Patient experience Question Title * 1. How recent was the experience you are thinking of? In the last 6 months Between 6 months and 1 year ago Between 1 and 2 years ago More than 2 years ago Question Title * 2. Thinking about your overall first impressions of the care you received, were you listened to: Always Usually Sometimes Never Question Title * 3. Were you able to speak in Welsh to staff if you needed to? Always Not applicable Usually Sometimes Never Question Title * 4. From the time you realised you needed to use this service, was the time you waited Shorter than expected About right A bit too long Much too long Question Title * 5. Thinking about the place where you received your care, did you feel well cared for? Always Usually Sometimes Never Question Title * 6. If you asked for assistance, did you get it when you needed it? Always Not applicable Usually Sometimes Never Question Title * 7. Thinking about your understanding and involvement in care, Did you feel you understood what was happening in your care? Always Usually Sometimes Never Question Title * 8. Were things explained to you in a way that you could understand? Always Usually Sometimes Never Question Title * 9. Were you involved as much as you wanted to be in decisions about your care? Always Usually Sometimes Never Question Title * 10. Overall ExperienceUsing a scale of 0 – 10 where 0 is very bad and 10 is excellent, how would you rate your overall experience? 0 10 Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 11. Thinking of your responses, was there anything particularly good about your experience that you would like to tell us about? Question Title * 12. Was there anything that we could change to improve your experience? Question Title * 13. Equality monitoring-what is your age? Under 15 16-24 35-34 35-44 45-54 55-64 65-74 75+ prefer not to say Question Title * 14. what is your gender? male female other prefer not to say Question Title * 15. at birth were you described as: male female other prefer not to say Question Title * 16. are your day-to-day activities limited because of a health problem or disability which has lasted or is expected to last at least 12months? yes, a lot yes, a little not at all prefer not to say Question Title * 17. which of the following options best describe how you think of yourself? heterosexual or straight gay or lesbian bisexual other prefer not to say Question Title * 18. what is your religion? no religion christian (all denominations) hindu muslim sikh jewish buddhist any other religion prefer not to say Question Title * 19. what is your ethnic group? white, welsh white, english white, scottish white, irish white, northern irish gypsy or irish traveller british white, other: mixed/multiple ethnic groups-white and black carribean mixed/multiple ethnic groups-white and black african mixed/multiple ethnic groups-white and asian mixed/multiple ethnic groups-any other mixed/multiple ethnic background Asian/Asian british-Indian Asian/Asian british-Pakistani Asian/Asian british-bangladeshi Asian/asian british-chinese any other asian background black/african/carribean/black british-african black/african/carribean/blackbritish-carribean any other black/african/carribean/black british background arab any other ethnic group prefer not to say Done