Saint Mary’s Hospital Department of Reproductive Medicine

Patient Feedback Survey

Your views are important to us.
Thank you for agreeing to take part in this important survey measuring customer satisfaction for the Assisted Conception service at Saint Mary's Hospital.
Your thoughts and opinions will help us to better serve you and other patients in the future.
This survey should only take no more than 15 minutes to complete.
Please be assured that all your answers will be kept in the strictest confidence.
1.So that we can gather information on our patient demographics, please could you write your full postcode below:
2.Please select which age group you belong to
25 or under
25-29
30-34
35-39
40 or over
Not applicable
Patient
Partner
3.Please select which treatment (s) you received this time?
4.Have you previously had fertility treatment?
5.Who referred you to Saint Mary’s?
6.Please consider the following questions;
Very Good
Good
Neither good nor poor
Poor
Very poor
How would you rate the patient informational videos and supporting information on the e-consenting platform prior to your treatment?
How would you rate the patient information session on the Trust website prior to your first clinic appointment?
7.Please tell us if there is any further information which was not available to you prior to your treatment  but which you feel would have been helpful?
8.How would you prefer to receive your patient information? (Please select all that apply)
9.Please only answer this question if you are a Fee-paying patient.
Yes
No
Don't know
Were you given information about treatment costs / funding prior to starting treatment?
Were you given adequate information regarding payment procedures?
Departmental Services
10.If you have had to contact the department via telephone which option did you choose? (Please select the option that applies to your most recent interaction)
11.Please consider the following questions;
Always
Sometimes
Rarely
Never
Not applicable 
Were you able to contact the Department by telephone easily?
When you telephoned were the team able to resolve your query?
If the team needed to call you back were you contacted in a timely manner?
If you telephoned to speak to a specific member of staff, were you able to speak to them?
12.Please consider the following questions;
Always
Sometimes
Rarely
Never
N/A
Were you greeted in a friendly manner when you arrived for your appointment?
Were questions that you asked during your appointment answered?
Were you shown courtesy and attention by staff throughout the department?
Did you feel you were treated with privacy and dignity during your appointments or treatments?
Did you feel confident that your information was secure and the terms on when/if and why it would be disclosed?
Were you given a clear understanding of what to expect at each step of your treatment?
13.Please consider the following questions;
Always
Sometimes
Rarely
Never
N/A
Was the information about your medication explained to you in a way that you could understand?
Based on the information did you feel confident to inject or ingest your drugs?
Did the home delivery service provide an efficient and professional service?
Was your medication delivered in a timely manner?
14.Please consider the following questions;
Yes, definitely
Yes, somewhat
No, not at all
Don’t know
During your clinic appointment were you given a satisfactory assessment of your situation and treatment options?
Were you given information regarding the treatments available, the risks, side effects and outcomes of your treatment?
Were you advised about the screening requirements and possible outcomes?
Were you advised about your waiting time for treatment?
Were you advised to keep in touch with the Department to advise of outcomes, or any changes to your information?
Were you advised about your right to withdraw or vary your consent?
Were you given enough information to make an informed decision about your treatment?
Were you made aware of research within the department?
Were you given an opportunity to take part in research within the department?
Were you made aware that any research decisions to participate or donate would not affect your treatment in any way?
Were you aware of the right to withdraw to consent for research or training up to the point the embryos are used?
15.Please consider the following questions;
Always
Sometimes
Rarely
Never
Not applicable
Did the staff introduce themselves?
Did the staff explain their role?
Did staff explain what they were going to do before a procedure?
16.Please consider the following questions;
Yes, definitely
Yes, somewhat
No, not at all
Don’t know
Did the Embryologist identify themselves on the telephone follow?
Were you contacted after your theatre session about what has happened since your procedure?
Did you understand the information you were given?
Did you understand what the next steps were?
17.Were you offered counselling?
18.Did you have any counselling sessions?
19.If you had counselling please tell us how much you agree with the following statements.
Strongly agree
Agree
Neither agree of disagree
Disagree
Strongly Disagree
I felt the counselling was private
I felt comfortable during the counselling
I felt the counselling was confidential
The counselling was held in comfortable and uninterrupted surroundings
20.Please consider the following questions?
Yes, definitely
Yes, somewhat
No, not at all
Don’t know
Did you feel supported as a patient by the department before your treatment?
Did you feel supported as a patient  by the department during your treatment?
Did you feel supported as a patient by the department after your treatment?
21.Did you feel the department were sensitive to any ethnic, religious, societal, cultural, or other factors individual to you?
22.How would you prefer to contact the Department? (please select your top two choices)
23.Were you given written or printed information regarding what you should do/not do after your procedure?
24.Did a member of staff tell you who to contact if you were worried about your condition or treatment after you went home?
25.Please rate your overall experience of our Unit
The following questions are optional, but we are keen to ensure that our services are suitable for all our communities so we would be grateful if you would help us by completing them.
26.Which of the following best describes how you think of yourself?
27.Is your gender the same as it was assigned at birth?
28.What age range are you?
29.What is your ethnic group?
30.Do you have a disability? (Any health issue or impairment which is likely to last more than 12 months and impact on your ability to carry out everyday activities)
31.Which of the following options best describes how you think of yourself?
32.What is your religion or belief , even if you are not currently Practicing?
33.Do you consent to your anonymous comments being used in the public domain?(Required.)
If you want to give your views to a more open forum, please go to hfea.gov.uk and follow the instructions below