This Healthwatch Staffordshire survey collects feedback about people's experiences of using the Hospital Treatment Services in Staffordshire.  You may respond as a patient who needs to use the service or on behalf of such a patient.

 

The survey is completely anonymous and the results will be used in our reports to influence the development of future services. Please note that any comments you give may be quoted (anonymously) in our public reports and/or shared with the County Council and/or the NHS to inform them of people's feedback.

 

If you would like any further information or have any other feedback about local Health and Social Care then please call us on 0800 051 8371 or email us at enquiries@healthwatchstaffordshire.co.uk

 

 

1. Please specify who you are:  *

 

2. Which hospital do you attend ? *

 

3. Which department/ward do you have treatment in? *

 

4. How many times per week do you attend treatment? Please specify

 

5. What transport do you use to travel to the hospital? *

 

6. Why do you use this method of transport *

 

7. If you use your own vehicle do you have accessible parking at the hospital? For example "parking issues at the hospital etc"

 

8. On average, how long do you wait for treatment to begin once you arrive at 

your appointment? / If you use Non Emergency Patient Transport, how many minutes early are you dropped off prior to your entry time/appointment time?

x
up to 30 minutes
30 minutes - 1 hour
1 hour - 2 hours
more than 2 hours.
 

9. If you arrive late for your appointment, how does this impact your treatment?

 

10. Do you feel well informed about your treatment plan, for example, the number of weeks of the treatment, the outcome of the treatment, and how the treatment will affect you?

 

11. Do you feel that as a patient you are listened to and respected by all staff involved in your care, for example, consultants, healthcare assistants, nurses, and transport staff? Are you treated in a friendly and caring manner and feel that your privacy and dignity are respected?

 

12. Do you feel your needs are accommodated whilst undergoing treatment?

 

13. Do you feel that as a patient you are engaged and communicated with throughout your visit to the hospital and involved in all stages of your care/transport needs?

 

14. If you are having treatment do you feel that your nutritional/hydration/cultural needs are adhered to, and are you able to communicate them to the staff if there are any issues?

 

15. Do you feel safe while undergoing treatment/using non-emergency transport?

 

16. Is there space to speak to staff confidentially?

 

17. If applicable, on average, how long do you wait for non-emergency transport to and from the hospital

30 minutes or less30 minutes to 1 hour1 hour - 2 hours
 

18. If applicable, generally on average, how many hours are you away from home?

Best timeWorst time
Treatment time 
Travel and waiting for transport
 

19. If applicable, are your care needs accommodated after finishing treatment and while waiting for transport home?

 

20. If applicable, how does a delay in leaving the hospital impact your care/support needs/home life? for example personal care, medication, childcare, other family members Please specify.

 

21. If you have other health conditions, and attend other hospital departments or your GP, do you feel suitably supported by the health professional you see?

YesNo
GP
Hospital Department
 

22. Are you or your relative aware of how to raise a complaint/concern for example, hospital or transport?

 

23. Additional comments

 

24. Please tell us your age

 

25. Please tell us your gender

 

26. Is your gender identity the same as your sex recorded at birth?

 

27. Please tell us which sexual orientation you identify with

 

28. Please select your ethnicity

 

29. Have you been diagnosed with any of the following?

 

30. Do you have a disability or long term health condition?

 

31. Which of the following disabilities or long term health condition do you have?