Wolverhampton Link
Help To Improve Local Health Care Services

 

Annual Health Check Survey

Introduction

To make sure the views of patients and the public are part of the Annual Health Check, the Health Care Commission have asked LINks (Local Involvement Networks) to let them know what people think about their local NHS Health Care Services.

Once a year the Health Care Commission (an independent ‘watch dog’ who regulate health care) carry out an Annual Health Check, to make sure that NHS Trusts are providing a high standard of care.

What will happen to the information I give?

Wolverhampton LINk will put together all of the information from the Surveys and send a report to the Health Care Commission.

The Health Care Commission will use the information that we send and information sent from our Local NHS Trusts, to give a rating of the NHS Trusts performance and make recommendations about things that need to change for the better. They will publish results from the Annual Health Check in October 2010.

  • The Survey is anonymous your name will not appear on the Survey.
  • You do not have to take part in the survey if you do not wish to and you don’t have to answer all of the questions.

If you would like a member of the LINk to help you to complete the survey or have any questions please contact:

Jane Viner
LINk Co-ordinator
WVSC
16 Temple Street
Wolverhampton
WV2 4AN
Tel: 01902 328973
Email: jviner@wolverhamptonvsc.org.uk

Thank you for taking the time and effort to fill out this Survey

EQUAL OPPORTUNITIES MONITORING FORM

This section of the form will be detached to protect your anonymity
I prefer to respond anonymously:
1) Safety:Think about a time you have been to a Health Service, Dr’s or Hospital this year....:Did you feel safe when you were there? (please tick box)
If No Please use the space below to tell us the name of the service, approximate date of your experience and what could be changed to make you feel safer?
2) Treatment:Think about a time you have been to a Health Service, Dr’s or Hospital this year....:Were you happy with the treatment that you got? (please tick box)
If No Please use the space below to tell us the name of the service, approximate date of your experience and what needs to be improved?
3) Discrimination:Think about a time you have been to a Health Service, Dr’s or Hospital this year...:Have you ever felt discriminated against by health services?
If Yes Please use the space below to tell us about your experience, the name of the service and approximate date.
What things do you think the health service should do to make sure it doesn’t happen again?
4) Compliments and Complaints:Think about a time you have been to a Health Service, Dr’s or Hospital this year....:Were you given information about how to make a compliment or complaint? (please tick box)
If No Please use the space below to tell us the name of the service, approximate date of your experience and suggestions about how this could be improved?
5) Dignity and Respect:Think about a time you have been to a Health Service, Dr’s or Hospital this year....:Did you feel that people treated you with dignity and respect? (please tick box)
If No Please use the space below to tell us the name of the service, approximate date of your experience and suggestions about how this could be improved?
6) Choice:Think about a time you have been to a Health Service, Dr’s or Hospital this year....:Were you able to take part in making choices about your treatment and care? (please tick box)
If No Please use the space below to tell us the name of the service, approximate date of your experience and what would make it easier for you to make choices?
7) Access to Services:Think about a time you have been to a Health Service, Dr’s or Hospital this year....:Is it sometimes difficult for you to get the health services that you need? (please tick box)
If Yes Please use the space below to tell us the name of the service, approximate date of your experience and what would make it easier?
8) Cleanliness and Comfort:Think about a time you have been to a Health Service, Dr’s or Hospital this year....:Cleanliness - Was the Service Clean? (please tick box)
Please use the space below to tell us the name of the service, approximate date of your experience and which areas were unclean?
:Think about a time you have been to a Health Service, Dr’s or Hospital this year....:Comfort - was the service comfortable? (please tick box)
If No Please use the space below to tell us the name of the service, approximate date of your experience and what would make you feel more comfortable there?
9) Food:Think about a time you have been to a Health Service, Dr’s or Hospital this year....:If you were given a meal did it meet your dietary needs? (please tick box)
If No Please use the space below to tell us the name of the service, approximate date of your experience and your comments about the food.
10) Your Health:Please can you tell us what you think the services could do to help you get healthier?:If you would like to make any other comments please use the space below:
:This section of the form will be detached to protect your anonymity:How would you identify your gender? (please tick box)
What is your age?
What is your ethnicity?
What is the first part of your Post Code?
Telephone: 01902 328973 Website Designed by Klick Solutions Media