Hospital Outpatients Clinics

Planned Care - Hospital Outpatients Clinics

We, in the local NHS, are interested in hearing about experiences people have had who have been referred and attended Hospital Outpatients clinics within this last year.

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* 1. Which practice are you from? Please state below.

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* 2. Hospital

Which Hospital did you attend?

Which department or specialty?

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* 3. Appointment

When did you have your first appointment? Please tick appropriate box.

January to March 2018

April to June 2018

July to September 2018

October to December 2018

From January 2019 onwards

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* 4. Experience

Which part of your experience was most important to you? Please indicate in order of priority from 1 to 5, with 1 being most important and 5 being least important.

	1	2	3	4	5
Timeliness of the first appointment	Timeliness of the first appointment 1	Timeliness of the first appointment 2	Timeliness of the first appointment 3	Timeliness of the first appointment 4	Timeliness of the first appointment 5
Timeliness of the investigations/tests	Timeliness of the investigations/tests 1	Timeliness of the investigations/tests 2	Timeliness of the investigations/tests 3	Timeliness of the investigations/tests 4	Timeliness of the investigations/tests 5
Timeliness of receiving results	Timeliness of receiving results 1	Timeliness of receiving results 2	Timeliness of receiving results 3	Timeliness of receiving results 4	Timeliness of receiving results 5
Timeliness of getting the diagnosis	Timeliness of getting the diagnosis 1	Timeliness of getting the diagnosis 2	Timeliness of getting the diagnosis 3	Timeliness of getting the diagnosis 4	Timeliness of getting the diagnosis 5
Timeliness of actions to resolve your problem	Timeliness of actions to resolve your problem 1	Timeliness of actions to resolve your problem 2	Timeliness of actions to resolve your problem 3	Timeliness of actions to resolve your problem 4	Timeliness of actions to resolve your problem 5

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* 5. Problems

Which of these, if any, gave you problems? Please tick all that apply.

Timeliness of the first appointment

Timeliness of the investigations/tests

Timeliness of receiving results

Timeliness of getting the diagnosis

Timeliness of actions to resolve your problem

None of the above

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* 6. Problems (continued)

Please indicate if any of the below are related to the problems in Question 4. Please add any details you wish.

Delayed referral

Missed appointment

Long wait times

Paperwork errors

None of the above

Other (please specify)

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* 7. Efficiency

To make your care more helpful and efficient, which of the following would you be prepared to consider. Please tick all that apply.

Going for investigations/tests before your first appointment

Would you consider follow up by telephone

Would you consider follow up by letter

Would you consider follow up by face to face computer call e.g. Skype

None of the above

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* 8. Change

If there is anything you could change about your experience, what would that be? Please comment below.

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* 9. If you would like us to inform you of the results of this survey and /or would be interested in taking part in future work around Outpatient Services, please leave your name and contact details below.

Name

Email Address

Hospital Outpatients Clinics

Planned Care - Hospital Outpatients Clinics

Question Title

* 1. Which practice are you from? Please state below.

Question Title

* 2. Hospital

Question Title

* 3. AppointmentWhen did you have your first appointment? Please tick appropriate box.

Question Title

* 4. ExperienceWhich part of your experience was most important to you? Please indicate in order of priority from 1 to 5, with 1 being most important and 5 being least important.

Question Title

* 5. ProblemsWhich of these, if any, gave you problems? Please tick all that apply.

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* 6. Problems (continued)Please indicate if any of the below are related to the problems in Question 4. Please add any details you wish.

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* 7. EfficiencyTo make your care more helpful and efficient, which of the following would you be prepared to consider. Please tick all that apply.

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* 8. ChangeIf there is anything you could change about your experience, what would that be? Please comment below.

Question Title

* 9. If you would like us to inform you of the results of this survey and /or would be interested in taking part in future work around Outpatient Services, please leave your name and contact details below.

* 3. Appointment

When did you have your first appointment? Please tick appropriate box.

* 4. Experience

Which part of your experience was most important to you? Please indicate in order of priority from 1 to 5, with 1 being most important and 5 being least important.

* 5. Problems

Which of these, if any, gave you problems? Please tick all that apply.

* 6. Problems (continued)

Please indicate if any of the below are related to the problems in Question 4. Please add any details you wish.

* 7. Efficiency

To make your care more helpful and efficient, which of the following would you be prepared to consider. Please tick all that apply.

* 8. Change

If there is anything you could change about your experience, what would that be? Please comment below.