Health and Social Care NI - Dermatology Photo Triage Patient Experience Survey - Page 1 of 3 - NI Direct

1. Please confirm the name and address (if known) of the GP Surgery you attended for your appointment:

GP Surgery Address

Postcode (if known)

2. Please confirm your year of birth:

Year of Birth (Required)

3. Was this your first time using the Dermatology Photo Triage service?

(Required) Yes No

4. Prior to your recent experience, were you aware that this service was available within your GP Surgery?

(Required) Yes No

5. When you attended your GP Surgery, did the GP or another member of staff (i.e. practice nurse) explain the referral process and enable you to ask any questions, if applicable?

(Required) Yes No

Comments:

6. Were you given any additional information on the Dermatology Photo Triage referral pathway?

(Required) Yes No

If Yes, what information were you given?

7. Did you find this information useful?

(Required) Yes No

If No, we would welcome any suggestions which will help to improve this information:

8. Did your GP explain the “Consent” process for taking photographs of your skin irregularity?

(Required) Yes No

9. How did you find your appointment with the GP?

(Required) Poor Experience Fair Experience Good Experience Very Good Experience Excellent Experience

Add your comments to explain why you have given this rating. (Required)

10. Did you have to attend the hospital for a further appointment?

(Required) Yes No

11. If Yes, how were you contacted? (Please tick any that applies)

(Required) Letter from Hospital Letter from GP Telephone Call Text Message Other

12. What was the outcome of your hospital appointment? (Please tick any that applies)

(Required) Medication for your skin lesion/mole Advice on how to manage your skin lesion/mole Biopsy of your skin lesion/mole Surgical removal of your skin lesion/mole

13. How did you find your appointment at the hospital?

(Required) Poor Experience Fair Experience Good Experience Very Good Experience Excellent Experience

Add your comments to explain why you have given this rating. (Required)

14. Did you feel involved in all decisions about your treatment?

(Required) Yes No

Comments:

15. Have you attended your GP in connection with your Photo Triage experience since your hospital appointment?

(Required) Yes No

16. Was your GP aware of your recent hospital appointment as part of your Photo Triage pathway and did you discuss this with them?

(Required) Yes No Unsure

17. Would you be happy to use this service again?

(Required) Yes No

18. Is there anything that could be improved?

Comments (Please provide any additional comments)

19. Have you any other comments you would like to include on any element of the service?

(Required) Yes No

Comments (Please provide any additional comments)