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.

https://mft.nhs.uk/privacy-policy/

Question Title

1. So that we can gather information on our patient demographics, please could you write your full postcode below:

Question Title

2. Please select which age group you belong to

	25 or under	26-29	30-34	35-39	40 or over	Not applicable
Patient	Patient 25 or under	Patient 26-29	Patient 30-34	Patient 35-39	Patient 40 or over	Patient Not applicable
Partner	Partner 25 or under	Partner 26-29	Partner 30-34	Partner 35-39	Partner 40 or over	Partner Not applicable

Question Title

3. Please select which treatment (s) you received this time?

Fresh IVF/ICSI

Frozen Embryo Cycle

Ovulation Induction with IUI

Ovulation Induction without IUI

Fertility preservation

Question Title

4. Have you previously had fertility treatment?

Yes

If you answered yes, please tell us where you had the fertility treatment.

Question Title

5. Who referred you to Saint Mary’s?

Self-referral

Another Hospital

Other (please specify)

Question Title

6. Please consider the following questions;

	Very Good	Good	Poor	Very Poor	Did not use
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 informational videos and supporting information on the e-consenting platform prior to your treatment? Very Good	How would you rate the patient informational videos and supporting information on the e-consenting platform prior to your treatment? Good	How would you rate the patient informational videos and supporting information on the e-consenting platform prior to your treatment? Poor	How would you rate the patient informational videos and supporting information on the e-consenting platform prior to your treatment? Very Poor	How would you rate the patient informational videos and supporting information on the e-consenting platform prior to your treatment? Did not use
How would you rate the information on the DRM website at mft.nhs.uk/saint-marys/services/gynaecology/reproductive-medicine?	How would you rate the information on the DRM website at mft.nhs.uk/saint-marys/services/gynaecology/reproductive-medicine? Very Good	How would you rate the information on the DRM website at mft.nhs.uk/saint-marys/services/gynaecology/reproductive-medicine? Good	How would you rate the information on the DRM website at mft.nhs.uk/saint-marys/services/gynaecology/reproductive-medicine? Poor	How would you rate the information on the DRM website at mft.nhs.uk/saint-marys/services/gynaecology/reproductive-medicine? Very Poor	How would you rate the information on the DRM website at mft.nhs.uk/saint-marys/services/gynaecology/reproductive-medicine? Did not use

Please feel free to provide any further feedback here.

Question Title

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?

Question Title

8. Please only answer this question if you are a Fee-paying patient.

	Yes	No
Were you given information about treatment costs / funding prior to starting treatment if previously an NHS patient?	Were you given information about treatment costs / funding prior to starting treatment if previously an NHS patient? Yes	Were you given information about treatment costs / funding prior to starting treatment if previously an NHS patient? No
Were you given adequate information regarding payment procedures, if you were not eligible for NHS funding?	Were you given adequate information regarding payment procedures, if you were not eligible for NHS funding? Yes	Were you given adequate information regarding payment procedures, if you were not eligible for NHS funding? No
Were you satisfied with the service and communication?	Were you satisfied with the service and communication? Yes	Were you satisfied with the service and communication? No

Departmental Services

Question Title

9. 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)

Option 1, Recurrent miscarriage / Endocrine / Endometriosis

Option 2, Treatment request

Option 3, Embryologist

Option 4, Fee paying

Option 5, Treatment query / nurses

Option 6, General enquiries

Question Title

10. Please consider the following questions;

	Always	Sometimes	Rarely	Never	Not applicable
Were you able to contact the department by telephone easily?	Were you able to contact the department by telephone easily? Always	Were you able to contact the department by telephone easily? Sometimes	Were you able to contact the department by telephone easily? Rarely	Were you able to contact the department by telephone easily? Never	Were you able to contact the department by telephone easily? Not applicable
Were you able to contact the department easily via the salve app?	Were you able to contact the department easily via the salve app? Always	Were you able to contact the department easily via the salve app? Sometimes	Were you able to contact the department easily via the salve app? Rarely	Were you able to contact the department easily via the salve app? Never	Were you able to contact the department easily via the salve app? Not applicable
Was the team able to resolve your query over the phone/using the salve app?	Was the team able to resolve your query over the phone/using the salve app? Always	Was the team able to resolve your query over the phone/using the salve app? Sometimes	Was the team able to resolve your query over the phone/using the salve app? Rarely	Was the team able to resolve your query over the phone/using the salve app? Never	Was the team able to resolve your query over the phone/using the salve app? Not applicable
If the team needed to call you back were you contacted in a timely manner?	If the team needed to call you back were you contacted in a timely manner? Always	If the team needed to call you back were you contacted in a timely manner? Sometimes	If the team needed to call you back were you contacted in a timely manner? Rarely	If the team needed to call you back were you contacted in a timely manner? Never	If the team needed to call you back were you contacted in a timely manner? Not applicable

Please feel free to provide any further feedback here.

Question Title

11. Please consider the following questions;

	Yes	No	N/A
Were you aware that if you are in assisted conception treatment you can use the SALVE app?	Were you aware that if you are in assisted conception treatment you can use the SALVE app? Yes	Were you aware that if you are in assisted conception treatment you can use the SALVE app? No	Were you aware that if you are in assisted conception treatment you can use the SALVE app? N/A
Did you use the SALVE app?	Did you use the SALVE app? Yes	Did you use the SALVE app? No	Did you use the SALVE app? N/A

If you did use the SALVE app, please provide feedback on your experience.

Question Title

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 at reception?	Were you greeted in a friendly manner when you arrived for your appointment at reception? Always	Were you greeted in a friendly manner when you arrived for your appointment at reception? Sometimes	Were you greeted in a friendly manner when you arrived for your appointment at reception? Rarely	Were you greeted in a friendly manner when you arrived for your appointment at reception? Never	Were you greeted in a friendly manner when you arrived for your appointment at reception? N/A
Were questions that you asked during your appointment answered by clinical staff?	Were questions that you asked during your appointment answered by clinical staff? Always	Were questions that you asked during your appointment answered by clinical staff? Sometimes	Were questions that you asked during your appointment answered by clinical staff? Rarely	Were questions that you asked during your appointment answered by clinical staff? Never	Were questions that you asked during your appointment answered by clinical staff? N/A
Were you shown courtesy and attention by staff throughout the department?	Were you shown courtesy and attention by staff throughout the department? Always	Were you shown courtesy and attention by staff throughout the department? Sometimes	Were you shown courtesy and attention by staff throughout the department? Rarely	Were you shown courtesy and attention by staff throughout the department? Never	Were you shown courtesy and attention by staff throughout the department? N/A
Did you feel you were treated with privacy and dignity during your appointments or treatments?	Did you feel you were treated with privacy and dignity during your appointments or treatments? Always	Did you feel you were treated with privacy and dignity during your appointments or treatments? Sometimes	Did you feel you were treated with privacy and dignity during your appointments or treatments? Rarely	Did you feel you were treated with privacy and dignity during your appointments or treatments? Never	Did you feel you were treated with privacy and dignity during your appointments or treatments? N/A
Did you feel confident that your information was secure and the terms on when/if and why it would be disclosed?	Did you feel confident that your information was secure and the terms on when/if and why it would be disclosed? Always	Did you feel confident that your information was secure and the terms on when/if and why it would be disclosed? Sometimes	Did you feel confident that your information was secure and the terms on when/if and why it would be disclosed? Rarely	Did you feel confident that your information was secure and the terms on when/if and why it would be disclosed? Never	Did you feel confident that your information was secure and the terms on when/if and why it would be disclosed? N/A
Were you given a clear understanding of what to expect at each step of your treatment?	Were you given a clear understanding of what to expect at each step of your treatment? Always	Were you given a clear understanding of what to expect at each step of your treatment? Sometimes	Were you given a clear understanding of what to expect at each step of your treatment? Rarely	Were you given a clear understanding of what to expect at each step of your treatment? Never	Were you given a clear understanding of what to expect at each step of your treatment? N/A

Please feel free to provide any further feedback here.

Question Title

13. Please consider the following questions (please only answer these questions if you did have any medication);

	Always	Sometimes	Rarely	Never	N/A
Was the information about your medication explained to you in a way that you could understand?	Was the information about your medication explained to you in a way that you could understand? Always	Was the information about your medication explained to you in a way that you could understand? Sometimes	Was the information about your medication explained to you in a way that you could understand? Rarely	Was the information about your medication explained to you in a way that you could understand? Never	Was the information about your medication explained to you in a way that you could understand? N/A
Based on the information did you feel confident to inject or ingest your drugs?	Based on the information did you feel confident to inject or ingest your drugs? Always	Based on the information did you feel confident to inject or ingest your drugs? Sometimes	Based on the information did you feel confident to inject or ingest your drugs? Rarely	Based on the information did you feel confident to inject or ingest your drugs? Never	Based on the information did you feel confident to inject or ingest your drugs? N/A
Did the home delivery service provide an efficient and professional service?	Did the home delivery service provide an efficient and professional service? Always	Did the home delivery service provide an efficient and professional service? Sometimes	Did the home delivery service provide an efficient and professional service? Rarely	Did the home delivery service provide an efficient and professional service? Never	Did the home delivery service provide an efficient and professional service? N/A
Was your medication delivered in a timely manner?	Was your medication delivered in a timely manner? Always	Was your medication delivered in a timely manner? Sometimes	Was your medication delivered in a timely manner? Rarely	Was your medication delivered in a timely manner? Never	Was your medication delivered in a timely manner? N/A

Please feel free to provide further feedback here.

Question Title

14. Please consider the following questions;

	Yes	Yes, somewhat	No	Don’t know
During your clinic appointment were you given a satisfactory assessment of your situation and treatment options?	During your clinic appointment were you given a satisfactory assessment of your situation and treatment options? Yes	During your clinic appointment were you given a satisfactory assessment of your situation and treatment options? Yes, somewhat	During your clinic appointment were you given a satisfactory assessment of your situation and treatment options? No	During your clinic appointment were you given a satisfactory assessment of your situation and treatment options? Don’t know
Were you given information regarding the treatments available, the risks, side effects and outcomes of your treatment?	Were you given information regarding the treatments available, the risks, side effects and outcomes of your treatment? Yes	Were you given information regarding the treatments available, the risks, side effects and outcomes of your treatment? Yes, somewhat	Were you given information regarding the treatments available, the risks, side effects and outcomes of your treatment? No	Were you given information regarding the treatments available, the risks, side effects and outcomes of your treatment? Don’t know
Were you advised about the screening requirements and possible outcomes?	Were you advised about the screening requirements and possible outcomes? Yes	Were you advised about the screening requirements and possible outcomes? Yes, somewhat	Were you advised about the screening requirements and possible outcomes? No	Were you advised about the screening requirements and possible outcomes? Don’t know
Were you advised about your waiting time for treatment?	Were you advised about your waiting time for treatment? Yes	Were you advised about your waiting time for treatment? Yes, somewhat	Were you advised about your waiting time for treatment? No	Were you advised about your waiting time for treatment? Don’t know
Were you advised to keep in touch with the Department to advise of outcomes, or any changes to your information?	Were you advised to keep in touch with the Department to advise of outcomes, or any changes to your information? Yes	Were you advised to keep in touch with the Department to advise of outcomes, or any changes to your information? Yes, somewhat	Were you advised to keep in touch with the Department to advise of outcomes, or any changes to your information? No	Were you advised to keep in touch with the Department to advise of outcomes, or any changes to your information? Don’t know
Were you advised about your right to withdraw or vary your consent?	Were you advised about your right to withdraw or vary your consent? Yes	Were you advised about your right to withdraw or vary your consent? Yes, somewhat	Were you advised about your right to withdraw or vary your consent? No	Were you advised about your right to withdraw or vary your consent? Don’t know
Were you given enough information to make an informed decision about your treatment?	Were you given enough information to make an informed decision about your treatment? Yes	Were you given enough information to make an informed decision about your treatment? Yes, somewhat	Were you given enough information to make an informed decision about your treatment? No	Were you given enough information to make an informed decision about your treatment? Don’t know
Were you made aware of research within the department?	Were you made aware of research within the department? Yes	Were you made aware of research within the department? Yes, somewhat	Were you made aware of research within the department? No	Were you made aware of research within the department? Don’t know
Were you given an opportunity to take part in research within the department?	Were you given an opportunity to take part in research within the department? Yes	Were you given an opportunity to take part in research within the department? Yes, somewhat	Were you given an opportunity to take part in research within the department? No	Were you given an opportunity to take part in research within the department? Don’t know
Were you made aware that any research decisions to participate or donate would not affect your treatment in any way?	Were you made aware that any research decisions to participate or donate would not affect your treatment in any way? Yes	Were you made aware that any research decisions to participate or donate would not affect your treatment in any way? Yes, somewhat	Were you made aware that any research decisions to participate or donate would not affect your treatment in any way? No	Were you made aware that any research decisions to participate or donate would not affect your treatment in any way? Don’t know
Were you aware of the right to withdraw to consent for research or training up to the point the embryos are used?	Were you aware of the right to withdraw to consent for research or training up to the point the embryos are used? Yes	Were you aware of the right to withdraw to consent for research or training up to the point the embryos are used? Yes, somewhat	Were you aware of the right to withdraw to consent for research or training up to the point the embryos are used? No	Were you aware of the right to withdraw to consent for research or training up to the point the embryos are used? Don’t know

Please feel free to tell us why you answered the way that you did.

Question Title

15. Please consider the following questions;

	Yes	Yes, sometimes	Rarely	Never	Not applicable
Did the staff introduce themselves?	Did the staff introduce themselves? Yes	Did the staff introduce themselves? Yes, sometimes	Did the staff introduce themselves? Rarely	Did the staff introduce themselves? Never	Did the staff introduce themselves? Not applicable
Did the staff explain their role?	Did the staff explain their role? Yes	Did the staff explain their role? Yes, sometimes	Did the staff explain their role? Rarely	Did the staff explain their role? Never	Did the staff explain their role? Not applicable
Did staff explain what they were going to do before a procedure?	Did staff explain what they were going to do before a procedure? Yes	Did staff explain what they were going to do before a procedure? Yes, sometimes	Did staff explain what they were going to do before a procedure? Rarely	Did staff explain what they were going to do before a procedure? Never	Did staff explain what they were going to do before a procedure? Not applicable

Please feel free to tell us why you answered the way that you did.

Question Title

16. Please consider the following questions;

	Yes, definitely	Yes, sometimes	No, not at all
Did the Embryologist identify themselves on the telephone follow up?	Did the Embryologist identify themselves on the telephone follow up? Yes, definitely	Did the Embryologist identify themselves on the telephone follow up? Yes, sometimes	Did the Embryologist identify themselves on the telephone follow up? No, not at all
Did the embryologist contact you after egg recovery to update you about the outcome of the eggs/embryos?	Did the embryologist contact you after egg recovery to update you about the outcome of the eggs/embryos? Yes, definitely	Did the embryologist contact you after egg recovery to update you about the outcome of the eggs/embryos? Yes, sometimes	Did the embryologist contact you after egg recovery to update you about the outcome of the eggs/embryos? No, not at all
Did you understand the information you were given?	Did you understand the information you were given? Yes, definitely	Did you understand the information you were given? Yes, sometimes	Did you understand the information you were given? No, not at all
Did you understand what the next steps were?	Did you understand what the next steps were? Yes, definitely	Did you understand what the next steps were? Yes, sometimes	Did you understand what the next steps were? No, not at all

Please feel free to tell us why you answered the way that you did.

Question Title

17. Were you offered counselling?

Yes

Question Title

18. Did you have any counselling sessions?

Yes

Question Title

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 the counselling was private Strongly agree	I felt the counselling was private Agree	I felt the counselling was private Neither agree of disagree	I felt the counselling was private Disagree	I felt the counselling was private Strongly Disagree
I felt comfortable during the counselling	I felt comfortable during the counselling Strongly agree	I felt comfortable during the counselling Agree	I felt comfortable during the counselling Neither agree of disagree	I felt comfortable during the counselling Disagree	I felt comfortable during the counselling Strongly Disagree
I felt the counselling was confidential	I felt the counselling was confidential Strongly agree	I felt the counselling was confidential Agree	I felt the counselling was confidential Neither agree of disagree	I felt the counselling was confidential Disagree	I felt the counselling was confidential Strongly Disagree
The counselling was held in comfortable and uninterrupted surroundings	The counselling was held in comfortable and uninterrupted surroundings Strongly agree	The counselling was held in comfortable and uninterrupted surroundings Agree	The counselling was held in comfortable and uninterrupted surroundings Neither agree of disagree	The counselling was held in comfortable and uninterrupted surroundings Disagree	The counselling was held in comfortable and uninterrupted surroundings Strongly Disagree

Please feel free to tell us why you answered the way that you did.

Question Title

20. Please consider the following questions?

	Yes, definitely	Yes, somewhat	No, not at all
Did you feel supported as a patient by the department during your treatment?	Did you feel supported as a patient by the department during your treatment? Yes, definitely	Did you feel supported as a patient by the department during your treatment? Yes, somewhat	Did you feel supported as a patient by the department during your treatment? No, not at all
Did you feel supported as a patient by the department after your treatment?	Did you feel supported as a patient by the department after your treatment? Yes, definitely	Did you feel supported as a patient by the department after your treatment? Yes, somewhat	Did you feel supported as a patient by the department after your treatment? No, not at all

Please feel free to tell us why you answered the way that you did.

Question Title

21. Did you feel the department were sensitive to any ethnic, religious, societal, cultural, or other factors individual to you?

Yes, definitely

Yes, somewhat

Please feel free to tell us why you answered the way that you did.

Question Title

22. Following your procedure, were you easily able to access the post procedure advice and guidance information on the SALVE app?

Yes

Question Title

23. Were you informed of your storage options and rules around storage?

Yes

N/A

Question Title

24. Please rate your overall experience of our Unit

Very good

Good

Neither good nor poor

Poor

Very poor

Thinking about your experience is there anything that you think we have done well or anything that you think we could do better?

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.

Question Title

25. Which of the following best describes how you think of yourself?

Woman (including trans woman)

Man (including trans man)

Non-Binary

Prefer not to say

Other (please specify)

Question Title

26. Is your gender the same as it was assigned at birth?

Yes

Prefer not to say

Other (please specify)

Question Title

27. What age range are you?

18 - 24

25 - 34

35 - 44

45+

Prefer not to say

Question Title

28. What is your ethnic group?

White British

White Other

Asian / Asian British

Black / African / Caribbean / Black British

Mixed / Multiple Ethic Groups

Prefer not to say

Other (please specify)

Question Title

29. 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)

Yes

Prefer not to say

Question Title

30. Which of the following options best describes how you think of yourself?

Heterosexual / Straight

Bisexual

Gay

Lesbian

Prefer not to say

Other (please specify)

Question Title

31. What is your religion or belief , even if you are not currently Practicing?

Christianity

Islam

Judaism

Hinduism

Buddhism

Sikhism

Humanism

Agnosticism

No religion

Prefer not to say

Other (please specify)

Question Title

32. Do you consent to your anonymous comments being used in the public domain? (Required.)

Yes

If you want to give your views to a more open forum, please go to hfea.gov.uk and follow the instructions below

Saint Mary’s Hospital Department of Reproductive Medicine

Patient Feedback Survey

Question Title

* 1. So that we can gather information on our patient demographics, please could you write your full postcode below:

Question Title

* 2. Please select which age group you belong to

Question Title

* 3. Please select which treatment (s) you received this time?

Question Title

* 4. Have you previously had fertility treatment?

Question Title

* 5. Who referred you to Saint Mary’s?

Question Title

* 6. Please consider the following questions;

Question Title

* 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?

Question Title

* 8. Please only answer this question if you are a Fee-paying patient.

Question Title

* 9. 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)

Question Title

* 10. Please consider the following questions;

Question Title

* 11. Please consider the following questions;

Question Title

* 12. Please consider the following questions;

Question Title

* 13. Please consider the following questions (please only answer these questions if you did have any medication);

Question Title

* 14. Please consider the following questions;

Question Title

* 15. Please consider the following questions;

Question Title

* 16. Please consider the following questions;

Question Title

* 17. Were you offered counselling?

Question Title

* 18. Did you have any counselling sessions?

Question Title

* 19. If you had counselling please tell us how much you agree with the following statements.

Question Title

* 20. Please consider the following questions?

Question Title

* 21. Did you feel the department were sensitive to any ethnic, religious, societal, cultural, or other factors individual to you?

Question Title

* 22. Following your procedure, were you easily able to access the post procedure advice and guidance information on the SALVE app?

Question Title

* 23. Were you informed of your storage options and rules around storage?

Question Title

* 24. Please rate your overall experience of our Unit

Question Title

* 25. Which of the following best describes how you think of yourself?

Question Title

* 26. Is your gender the same as it was assigned at birth?

Question Title

* 27. What age range are you?

Question Title

* 28. What is your ethnic group?

Question Title

* 29. 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)

Question Title

* 30. Which of the following options best describes how you think of yourself?

Question Title

* 31. What is your religion or belief , even if you are not currently Practicing?

Question Title

* 32. Do you consent to your anonymous comments being used in the public domain? (Required.)

Question Title

Question Title

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

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;

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. Please only answer this question if you are a Fee-paying patient.

9. 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)

10. Please consider the following questions;

11. Please consider the following questions;

12. Please consider the following questions;

13. Please consider the following questions (please only answer these questions if you did have any medication);

14. Please consider the following questions;

15. Please consider the following questions;

16. Please consider the following questions;

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.

20. Please consider the following questions?

21. Did you feel the department were sensitive to any ethnic, religious, societal, cultural, or other factors individual to you?

22. Following your procedure, were you easily able to access the post procedure advice and guidance information on the SALVE app?

23. Were you informed of your storage options and rules around storage?

24. Please rate your overall experience of our Unit

25. Which of the following best describes how you think of yourself?

26. Is your gender the same as it was assigned at birth?

27. What age range are you?

28. What is your ethnic group?

29. 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)

30. Which of the following options best describes how you think of yourself?

31. What is your religion or belief , even if you are not currently Practicing?

32. Do you consent to your anonymous comments being used in the public domain? (Required.)