1. Please help us to plan physiotherapy services for the future by sharing your experiences. All information gathered will be confidential and only used for our planning purposes. All questions are optional.
Before the appointment
Have you ever visited this outpatients department before for the same condition?
2. From the time you were first told you needed an appointment to the time you went to the Outpatients Department, how long did you wait for your appointment?
3. Did your symptoms or condition get worse while you were waiting for your appointment?
4. Thinking about your most recent visit to the Physiotherapy Department...
Were you given a choice of appointment times?
5. Before your appointment, were you given any printed information about your condition or treatment?
6. Before your appointment, did you know who to contact if your symptoms or condition got worse?
7. Who referred you to see a physiotherapist? (Tick ONE only)
8. What sources of information did you use to help you choose where to have your outpatient appointment? (Tick ALL that apply)
9. Tests (e.g. x-rays or scans)
Did you have any tests (such as x-rays, scans or blood tests) when you last visited the Physiotherapy Department?
10. Before your appointment, were you told that you would have a test(s)?
11. APPOINTMENT WITH PHYSIOTHERAPY
Did you have enough time to discuss your health or medical problem with the physiotherapist?
12. How long were you with him/her?
13. Did he/she explain the reasons for any treatment or action in a way that you could understand?
14. Did he/she listen to what you had to say?
15. If you had important questions to ask him/her, did you get answers that you could understand?
16. Did he/she seem aware of your medical history?
17. If you had any worries or fears about your condition or treatment, did he/she discuss them with you?
18. Did clinical or non-clinical staff talk in front of you as if you weren't there?
19. How much information about your condition or treatment was given to your family, carer or someone close to you?
20. Were you involved as much as you wanted to be in decisions about your care and treatment?
21. Was your appointment about a long term condition or illness that you need ongoing care or treatment for?
22. Did staff ask you what was important to you in managing your condition or illness?
23. Did your appointment help you to feel that you could better manage your condition or illness?
24. As far as you know, was your GP given all the necessary information about the treatment or advice that you received at your appointment?
25. Before you left the Outpatients Department, were you given any written or printed information about your condition or treatment?
26. Before you left the Outpatients Department, were you told what would happen next (e.g. whether you needed another outpatients appointment, to see your GP etc)?
27. Did staff tell you who to contact if you were worried about your condition or treatment after you left the department?
28. Did staff give you information about voluntary and support groups for people who have a similar condition in your local area?
29. OVERALL IMPRESSION
Was the main reason you went to the Outpatients Department dealt with to your satisfaction?
30. Overall, did you feel you were treated with respect and dignity while you were at the Outpatients Department?
31. Overall, how would you rate the care you received at the Outpatients Department?
32. Overall, were you treated with kindness and understanding while you were in the Outpatients Department?
33. Would you recommend this Outpatients Department to your family and friends?
34. While at the department, did you ever see any posters or leaflets explaining how to complain about the care you received?
35. ANY OTHER COMMENTS
If there is anything else you would like to tell us about your experiences in the Physiotherapy Department, please do so here.
Was there anything particularly good about your visit to the Physiotherapy Department?
Was there anything that could have been improved?
Any other comments?