1 FFT Inpatient April 2020 Web Form  
 
 
 
 
V1-2020
Tell us what you think about the quality of your care!
Thinking about your recent stay in hospital...
Equality Monitoring
Date of feedback:
//
What went well with your care and treatment?
If yes, please state:
Ward:
Postcode:
What could we do better?
Are you male or female?
Male
Female
Prefer not to say
Prefer to use
my own term
What is your age?
65-74
45-54
25-34
35-44
55-64
75+
0-15
16-24
Prefer not
to say
What is your sexual orientation?
Heterosexual
Bisexual
Prefer not to say
Gay-Lesbian
Overall, how was your experience of our service?
Very
Good
Don't
know
Good
Very
Poor
Poor
Neither Good
nor Poor
If you DO NOT wish your anonymous comments to be used in our promotional material, please tick here:
What is your ethnic group?
White
Mixed
Black
Prefer not to say
Asian
Other
Office Use Only
I am answering this as a...
Patient
Relative/Carer/Advocate
(please answer the questions below
about the patient)
Prefer not to say
Do you have a disability?
No
Yes
Prefer not to say
1 HRI - Surgical Assessment Unit HRI
10 HRI
11 HRI - General Surgery
12 HRI - Oncology
14 HRI
15 HRI - Elderly Care
17 HRI - Gastroenterology
18 - HRI - Isolation Ward
19 HRI - Trauma and Orthopaedics
1D CRH - Gynae Assessment Unit (GAU) and Early Pregnancy Assessment Unit (EPAU)
20 HRI - Elderly Care
21 HRI - Trauma and Orthopaedics
22 HRI
2A CRH - Ambulatory
2BCD CRH - Acute Floor CRH
3 HRI - Vascular Surgery
5 HRI - Elderly Medicine
5A CRH
5BCD CRH - Respiratory Floor
6 HRI - Short Stay Unit
6AB CRH - General Medicine
6C CRH - Cardiology
6D CRH - Angiography Daycase
7ABCD CRH - Stroke Unit
8A CRH
8B CRH
8C CRH - Ear Nose and Throat (ENT)
8D CRH
Acute Floor HRI - Ward 8 and 9
Ambulatory Assessment Unit HRI
CCU CRH - Coronary Care
CRAS CRH - Rapid Assessment Unit CRH
DISL HRI - Discharge Lounge
DPU CRH - Day Procedure Unit
DSU HRI - Elective Surgery Unit
ENDO CRH - Endoscopy
ENDO HRI - Endoscopy
Greenlea Unit HRI (Oncology/Haematology)
H22LITHO - Lithotripsy Clinic
HRI - Birth Centre (Temp Inpatient Ward)
ICU CRH - Intensive Care Unit
ICU HRI - Intensive Care Unit
Macmillan Unit CRH (Oncology/Haematology)
Max Fax Tht HRI - Maxillofacial Theatres HRI
PMDC CRH - Pain Management Daycase
SAU HRI - Surgical Assessment Unit
SDEC MED
SDEC SURG
XRAY - Radiology Daycase CRH
XRAY - Radiology Daycase HRI