1. Is A&E for me? Public and Patient Engagement Forum 9 July 2014 Results of the forum’s electronic vote about urgent care services

2. What gender are you? A.Male B.Female

3. What age group are you in? A.Under 18 B.18 – 30 C.31 – 50 D.51 – 70 E.70 – 80 F.Over 80

4. Are you… A.Working B.Not currently in employment C.In full-time education D.Retired E.Other

5. Have you attended A&E in the last 12 months? A.Yes B.No C.Don’t know / can’t remember

6. When did you attend? A.Between 8am and 6pm on a weekday B.Between 6pm and 8am on a weekday C.Between 8am and 6pm on a weekend D.Between 6pm and 8am on a weekend E.Not applicable

7. Roughly, how far do you live from A&E? A.Less than one mile B.1-3 miles C.4-6 miles D.7-9 miles E.10 + miles

8. How quickly can you get to A&E from your home using your own or public transport? A.In under 10 minutes B.11 – 20 minutes C.20 – 30 minutes D.30 – 40 minutes E.40 – 60 minutes F.Over one hour G.Don’t know

9. Thinking about the last time you used A&E, did you use it for… A.A problem you had B.A problem a child you care for had C.A problem an adult you care for had D.Other E.Not applicable

10. What mode of transport did you use to get to A&E? A.Ambulance B.Your own car C.A friend or relative’s car D.Taxi E.Bus F.Motorcycle G.Bicycle H.On foot I.Not applicable

11. Who advised you to attend? A.GP B.NHS 111 C.NHS Choices D.Friend or relative E.No-one F.Other

12. What level of skilled professional did you expect to see? A.Specialist Consultant B.A&E Consultant or Registrar C.Junior Doctor D.Nurse E.Other (e.g. Emergency Care Practitioner) F.Don’t know

13. How long did you wait in A&E before you were seen by a doctor? A.Less than one hour B.1 – 2 hours C.2 – 3 hours D.3 – 4 hours E.Over 4 hours F.I wasn’t seen by a doctor

14. How long did you wait before you were seen the professional who decided which action to take? A.Longer than I expected B.About what I expected C.Less time than I expected

15. Was the recommended course of action what you expected? A.Yes B.No C.Don’t know / can’t remember

16. Did a member of staff advise you what to do if the problem persisted or worsened? A.Yes B.No C.Don’t know / can’t remember

17. What was the outcome of your last visit to A&E? A.Admitted to ward B.Discharged with suggested follow up by GP C.Discharged without follow up D.Referred for treatment by clinic E.Other

18. For what possible reasons might you attend A&E? A.I’m afraid I meet to be admitted B.I’m anxious that I need immediate treatment C.The advice I’ve received so far hasn’t worked / problem has got worse D.I don’t feel I can get appropriate treatment from another service E.I think other services will tell me to go to A&E anyway F.I don’t have enough information to allay my fears G.I’m on my own with no support network

19. Has this evening’s discussion altered what you would do next time? A.Yes B.No C.Maybe D.Don’t know

20. What factors are important when choosing an Urgent Care service? A.Close to home B.Close to other services C.Accessible by public transport D.Accessible by car E.Being seen quickly F.Seeing a professional face to face G.Being seen and treated in the same place H.Whether or not I can be seen at my GP practice I.Other

21. If you were placed in similar circumstances, would you choose another service A.Yes B.No C.Maybe

22. If you wanted information about urgent care services, where would you look first? A.GP practice B.NHS 111 C.NHS Choices D.Phone directory E.Internet F.Local directory (leaflet through your door) G.Health Centre / Clinic H.Hospital I.Library J.Other

23. If you needed advice during ‘office hours’, who would you contact first? A.GP Practice B.NHS 111 C.NHS Choices D.Hospital E.Pharmacy F.Friend or relative G.No-one H.Internet I.Other

24. If you needed advice ‘out of hours’, who would you contact first? A.GP Out of Hours service B.NHS 111 C.NHS Choices D.Hospital E.Pharmacy F.Friend or relative G.No-one H.Internet I.Other

25. Are you registered with a GP practice in the Vale of York? A.Yes B.No C.Don’t know

26. At your registered GP practice, are you able to see a GP or Practice Nurse A.On the same day B.Within 1-2 days C.Within a week D.None of the above E.Don’t know

27. Would you expect people to attend A&E if they can’t be seen during GP practice opening times? A.Yes B.No C.Don’t know

28. If you were caring for a child who had a high temperature, and your GP practice was closed, would you… A.Wait until the practice was open B.Call NHS 111 C.Attend a pharmacy D.Attend a minor injuries unit E.Attend A&E F.Other

29. If you were anxious about acute back pain, and your GP practice was closed, would you… A.Wait until the practice was open B.Call NHS 111 C.Attend a pharmacy D.Attend a minor injuries unit E.Attend A&E F.Other

30. Does the pharmacy you normally use have an area where you can discuss your concerns in private? A.Yes B.No C.Don’t know

31. Do you think you keep a good range of medicines / first aid supplies at home? A.Yes B.No C.Don’t know

32. What kind of things do you usually keep in your medicine cabinet? A.Pain relief B.Indigestion tablets C.Cough medicine D.Sticking plasters /bandages E.Anti-histamines F.Sting relief G.Antiseptic creams H.Eye drops