Share your experiences of hospital treatment in Wales
The Older People’s Commissioner for Wales would like to find out about older people’s experiences in hospital to support on-going work following her ‘Dignified Care?’ Review. Please complete this short questionnaire if:
· You have been in hospital in the last 12 months and would like to share your experience.
· A family member, someone you care for or someone you know has been in hospital in the last 12 months and would like to share information about their experience.
Please describe your hospital experience and how this made you feel, in particular whether you were treated with dignity and respect (include additional sheets if you need to).
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Was there anything particularly good about your experience that you would like to share?
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Was there anything particularly bad about your experience that you would like to share?
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Was there anything that you feel could be improved in the future?
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Name of health board / trust – please select
Abertawe Bro Morgannwg Aneurin Bevan
Betsi Cadwaladr Cardiff & Vale
Cwm Taf Hywel Dda
Powys Velindre
Name of hospital / ward (optional):......
Thank you for sharing your experiences. Unless you state otherwise, we will assume that by sending us this form you are consenting to us using the information in our Casebook. Please note that the information you have provided may also be published in reports, on our website and in briefings / interviews with the media. We will anonymise any information used for case studies and will not share or publish your personal information.
We may need to contact you to obtain further information about your experiences. If you are happy for us to do so, please provide your contact details below.
Name: ......
Address: ......
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Telephone: ......
Email address: ......
Preferred method of contact: ......
Please return to Older People’s Commissioner for Wales, Cambrian Buildings, Mount Stuart Square, Cardiff, CF10 5FL by Friday 28 June 2013