Please rate your experience of staffs’ courtesy. Did they address you by name? Did they say please and thank-you when dealing with you and apologise for any delays. Did they deal with you in a timely way?

Please rate your experience of the level of respect you received from staff. Did they look you in the eye when talking to you? Did they use your name appropriately and respect your choices and rights? Did they act in a culturally sensitive way to you or ask if you required any assistance as a result of a disability? Did they respect your sexuality or act in an age appropriate way? Did they safeguard your confidentiality?

Please rate your opinion of the general cleanliness of the premises from which your care was given. Were the waiting room chairs clean? Did the floor look clean? Were the public bathrooms maintained in a hygienic way?

If you arrived by bus, please rate how convenient the situation of the bus stop is to the premises at which you are receiving care.

If you arrived by car, or other private vehicle, please rate your opinion of car parking facilities. Are there enough spaces? Is there adequate provision for disabled drivers?

If you arrived by car, or other private vehicle, how would you rate the charges for car parking, the payment meters, time lengths and penalty charges imposed?

 

Please rate your opinion of any health advice received as part of your consultation or care package. Did the practitioner advise you on diet, alcohol consumption, exercise or smoking?

Please rate your experience of using repeat prescription facilities? Are there a range of ways in which you can access this service? Are the times at which this service is available  convenient to your lifestyle choices.

If you have had cause to make a complaint, please rate your experience. Was your complaint acknowledged? Did the staff investigate and report back to you within 25 days? Were you offered a meeting to resolve your complaint? Did you receive any feedback if changes were made as a result of your complaint? Were you told how to appeal should you wish to?

Please rate how you felt the availability of appointments suited your needs and requirements. Was consideration given to whether you had to go to work, or use public transport? Did you feel that the appointment was given suitable priority?

 

If you were given an appointment time please rate your experience of the punctuality of the staff. Did staff explain the reasons and apologise if there were any delays?

 

If you were not given an appointment time, how would you rate the length of your wait? Were you adequately advised about the length of wait? Did staff keep you informed?

 

How would you rate the opening times of the service? Do you feel that the opening times accommodate the needs of the service users?

 

Please rate your opinion of the level of dignity you were afforded by the staff when receiving your care/ treatment. Did the staff protect your modesty when examining you? Did they plan the care around your needs rather than the needs of the staff?

 

If you have a NHS dentist, please rate your experience with regard to how easy you have found it to access treatment such as fillings or extractions.

 

If your experience of the service involved being served food, please give us your rating of the quality of the food. Was it nutritionally balanced? Was it served at an appropriate temperature? Was it pleasantly presented? Did you have an adequate choice? 

 

If your experience of treatment/care involves having a daily programme of activity organised on your behalf, please rate its quality? Did you feel involved in designing the programme? Was it culturally, age and disability sensitive? Did the programme happen always as planned and without interruption?

 

How would you rate the overall quality of the care received?

 

If you were in close proximity to staff giving you care and treatment, please rate the cleanliness of their uniform, personal hygiene, compliance with recommended hand washing.

 

If a staff member was required to touch you as part of your treatment/care, please rate your opinion of their compliance with hand-washing policies. The staff should wash their hands before and after your treatment/care.

 

Please rate the availability of hand wash stations? Were hand wash stations adequately signed, and filled up? Were you encouraged to use them?

 

If a staff member is required to clean your home or do your shopping please rate the delivery of that service as compared to the specification agreed with the commissioner of the service.

 

If a staff member is required to assist you with your personal hygiene, please rate the delivery of that service as compared to the specification agreed with the commissioner of the service.

 

Please rate your satisfaction with your continuity of care. Do you regularly have the same staff member coming to see you to give you treatment?

 

How would you rate the signage for each department in the hospital? Did you feel that there was sufficient detail? Were signs placed in the right position, and pointing the best way?