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Mystery Shopper Pre Booked Hospital Appointment
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Page 1

Please look at the questions before your appointment and answer them afterwards.
Please do not take the questionnaire with you to the appointment.
Please do not announce yourself as being a mystery shopper or as being from Healthwatch Derby.
Please answer not applicable to any questions that are not relevant to the type of appointment that you had.

Please enter the following information into the box below:

Name of Healthwatcher

Appointment at (add department and hospital if relevant)

Date of visit

 

If this is your first appointment at this department, please go to the section headed Referral.  

If this is a follow on appointment, please go straight to the section headed Before the appointment.
Question 1.

Referral

Please tell us who referred you to the hospital - for example, GP, Practice Nurse, Dentist.

Question 2.

Have you got any comments about the referral system?

Question 3.

Before the appointment

How easy was it to get an appointment?

Question 4.

How far in advance was the appointment?

Question 5.

What type of appointment were you given?

Question 6.

Were you given a choice about the type of appointment?

This is required
Question 7.

How convenient was this for you?

Question 8.

How did you make your appointment?

This is required

Comments

Question 9.

Access

Is the hospital easily accessible (walking/public transport/driving)?

Question 10.

Is there a ramp or flat access?

Question 11.

Can wheelchair users and people with mobility issues get in easily?

Question 12.

Is there a wheelchair accessible toilet?

Comments

Question 13.

On arrival at the hospital

Are there signs providing information in your first language?

Question 14.

Were you acknowledged on arrival (eye contact, smiles, a greeting)?

Question 15.

Did the reception staff make you feel welcome and at ease?

Question 16.

Does the environment appear to be clean and well maintained?

Comments

Question 17.

On arrival at the department

Are there signs providing information in your first language?

Question 18.

Were you acknowledged on arrival? (eye contact, smiles, a greeting?)

Question 19.

Did the reception staff make you feel welcome and at ease?

Question 20.

Does the environment appear to be clean and well maintained?

Question 21.

Comments

Question 22.

General department information

Is information available clear and visible?

Question 23.

Is there hand gel available?

Question 24.

Is there information about the staff members and the person in charge?

Question 25.

Are security and fire procedures evident?

Comments

Question 26.

Waiting Time

Was your appointment on time?

Question 27.

If not, how long was the delay?

Comments

Question 28.

Appointment

Was the person you saw/spoke to helpful?

Question 29.

Did they give you all the information you needed?

Question 30.

Were you able to ask questions?

Question 31.

Did they explain your treatment and/or medication and what happens next?

Comments

Question 32.

Recommendation

How likely are you to recommend this hospital to friends or family if they needed similar care or treatment?

 

Comments

Anything else?

Comments