Children, young people - inpatients Friends and Family Test (FFT) Survey

English

Children, young people inpatient survey

Your feedback helps us to celebrate what's working well and identify where we need to improve. We would be grateful if you would take a moment to review the ward where you spent most of your time.

Please choose the service you visited:

1. Please tell us who is completing this form

The child who went to hospital The parent or carer of the child who went to hospital Both the child and parent/carer together

Notes

2. Age of patient/child

Notes

3. Were there enough things for you to do in the hospital?

Yes No

Notes

4. Did you feel able to ask staff questions?

Yes No I didn't have any questions

Notes

5. Were you involved in decisions about your care and treatment?

Yes Sometimes No I didn't want to be involved

Notes

6. Were you given enough privacy when you were receiving care and treatment?

Yes Sometimes No

Notes

7. In your opinion was the ward environment well-maintained?

Yes Could be better No I didn't notice

Notes

8. What did you think of your visit to hospital? Please tick one box only

Very good Good Neither good nor poor Poor Very poor Don't know

Notes

9. Did a member of staff talk to you about what was going to happen with your care after you’ve left hospital?

Yes No

Notes

10. Other than doctors and nurses, did you have confidence and trust in any other staff caring for you (e.g. physiotherapists, speech therapists, play specialists, social workers)?

Yes always Sometimes No I wasn't seen by any other health professionals

Notes

11. Please tell us what was good about your hospital stay?

4000 characters remaining

Notes

12. Please tell us what we could do better?

4000 characters remaining

Can we share your comment publicly (for example, on our website or printed material such as posters)?

Yes No

Notes

13. Please tell us the gender of the patient?

Boy Girl Gender neutral Other Prefer not to say

Notes

14. What is your ethnicity?

Asian / Asian British Black / African / Caribbean / Black British Mixed / Multiple ethnic groups White / White British Self-describe Prefer not to say

Notes

15. If you answered 'self-describe', please specify:

4000 characters remaining

Notes

Children, young people inpatient survey

Your feedback helps us to celebrate what's working well and identify where we need to improve. We would be grateful if you would take a moment to review the ward where you spent most of your time.

1. Please tell us who is completing this form

2. Age of patient/child

3. Were there enough things for you to do in the hospital?

4. Did you feel able to ask staff questions?

5. Were you involved in decisions about your care and treatment?

6. Were you given enough privacy when you were receiving care and treatment?

7. In your opinion was the ward environment well-maintained?

8. What did you think of your visit to hospital? Please tick one box only

9. Did a member of staff talk to you about what was going to happen with your care after you’ve left hospital?

10. Other than doctors and nurses, did you have confidence and trust in any other staff caring for you (e.g. physiotherapists, speech therapists, play specialists, social workers)?

11. Please tell us what was good about your hospital stay?

12. Please tell us what we could do better?

Can we share your comment publicly (for example, on our website or printed material such as posters)?

13. Please tell us the gender of the patient?

14. What is your ethnicity?

15. If you answered 'self-describe', please specify:

Submit

Thank you for taking the time to share your feedback.

©2021 University Hospital Southampton NHS Foundation Trust. All rights reserved. Not to be reproduced in whole or in part without the permission of the copyright holder. Published January 2021