We have developed this survey in response to national data which shows people who describe themselves as Black, Asian or Minority Ethnic (BAME) report poorer patient experiences compared to people who describe themselves as White.

Whilst it is acknowledged BAME is a term that covers a wide range of people with a very diverse range of needs, we want to understand what the barriers to a positive patient experience are and what we can do to best support all patients of an ethnic minority.

If you require this survey in a different way such as easy read, a different language, larger print, or braille please contact the Patient Experience Team: sath.patientexperience@nhs.net

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* 1. When you had important questions to ask, did you get answers that you could understand?

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* 2. How did staff members make you feel when you spoke to them?

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* 3. Did you feel treated with dignity and respect while you were in the hospital?

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* 4. Could we have done anything better in regards to maintaining your privacy, dignity and respect?

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* 5. Do you feel represented by staff within the hospital? 

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* 6. Was your experience in hospital affected by staff representation?

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* 7. If you were referred to any support groups or organisations, do you feel these were representative/appropriate to your background and needs?

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* 8. How easy was it to access treatment in the hospital?

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* 9. Did you experience any barriers to accessing treatment?

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* 10. Do you feel your physical needs were met by the staff looking after you?

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* 11. What could we have done differently to better meet your physical needs?

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* 12. Do you feel your emotional needs were met by the staff looking after you?

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* 13. What could we have done differently to better meet your emotional needs?

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* 14. Do you feel you spiritual needs were met by the staff looking after you?

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* 15. What could we have done differently to better meet your spiritual needs?

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* 16. Do you feel you had as much involvement in your care as you would have liked?

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* 17. Is there anything we could have done better to involve you?

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* 18. Do you feel the information you were given was representative of your background and needs?

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* 19. Is there anything we could do better to represent your background and needs in the patient information you are given?

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* 20. Do you feel you were treated differently to patients of other demographic backgrounds?

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* 21. What is your ethnic group?

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* 22. Where did you receive treatment in the hospital?
(Please include the ward number/department and site e.g. Ward 1 Princess Royal Hospital, Audiology Royal Shrewsbury Hospital)

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* 23. When did you receive treatment in the hospital?

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