Friends and Family Test - Emergency Department Survey

The Shrewsbury and Telford Hospital NHS Trust is working with Poppy’s Promise to understand how patients and the people important to them feel about the care we provide. Celebrating what is working well and improving where it matters most.

This information is confidential. We will not ask for any personal details. We cannot trace your answers back to you.

Thank you for taking the time to share feedback on your experience.

Please choose the service you visited:

1.
On what date did you visit the Emergency Department (A&E)?

2.
Thinking about your recent visit to A&E, overall, how was your experience of our service?

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

3.
What do you feel has been good about the care or experience you have received ?

4.
Do you want to tell us anything else about your visit and what we could improve ?

Poppy's Promise is about listening, understanding and treating every patient and the people important to them with compassion and respect. It brings kindness and communication to the heart of care at The Shrewsbury and Telford Hospital NHS Trust. Your feedback helps us make care better for everyone.

5.
Did you feel listened to?

Yes, often Sometimes No, never Don't know / can't remember

6.
Did you feel that you were able to ask questions?

Yes, always Sometimes No, I did not feel able to ask questions I did not have any questions to ask Don’t know / can’t remember

7.
Did staff explain things in a way you could understand?

Yes, always Sometimes No, never Don't know / can't remember

8.
Do you understand what happens next in your care?

Yes, definitely Yes, to some extent No I did not need further care Don’t know / can’t remember

9.
If this were a standalone app. for quick feedback after every visit, would you use it?

Yes No

10.
Do you have any other comments you would like to share?

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

Yes No

Demographics Information

Demographic information is important to us. It tells us who we are reaching in our community. From the information we gather we can tell which people we are not reaching. We can then try and engage with those groups. We want to hear views from as many groups as possible. This helps us to improve our services for everyone. You do not have to fill in the questions. You can skip some of them if you prefer. Your answers are confidential. We cannot identify you if you fill them in.

11.
If you would prefer not to respond to this next section covering demographics, please click move to end of survey option

Move to end of survey Carry on completing demographics

12.
What age group are you in ?

0 - 5 years 6 - 17 years 18 - 25 years 26 - 35 years 36 - 45 years 46 - 55 years 56 - 64 years 65 - 74 years 75 - 84 years 85 years + Prefer Not to say

13.
Are your day-to-day activities restricted due to a health problem, disability or other impairment which has lasted, or is expected to last, at least 12 months (include any problems related to old age)?

Yes, limited a lot Yes, limited a little No Prefer not to say

14.
Please indicate your health condition, disability or other impairment and tick all sections which apply:

Vision (e.g. due to partial sight or blindness) Hearing (e.g. due to partial hearing or deafness) Mobility, such as difficulty walking short distances, climbing stairs, lifting and carrying objects Learning, concentrating or remembering Mental Health Stamina or breathing difficulty Social or behavioural issues (e.g. due to neuro diverse conditions such as Autism, Attention Deficit Disorder or Asperger’s Syndrome) Other impairment, health condition or disability; Prefer not to say

15.
What is your ethnic group? Tick the appropriate box to indicate the patient ethnic group.

16.
Which of the following best describes your gender?

Male Female Non-binary Prefer not to say In your own words

17.
Which of the following best describes your sexual orientation?

Heterosexual / straight Gay woman / lesbian Gay man Bi / bisexual Prefer not to say In your own words

18.
What is your first language

19.
Trans is an umbrella term to describe people whose gender is not the same as the sex they were assigned at birth. Do you consider yourself to be a trans person?

Yes No Prefer not to say In your own words

20.
What is your legal marital or civil partnership status?

Single Living with partner Married or in a registered civil partnership Separated, but still in a registered civil partnership or legally married Divorced or formerly in a registered civil partnership which is now dissolved Widowed or surviving partner from a registered civil partnership Prefer not to say

21.
Are you a veteran, including National Service, or do you have a connection to the Armed Forces?

Yes No Prefer not to say

22.
What is your faith or belief?

No recognised faith or belief Buddhist Hindu Jewish Sikh Atheist Christian Humanist Muslim Prefer not to say Any other religion

23.
Do you look after, or give any help or support to family members, friends, neighbours or others because of either long-term physical or mental ill-health / disability, or problems related to old age?

Yes No Prefer not to say