This survey aims to provide service users from the critical care units with the opportunity to evaluate the interim Adult Critical Care Transfer Services that commenced in December 2020.  This survey will allow us to gain your important feedback on the positive impact of the service whilst also allowing opportunity to highlight areas for improvement so we can learn to further develop the service.

This survey will maintain anonymity for the person completing the form but will identify the relevant critical care unit. This will allow us to provide any feedback or learning to the relevant critical care unit.  

We really welcome your feedback so that we can continue to develop the Service across the region.  Thank you for your time in completing this survey.

Question Title

* 1. Name of the Hospital and Critical Care Unit you are providing feedback for - Please state fully and do not use abbreviations

Question Title

* 2. Which Adult Critical Care Transfer Service are you providing feedback on?

Question Title

* 3. Have you utilised the Interim Adult Critical Care Transfer Service in the last 6 weeks?

Question Title

* 4. How would you rate the Adult Critical Care Transfer Service, with regards to the following

  Very Poor Poor Average Good Excellent
Ease of Booking
General Communications with the service
Availability of the Service
Availability of a transfer team
Equipment provided to support the transfer
Timeliness of Transfer

Question Title

* 5. Overall, How would you rate your experience of transferring patients using the Adult Critical Care Transfer Service?

Question Title

* 6. What has gone well with transfers, when using the Adult Critical Care Transfer Service?
Please tick as many boxes as applicable

Question Title

* 7. How many times have you encountered difficulties using the Adult Critical Care Transfer Service in the last 6 weeks?

Question Title

* 8. If you have encountered difficulties with the Adult Critical Care Transfer Service, what were they?
Please tick as many boxes as applicable

Question Title

* 9. Have you encountered any adverse events which have required Datix Clinical Incident reporting relating to transfers using the Adult Critical Care Transfer Service?

Question Title

* 10. Were any unit staff supporting the Adult Critical Care Transfer Service, repatriated back to their Unit by the service?

Question Title

* 11. What benefits would you say that you have seen from the dedicated Adult Critical Care Transfer Service?

Question Title

* 12. What improvements to the dedicated Adult Critical Care Transfer Service would you like to see or recommend?

Question Title

* 13. Is there anything in particular that needs to be taken into consideration for any long-term dedicated Adult Critical Care Transfer Service within the region?

Question Title

* 14. Over The last 6 weeks have you used an alternative transfer provider to the interim Adult Critical Care Transfer Service within your Network?

Question Title

* 15. If you have used an alternative transfer provider, what was the reason behind this? (Tick all that may have applied)

Question Title

* 16. Do you have any additional comments you would like to make?

T