, did you have the opportunity to ask questions?

Yes

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* 7. Could the process of getting a diagnosis have been improved?

Yes

If Yes please specify

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* 8. Who do you currently see to help you manage your breathing/chest problems (please indicate approximately how many times a year you see any of the Health Professionals listed below)

Practice Nurse

Health First Breathlessness Service

Respiratory Consultant Outpatient

Hospital Respiratory Nurse

COPD Unit

Bridgewater Community Respiratory Team

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* 9. Have you been given a written plan explaining what you should do and who you should call if your breathing/chest gets worse (such as if you develop a chest infection)?

Yes

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* 10. Who would you contact first if you breathing gets worse?

A&E

COPD Unit

Practice Nurse

Respiratory Nurse

Other Please State

if other please specify

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* 11. Do you think that a clearly written personalised plan, explaining what to do in the event of a worsening of your condition would be helpful?

Yes

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* 12. Have you smoked in the past 2 months?

Yes

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* 13. If yes, have you been offered NHS help to quit?

Yes

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* 14. If you use inhalers, have you been taught how to use each one by a healthcare professional?

Yes

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* 15. When was the last time a healthcare professional observed you taking your inhalers?

years

months

weeks

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* 16. Do you understand what each of your prescribed medications are for and why you need them?

Yes

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* 17. Do you take all of the medication prescribed to you?

Yes

If not all please state why

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* 18. Has any healthcare professional reviewed all of your prescription medications in the last 12 months?

Yes

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* 19. Do you get your seasonal flu jab?

Yes

If not please state why

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* 20. Have you been given any information leaflets from any part of the Respiratory Service in Wigan?

Yes

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* 21. If you answered Yes to question 21 please answer

	Yes	No
Was it well presented	Was it well presented Yes	Was it well presented No
Was it well explained	Was it well explained Yes	Was it well explained No
Was it too much detail	Was it too much detail Yes	Was it too much detail No
Was it not enough detail	Was it not enough detail Yes	Was it not enough detail No

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* 22. Do you feel that you have been involved in the decisions about your Respiratory Care?

Yes

If not how do you think this could be improved

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* 23. Where would you prefer to go for your routine respiratory health check appointments? (such as annual check-ups, appointments for chest infection etc)

	Most Preferred	Would rather	Neutral	Rather not	Definitely not
GP Practice	GP Practice Most Preferred	GP Practice Would rather	GP Practice Neutral	GP Practice Rather not	GP Practice Definitely not
Community Health Centre	Community Health Centre Most Preferred	Community Health Centre Would rather	Community Health Centre Neutral	Community Health Centre Rather not	Community Health Centre Definitely not
Hospital	Hospital Most Preferred	Hospital Would rather	Hospital Neutral	Hospital Rather not	Hospital Definitely not

Question Title

* 1. Do you have a diagnosis for your breathing complaint.

Question Title

* 2. What is your diagnosis? (please tick all that apply)

Question Title

* 3. Who diagnosed your breathing condition?

Question Title

* 4. How long did it take to get diagnosis from when you first visited a clinic?

Question Title

* 5. When you were given the diagnosis, was it explained to you in a way that you understood?

Question Title

* 6. When you were given your diagnosis, did you have the opportunity to ask questions?

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* 7. Could the process of getting a diagnosis have been improved?

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* 8. Who do you currently see to help you manage your breathing/chest problems (please indicate approximately how many times a year you see any of the Health Professionals listed below)

Question Title

* 9. Have you been given a written plan explaining what you should do and who you should call if your breathing/chest gets worse (such as if you develop a chest infection)?

Question Title

* 10. Who would you contact first if you breathing gets worse?

Question Title

* 11. Do you think that a clearly written personalised plan, explaining what to do in the event of a worsening of your condition would be helpful?

Question Title

* 12. Have you smoked in the past 2 months?

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* 13. If yes, have you been offered NHS help to quit?

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* 14. If you use inhalers, have you been taught how to use each one by a healthcare professional?

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* 15. When was the last time a healthcare professional observed you taking your inhalers?

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* 16. Do you understand what each of your prescribed medications are for and why you need them?

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* 17. Do you take all of the medication prescribed to you?

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* 18. Has any healthcare professional reviewed all of your prescription medications in the last 12 months?

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* 19. Do you get your seasonal flu jab?

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* 20. Have you been given any information leaflets from any part of the Respiratory Service in Wigan?

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* 21. If you answered Yes to question 21 please answer

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* 22. Do you feel that you have been involved in the decisions about your Respiratory Care?

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* 23. Where would you prefer to go for your routine respiratory health check appointments? (such as annual check-ups, appointments for chest infection etc)

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* 24. What do you feel can be done to improve the Respiratory Services in Wigan?