King's - How are we doing?

King’s How are we doing?

Improving the quality of patient care is our main priority – that means listening to and acting on patients’ real concerns.

Please help us to improve services by filling out this short questionnaire. Your answers will be confidential.

If you are the relative or carer of a patient, then please help them to complete a questionnaire if they need assistance.

Thank you for your help – Please put your completed questionnaire in the ‘How are we doing?’ box or give it to a member of staff.

1. How likely are you to recommend our ward to friends and family if they needed similar care or treatment?  

• Extremely Likely
• Likely
• Neither likely nor unlikely
• Unlikely
• Extremely unlikely
• Don't know

Please can you tell us the main reason for the answer that you have given to question 1 in the space below?

3. Overall, did you feel you were treated with respect and dignity while you were on our ward?

• Yes always
• Yes sometimes
• No

   

4. Were you involved as much as you wanted to be in decisions about your care?  

• Yes definitely
• Yes to some extent
• No

5. During your stay were you treated with kindness and understanding by staff?  

• Yes always
• Yes sometimes
• No

6. Do you feel you got enough emotional support from hospital staff during your stay?  

• Yes always
• Yes sometimes
• No
• I did not need any emotional support

7. Did the doctors talk in front of you as if you weren’t there? 

• Yes often
• Yes sometimes
• No

8. Did you get enough help from staff to eat your meals? 

• Yes always
• Yes sometimes
• No
• I did not need help to eat my meals

8. During your stay in hospital did you get enough to drink? 

• Yes
• No because I did not get enough help to drink
• No because I was not offered enough to drink
• No for another reason

9. Do you think the hospital staff did everything they could to control your pain? 

• Yes always
• Yes sometimes
• No
• I did not have any pain

10. Did you feel you were involved in decisions about your discharge from hospital? 

• Yes definitely
• Yes to some extent
• No
• I did not want to be involved

11. Did hospital staff tell you who to contact if you were worried about your condition or treatment after you left hospital? 

• Yes
• No
• Don’t know / can’t remember
• A little about yourself 

12. Who was the main person or people that filled in this questionnaire? 

• The patient
• Family member friend or carer of the patient

 13. Are you male or female? 

• Male
• Female
• Other

 14. In which age group are you? 

• Under 16
• 16-24
• 25-34
• 35-44
• 45-54
• 55-64
• 65-74
• 75-84
• 85+

 15. If you have a physical or mental disability or impairment, please tell us what it is - please circle all that apply. 

• I do not have a disability
• Mobility difficulty
• Blind or partially sighted
• Deaf or hard of hearing
• Communication difficulty
• Learning disability
• Mental health condition
• Other

 16. What do you consider to be your ethnic background? 

• White British
• White Irish
• White other
• Black Carribean
• Black African
• Black other
• Indian
• Pakistani
• Bangladeshi
• Chinese
• Asian other
• Mixed Background
• Other

 17. What is your religion? 

• No religion
• Buddhist
• Christian
• Hindu
• Jewish
• Muslim
• Sikh
• Other
• I would prefer not to say

 18. Which of the following best describes how you think of yourself? 

• Heterosexual/Straight
• Gay/Lesbian
• Bisexual
• Other
• I would prefer not to say

 19. If you had contact with a hospital volunteer while you were in hospital, did you find it helpful? 

• Yes
• No
• Don't know/can't remember
• I did not have contact with a hospital volunteer

Please return this survey to the patient experience team.