| Your 999 Emergency Call |
| 1 | Please tick all of the options below that are important to you when you make an emergency call.
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| Knowledgeable staff |
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Professionalism |
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| Speed of response |
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Reassurance |
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| Appropriate advice |
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Calmness of call taker |
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| 2 | Were you told how long it would take an emergency ambulance to reach you?
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| 3 | How long were you told the emergency ambulance would take to reach you?
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| 4 | What did you decide to do?
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| 5 | If you waited, was there anything else we could do to help?
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| 6 | Were you asked to make your own way to the hospital emergency department?
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| 7 | What did you decide to do?
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| 8 | The Ambulance Staff communicated in a way that was clear and easily understood. Do you:
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| 9 | The patient was involved with decisions about their care and treatment options. Do you:
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| 10 | The patient was provided with appropriate care and reassurance from the ambulance staff during their journey. Do you:
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| 11 | The patient felt safe in the ambulance vehicle at all times. Do you:
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| Information about the patient. |
| 20 | Age of the Patient
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| 21 | Gender of the patient
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| 22 | If you, the patient, consider yourself to have a disability, please indicate the type of disability below? (Select all that apply)
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| Hearing Impairment |
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Learning Disability |
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| Visual Impairment |
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Mobility Impairment |
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| Other |
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Mental Health |
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| No disability |
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| 23 | Please indicate your (the patient) ethnicity
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| 24 | Please indicate your specific white ethnicity
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| 25 | Please indicate your specific black ethnicity
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| 26 | Please indicate your specific dual ethnicity
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| Opportunity to participate |
| 27 | The North West Ambulance Service (NWAS) is a learning organisation, so if you feel your recent experience of using our service could help us improve, through Patient Stories, please tick this box and provide your contact details and a member of the patient engagement team will be in touch to discuss further.
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| 28 | NWAS have a Patient and Public Panel (PPP) - volunteer members of the public who work with the trust on a number of different involvement projects. If you would be interested in becoming an NWAS PPP volunteer, please tick and provide contact details and we will send you an email with further information on how to join
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| 29 | Across the areas that we serve, NWAS holds annual Community Engagement Events. It’s an opportunity to engage with and hear directly from leads from the different service lines. If you would like to be informed when we are holding one in your area, please tick and provide contact details and we will email you.
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| 30 | Please provide your name here.
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| 31 | Please provide your telephone number here:
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| 32 | Please provide your email address here:
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