COMPLAINTS QUESTIONNAIRE

If you have recently had a reason to complain about any of the services provided by the Royal LiverpoolBroadgreen University Trust please would you be kind enough to complete the form below?

Your views are very important to us as we are always looking for ways in which our complaints handling service could be improved.

1. Did you receive appropriate information on the NHS Complaints procedure, ie the process we investigate and respond to your complaint? / Yes / No
2. Did you feel that your concerns were treated seriously and with sensitivity? / Yes / No
3. Did you feel we addressed all the points you made? / Yes / No
4. Did we provide a clear and understandable response? / Yes / No
5. Did you feel your complaint was responded to within a reasonable period of time? / Yes / No
6. Did we keep you sufficiently informed if there was a delay in providing you with a response? / Yes / No
7. Did you feel you were treated differently as a result of your complaint
Treated better
No difference
Treated worse
8. Overall, how do you feel your complaint was handled?
Very well
Well
Average
Poor
Very poor
9. Do you have any other comments you would like to make?

The Department of Health requires us to collect the following information, so we would be most grateful if you could complete the following:

Please select appropriate

Male
Female

How would you describe your ethnic origin? (These classifications are those recommended by the Commission for Racial Equality).

White British / Asian / British Indian
White Irish / Asian / British Pakistani
Any other White background / Asian / British Bangladeshi
Mixed White / Black Caribbean / Any other Asian background
Mixed White / Black African / Black / British Caribbean
Mixed White / Asian / Black / British African
Any other mixed background / Any other Black background
Any other ethnic group

Thank you for your help