DRAFT 2 31stJanuary 2013

Survey for minimum data set to measure patient experience

All Wales Service User Experience Group

Patient Experience Questionnaire

These questions are based on the things that patients have said matter most to them. We would be grateful if you could answer them in relation to your most recent experience of the health service.

Thinking about your overall first impressions of the service

  1. How often do you feel you were treated with courtesy and respect?

Never / Sometimes / Usually / Always
  1. How often do you feel that you were:

Listened to? / Never / sometimes / Usually / Always
Treated as an individual? / Never / Sometimes / Usually / Always
Given all the information you need? / Never / Sometimes / Usually / Always
  1. How often do you feel you were given enough privacy?

Never / Sometimes / Usually / Always
  1. From the time you realised you needed to use this service, do you feel you had to wait:

A long time / Longer than needed / A little longer than needed / A short time

Thinking about the environment where you received your care

  1. How often was the environment you were in clean?

Not clean at all / Not very clean / Fairly clean / Very clean / Not applicable
  1. How often did you see staff clean their hands before they cared for you?

Never / Sometimes / Usually / Always / Don’t know
  1. How often did you feel the environment had everything you needed?

Never / Sometimes / Usually / Always
  1. If you asked for assistance, how often:

Did you get it? / Never / sometimes / Usually / Always
Get it when you needed it? / Never / Sometimes / Usually / Always

Thinking about your understanding and involvement in care

  1. How often were you involved as much as you wanted to be in decisions about your care and treatment?

Never / Sometimes / Usually / Always
  1. How often did we meet your individual needs?

Never / Sometimes / Usually / Always
  1. How often were things explained to you in a way that you could understand?

Never / Sometimes / Usually / Always
  1. How often did you feel you understood what was happening in your care and treatment?

Never / Sometimes / Usually / Always

13. Were you:

Asked which language you prefer to use? / Never / sometimes / Usually / Always
Able to speak in Welsh to staff if you needed to? / Never / Sometimes / Usually / Always

Overall, how would you rate your experience?

0 / 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10

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Thinking of your responses above,

Was there anything particularly good about your experience that you would like to share?

Was there anything that you feel could be improved in the future?

Thank you.