Macmillan Quality Environment Standard Patient and Visitor Feedback Form

Macmillan Cancer Support is keen to ensure that the environment in which patients are treated and in which relatives accompany their friends and family to appointments, are always set out and designed to ensure visits to units such as this one are as good as they can be. To this end we have decided to regularly ask our visitors whether they are happy with the ‘environment’ of our cancer unit and to find out whether or not we should be looking to change things. Please would you help us by answering the following short questionnaire?

1. Do you find the Macmillan Unit welcoming?

Yes, definitely
Yes, Somewhat
No

2. Do you have any difficulty accessing the unit (e.g. difficult to find, no clear signage, public transport links etc)

Yes
No

Please tell us about any difficulties you encountered

3. Do you feel that your dignity and privacy are protected in the following areas:

	Yes, definitely	Yes, to some extent	No
Reception and waiting areas	Reception and waiting areas Yes, definitely	Reception and waiting areas Yes, to some extent	Reception and waiting areas No
Consultation rooms	Consultation rooms Yes, definitely	Consultation rooms Yes, to some extent	Consultation rooms No
Treatment areas	Treatment areas Yes, definitely	Treatment areas Yes, to some extent	Treatment areas No

4. How would you rate the cleanliness and tidiness of the following areas of the unit

	Very clean and tidy	Fairly, clean and tidy	Not very clean and tidy
Reception and waiting areas	Reception and waiting areas Very clean and tidy	Reception and waiting areas Fairly, clean and tidy	Reception and waiting areas Not very clean and tidy
Treatment areas / consultation rooms	Treatment areas / consultation rooms Very clean and tidy	Treatment areas / consultation rooms Fairly, clean and tidy	Treatment areas / consultation rooms Not very clean and tidy
Toilets	Toilets Very clean and tidy	Toilets Fairly, clean and tidy	Toilets Not very clean and tidy

5. In terms of your comfort and well being what is your overall impression of the following aspects of the unit:

	yes, definitely	yes, to some extent	No
The internal décor is pleasant	The internal décor is pleasant yes, definitely	The internal décor is pleasant yes, to some extent	The internal décor is pleasant No
The furniture is comfortable	The furniture is comfortable yes, definitely	The furniture is comfortable yes, to some extent	The furniture is comfortable No
The garden / large windows promote well-being	The garden / large windows promote well-being yes, definitely	The garden / large windows promote well-being yes, to some extent	The garden / large windows promote well-being No
The artwork and displays help as a positive distraction	The artwork and displays help as a positive distraction yes, definitely	The artwork and displays help as a positive distraction yes, to some extent	The artwork and displays help as a positive distraction No

6. Do you feel confident about your safety in the unit?

Yes, definitely
Yes, to some extent
No

7. Do you think the layout and signposting in the unit ensures you are able to safely find your way around the facility?

Yes, definitely
Yes, to some extent
No

8. Do you feel able to ask staff questions when you are visiting or being treated on the unit?

Yes, definitely
Yes, to some extent
No

9. Do you feel confident in the care and support you are offered in the unit?

Yes, definitely
Yes to some extent
No

10. Do you feel you are given any personal control during your visits (for example moving the chairs, changing the lighting etc)?

Yes
No

11. Is there the opportunity to give the staff in the Macmillan unit any feedback regarding your experience?

Yes
No

12. Sometimes there can be delays in the unit and therefore longer waiting times for appointments?

	Always	Sometimes	Never	N/A
Do you feel you are kept adequately informed if there is a delay?	Do you feel you are kept adequately informed if there is a delay? Always	Do you feel you are kept adequately informed if there is a delay? Sometimes	Do you feel you are kept adequately informed if there is a delay? Never	Do you feel you are kept adequately informed if there is a delay? N/A
Do you feel that these delays are justified?	Do you feel that these delays are justified? Always	Do you feel that these delays are justified? Sometimes	Do you feel that these delays are justified? Never	Do you feel that these delays are justified? N/A

Please leave a comment

13. Do you find the information booklets available in the unit relevant and helpful?

Yes, definitely
Yes, to some extent
No

14. What do you feel are the key benefits of the unit for you?

15. Are there any aspects of the unit that could be improved? If yes, please describe which aspects?

Powered by SmartSurvey

Check out our survey templates or create your own.