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Tell us what you think

We would like to hear from you, your family or carer about the service and care you have received. We welcome your comments, good or bad, and would be grateful if you spend a few moments to complete this questionnaire.

This information will be used to improve and develop our services in future.

Please answer as many questions as you can and tick the box which you think is most appropriate. Please use the comments box to explain further.

Personal response about an urgent issue

If you would like a personal response about an urgent issue, please speak to the staff involved or ask for the manager or matron. They will be pleased to help.

Other help

If you would prefer to speak to someone not directly involved with your care and treatment, you can contact the Patient Advice and Liaison Service (PALS).

This service is confidential and provides help and support to resolve any concerns you may have. It can provide advice and information about the NHS and social care and all feedback is welcome.

You can contact PALS on 01271 314090 between 9.30am and 4.30pm or by email: ndht.PALS@nhs.net

You can also visit the PALS and Information centre in person at North Devon District Hospital in Barnstaple. Or alternatively it may be possible for us to arrange an appointment in your area.

You can also provide feedback at NHS Choices or Patient Opinion – please see Getting involved and having your say

Service and location

Where did you receive treatment? (eg, name of hospital/ health centre, at home)

Did you use a particular service? If so, what was it? (eg, audiology, district nurse, eye clinic)

Did you stay in hospital? If so, which ward?

How good was the service given by:

Doctors:
very goodOKpoordon't see/don't knowno comment

Nurses:
very goodOKpoordon't see/don't knowno comment

Therapists:
very goodOKpoordon't see/don't knowno comment

Housekeeping staff:
very goodOKpoordon't see/don't knowno comment

Admin or reception staff:
very goodOKpoordon't see/don't knowno comment

Care and treatment:

Thinking about the main person or team looking after you…

Did they include you in planning your care?
yes, all the timesome of the timenodon't knowno comment

Were you given information you could understand about any treatments or tests?
yes, all the timesome of the timenodon't knowno comment

Were you given information you could understand about what was happening to you?
yes, all the timesome of the timenodon't knowno comment

Was this information easy to understand?
yes, all the timesome of the timenodon't knowno comment

Were they polite?
yes, all the timesome of the timenodon't knowno comment

Were they helpful?
yes, all the timesome of the timenodon't knowno comment

Did you feel cared about as a person?
yes, all the timesome of the timenodon't knowno comment

Did you feel listened to?
yes, all the timesome of the timenodon't knowno comment

Did they respect your privacy?
yes, all the timesome of the timenodon't knowno comment

Did they treat you with respect?
yes, all the timesome of the timenodon't knowno comment

If you raised concerns, were they dealt with properly?
yes, all the timesome of the timenodon't have any concernsno comment

Waiting times:

How long did you have to wait to be seen?
a few minutes or not at allthere was some delayI waited much too longdon't knowno comment

Please complete the following questions if you were treated in an NHS building

Was the ward or department you needed easy to find?
yesOKnodon't knowno comment

Was there a nice atmosphere inside the building? (for example in the waiting area)
yesOKnodon't knowno comment

Were the toilets clean?
yesOKnodon't knowno comment

Was the room where you were treated comfortable?
yesOKnodon't knowno comment

Was it clean?
yesOKnodon't knowno comment

Please complete the following questions if you stayed in hospital

Did the meal times suit you?
yes, all the timesome of the timenodon't knowno comment

Did the meals taste good?
yes, all the timesome of the timedon't knowno comment

If you have a special diet, was this catered for?
yes, all the timesome of the timedon't knowno comment

Was there enough variety of meals?
yes, all the timesome of the timedon't knowno comment

Was the food at the right temperature?
yes, all the timesome of the timedon't knowno comment

Was the drinks at the right temperature?
yes, all the timesome of the timedon't knowno comment

Were the visiting times OK for your friends/family/carers?
yes, all the timesome of the timedon't knowno comment

Were you disturbed by noise?
yes, by staffyes, by other patientsyes, by visitorsnocan't rememberno comment

Overall

In general, how would you rate the service you received?
very goodOKpoorno comment

Would you be happy to use the service again?
yesnomaybedon't knowno comment

Any other comments

Please use this section to give more details on any of your answers. Was there anything we did well? What could we do to improve our service?

If you would like to receive a personal response to your comments, please provide your contact details below.

Name:

Address:

Phone:

Your Email

Would you like to be contacted in future to help with other patient surveys, consultations or patient involvement events?
yesno

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