Feedback for Dr Guy Jackson

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All doctors are expected to seek feedback on a regular basis from those they work with and treat. Information from patients, relatives and friends is an important part of this process.

I have used the recomended feedback form designed by the Royal College of Anaesthetists and transferred to this Google Forms survey

Your feedback will be reviewed, discussed and acted on as appropriate as part of annual appraisal and 5 yearly revalidation processes

In responding to each question please select the box that most represents your situation or viewpoint. You also have the opportunity to state what your Anaesthetist did particularly well, or anything he or she could improve on. The answers you give should only be about today’s interaction with your anaesthetist.

Many thanks for your feedback

Are you filling in this questionnaire for:

Yourself

Your child

A relative, spouse, partner or friend. If you are filling this in for someone else, please answer the following questions from the patient’s point of view.

Clear selection

Why did you see the Anaesthetist today?

I am having an operation today or tomorrow

I am having an epidural for pain relief in labour

I am a patient in Intensive Care/High Dependency Unit

I am attending a pre-assessment or maternity clinic

Other:

Clear selection

How would you rate your Anaesthetist at each of the following? *

Very poor

Less than satisfactory

Satisfactory

Good

Very good

Does not apply / do not know

Introducing themselves to you

Being polite

Putting you at ease

Listening to you

Assessing you for your anaesthetic

Explaining your anaesthetic/treatment to you

Involving you in decisions about your anaesthetic/treatment

Answering your questions

Please decide how strongly you agree or disagree with the following statements about your Anaesthetist *

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

Does not apply / do not know

The Anaesthetist seems approachable

I have confidence in the ability of this Anaesthetist to provide safe care

I was satisfied with the Anaesthetist and would be happy to see him again

The Anaesthetist treated me with dignity and respect

I was given enough privacy by the Anaesthetist

Was there anything else that this Anaesthetist did particularly well, or anything that he or she could improve on?

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