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Feedback about your experience

Feedback about your experience

Patient feedback

We are constantly striving to improve the quality of our service and we
welcome your honest comments on our patient feedback forms.

Give feedback on our service
Patient Questionnaire

Any information you provide within this questionnaire will remain anonymous. Feedback received will help us to build upon and improve the service for other patients.

If you have any further questions about how your personal information is used please contact the governance team by emailing kernowhealthcic.khcicgovernance@nhs.net

Patient Questionnaire

Your initial call

Excluding any pre-recorded message, how long did it take for your call to be answered? *
Did you understand the information you were given about what would happen after your call? *

Your telephone conversation

How would you rate the manner in which the clinician conducted the telephone conversation? *
How at ease did the clinician make you feel?
How would you rate the usefulness of the advice given?
Did this telephone consultation finish as

If your call ended with telephone advice

Did you find the advice helpful?
Did the clinician make it clear what to do if your condition worsened or not improve?
How would you rate the professionalism of our staff?

If you were seen in a Treatment Centre

How long did you wait to be seen by a clinician after arriving at the Treatment Centre

If you were visited at home

If you were seen at home, how long did you wait for the clinician to arrive?

With regard to the clinician you saw, how would you rate the following?

Listening to me
Understanding my concern
Treatment given
Advice given

Rate your overall experience

Overall how satisfied were you with your experience of the service? *

If you could not get through to the 111 service

What alternative service would you use?

Any other comments?

Name
Name
First
Last
Take our Friends & Family questionnaire
Friends & Family survey
Please take a few minutes to fill out this survey on the quality of service you have received. Your responses will be used to improve our future performance. Thank you.
Friends & Family survey

Would you recommend us?

How likely is it that you would recommend the service to a friend or family member?

About our professionalism

How would you rate the professionalism of our staff?

What would have made your visit better?

What was best about your visit today?

Do you have any other comments?

About yourself

What is your sex?
What is your age?
What is your ethnic group?

Privacy information

The information you provide us (Kernow Health CIC) about your experiences of using the Cornwall 111 Service will help us to further improve and shape the service. Any personal information contained within this form will not be used or shared with any other organisation or person. Should you wish to know more about how your information is being used please contact the office on: Kernowhealthcic.enquiries@nhs.net
Make a complaint
Complaint feedback

Please use this form to register your complaint. If you wish to remain anonymous we will still use your feedback to improve our services. However we will not be able to reply to you unless you leave your contact details below, Thank you.

Complaint feedback

About your complaint

Have you contacted the 111 service before about this issue? *

Complaining on behalf of someone else

Are you raising a complaint on behalf of someone else?
Select your relationship with the person from the options below

Complaining on behalf of an organisation

Are you raising a complaint on behalf of an organisation?

Details of your complaint

How can we put matters right?

Please select what you think we can do to put matters right:

Would you like a reply?

If you would like a reply please let us know how you would like to receive it:
Please give feedback on our care to the CQC

Give feedback on our care

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