NHS Continuing Healthcare Services: Self / Family Feedback Survey

This survey seeks feedback on your own or a family / friend’s experience of the NHS Cheshire Continuing Healthcare Services.

Your answers are important to us as they will help us improve our service. All feedback will remain anonymous, so please answer as honestly as you can. For each question, please select one answer and provide additional information as required.

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* 1. Please state who you are filling in this questionnaire for?

Yourself

As someone’s carer / relative/ friend etc.

If you are filling in the questionnaire for someone else, please state your relationship to them

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* 2. Do you provide care for the individual you are completing the questionnaire for?

Yes

Not applicable as you are the one receiving the care

If you have answered yes, please state whether you are an unpaid carer or paid carer?

Please select whether you agree or disagree with the following statements and give reasons for your selected answers.

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* 3. I received clear information in a way that I understood throughout the process.

Yes

Please tell us why you feel this way:

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* 4. I was kept informed about what was going to happen and when.

Yes

Please tell us why you feel this way:

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* 5. I knew who to contact if I had any questions.

Yes

Please tell us why you feel this way:

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* 6. I understood why the assessment / review took place and the outcome.

Yes

Please tell us why you feel this way:

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* 7. I feel that the assessment / review reflected my current health needs.

Yes

Please tell us why you feel this way:

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* 8. I feel I was treated with kindness, compassion, dignity and respect throughout the process.

Strongly disagree

Disagree

Neither agree or disagree

Agree

Strongly Agree

Strongly disagree

Disagree

Neither agree or disagree

Agree

Strongly Agree

Please tell us why you feel this way:

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* 9. I feel that I was listened to and my views were considered.

Strongly disagree

Disagree

Neither agree or disagree

Agree

Strongly Agree

Strongly disagree

Disagree

Neither agree or disagree

Agree

Strongly Agree

Please tell us why you feel this way:

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* 10. I feel that the Commissioning Nurse was polite and friendly.

Strongly disagree

Disagree

Neither agree or disagree

Agree

Strongly Agree

Strongly disagree

Disagree

Neither agree or disagree

Agree

Strongly Agree

Please tell us why you feel this way:

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* 11. How would you rate our involvement of yourself or your relative/representative throughout the process?

Extremely Poor

Poor

Satisfactory

Very Good

Excellent

Extremely Poor

Poor

Satisfactory

Very Good

Excellent

Please tell us why you feel this way:

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* 12. Do you agree with the outcome of your assessment / review?

Yes

Please tell us why you feel this way:

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* 13. Was the assessment / review convenient for you?

Yes

Please tell us why you feel this way:

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* 14. Was a Personal Health Budget offered and discussed with you?

Yes

Please state any further comments:

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* 15. What was good about your experience? Please tell us what we did well.

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* 16. How could we improve our service?

Many thanks for taking the time to complete our survey. Your answers are important to us and will help us improve the service.