We are the part of the NHS that plans and pays for most of your health services. It is important to us that everyone has the same opportunity to receive health services, whoever they are.
To make services fair for everyone, we want you to tell us what we are doing right and what we are doing wrong. We can then use your comments to create a better system. Please answer the following questions to help us improve services.

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* 1. Please tell us the area where you live.

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* 2. Do you consider that local healthcare services meet your health needs?

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* 3. Are you able to be involved as much as you wish to be in decisions about your health care?

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* 4. The NHS will seek to move people between different services, when necessary. For example, from hospital to a community based service for rehabilitation. Have you or a relative ever been transferred from one service to another?

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* 5. IF YOU ANSWERED 'YES' AT Q4: In your experience how would you describe the way your transfer of care was managed? (If you have had more than one transfer please describe your typical
experience).

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* 6. In relation to the information you are provided about your health and care:

  Not at all Sometimes Most of the time Always I don't know
Are you given enough information?
Do you understand the information?
Is the information given in the best way for you?

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* 7. When you have a doctor or hospital appointment do you ever experience access problems? (Please tick all that apply)

  Doctor Appointment Hospital Appointment
Communication
No access to foreign language interpreter
No access to British Sign Language (BSL) interpreter
No loop system
Mobility issues
Access to building
Transport problems
No issue

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* 8. Have you experienced positive care or support from the NHS?
If yes please select all the options which describe your positive experience.

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* 9. Have you experienced mistakes or mistreatment when you (or someone for whom you care) have received treatment or care from the NHS?

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* 10. IF YOU ANSWERED 'YES' AT Q9: Please select all the options which describe the mistakes /
mistreatment you have experienced.

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* 11. Do you know about national screening, check-ups or programmes? (e.g. breast screening or vaccinations)

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* 12. IF YOU ANSWERED 'YES' AT Q11: How did you find out about screening programmes?

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* 13. The NHS welcomes feedback from patients and their relatives. Do you know how to give feedback and would feel able to tell us about your experiences, good and bad?

  Yes Not sure No
Can you tell us positive (good) experience about our staff and services?
Do you feel able to make a complaint if you want to?

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* 14. If you have made a complaint was it handled respectfully and efficiently?

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* 15. If you have any other comments about issues raised by this questionnaire please tell us in the box below:

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* 16. Are you completing this survey for yourself, for someone you care for, or on behalf of an organisation?

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* 17. How old are you?

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* 18. What is your gender?

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* 19. What is your sexual orientation?

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* 20. What is your ethnic group?

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* 21. Do you consider yourself to be disabled?

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* 22. IF 'YES' AT Q21: Please say what your disability is. (Please select as many options as apply.)

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* 23. Do you look after, or give any help or support to family members, friends, neighbours or others because of long-term physical or mental ill-health / disability or problems relating to old age?

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* 24. Do you have any dependent children aged under 18?

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* 25. NHS North East Hampshire and Farnham Clinical Commissioning Group is the part of the NHS that plans and pays for most of the NHS services provided to the 235,000 people registered with GP surgeries in North East Hampshire and Farnham.
We want to work with you so that local people's views are included in all of our work. If you are happy to receive information from us on our plans, campaigns, events etc., please provide a contact email address so that we can reach you.
You can contact us at any time to ask that we remove your details from our contact list.

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