Monitoring and improving our service for hip and knee replacement patients

We understand you or a loved one have recently had an operation, referred to clinically as arthroplasty, to reconstruct one of your joints (hip or knee) at Royal Hampshire County Hospital (RHCH), Winchester.

As we have centralised this service to improve waiting times, length of stay and improve consultant cover seven days a week, we would like your feedback to help us understand what went well and what we might try and improve.

It should only take you three to five minutes to complete and all feedback is anonymous unless you choose to leave your name and contact details because you would like someone to
contact you about your experience.

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* 1. Are you:

The patient

Answering on behalf of a patients (eg relative, friend or carer)

Answering as a relative, friend or carer

Other (please specify)

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* 2. Which do you consider to be your local hospital?

Basingstoke and North Hampshire Hospital

Royal Hampshire County Hospital (Winchester)

Other (please specify)

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* 3. What is the start of your postcode?

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* 4. How did you travel to RHCH for your operation?

NHS patient transport

Voluntary services patient transport

I was given a lift

Taxi

Bus/train

Other, please specify

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* 5. Would you have made other travel arrangements if your operation had been at your local hospital?

Not applicable as this was my local hospital

No, I would have made the same arrangements

Yes (please specify)

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* 6. Thinking about your overall experience, how would you rate the service you received?

Very good

Good

Neither good or poor

Poor

Very poor

Don't know

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* 7. Please tell us as concisely as possible, why you gave your rating of the experience received.

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* 8. Thinking about carers, family members and friends, how did these new ways of working impact on them:

Positive impact

Acceptable impact. They understood the benefits

Minimal negative impact

Significant negative impact

If you answered minimal or significant negative impact, please tell us why.

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* 9. Please can you tell us up to three things you feel went well and up to three things you feel we could improve.

Did well

Could improve

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* 10. If you wish, please use the space below to tell us more about your experience.

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* 11. If you would like someone to call you to discuss your experience in more detail, please also leave your name and preferred contact details.

Name (optional)

Telephone number/email address (optional)

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* 12. About you (optional section)

Are you:

Male

Female

Prefer not to say

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* 13. Your age group:

17 or under

18-24

25-34

35-44

45-54

55-64

65-74

75-84

85+

Prefer not to say

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* 14. Your ethnic background

Bangladeshi

Black African

Black Caribbean

Chinese

Indian

Nepali

Pakistani

White and Asian

White and Black African

White and Black Caribbean

White British

White Irish

Any other Asian background

Any other Black background

Any other White background

Prefer not to say

Any other ethnic background (please specify below):

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* 15. Do you consider yourself to have a disability?

Yes

Prefer not to say

If yes, please tell us about your disability below:

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* 16. Your religion or belief:

Atheism

Buddhism

Christianity

Hinduism

Islam

Judaism

Sikhism

Other religion or belief

Prefer not to say

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* 17. You would describe your sexuality as:

Bisexual

Gay man

Heterosexual/straight

Lesbian/gay woman

Prefer not to say

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* 18. Are you a carer?

Yes, for child/children under 18 years living at home

Yes, for a relative or person living with you

Yes, for a relative or person living elsewhere

Monitoring and improving our service for hip and knee replacement patients

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* 1. Are you:

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* 2. Which do you consider to be your local hospital?

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* 3. What is the start of your postcode?

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* 4. How did you travel to RHCH for your operation?

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* 5. Would you have made other travel arrangements if your operation had been at your local hospital?

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* 6. Thinking about your overall experience, how would you rate the service you received?

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* 7. Please tell us as concisely as possible, why you gave your rating of the experience received.

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* 8. Thinking about carers, family members and friends, how did these new ways of working impact on them:

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* 9. Please can you tell us up to three things you feel went well and up to three things you feel we could improve.

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* 10. If you wish, please use the space below to tell us more about your experience.

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* 11. If you would like someone to call you to discuss your experience in more detail, please also leave your name and preferred contact details.

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* 12. About you (optional section)Are you:﻿

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* 13. Your age group:

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* 14. Your ethnic background

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* 15. Do you consider yourself to have a disability?

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* 16. Your religion or belief:

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* 17. You would describe your sexuality as:

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* 18. Are you a carer?

* 12. About you (optional section)

Are you: