Written response questionnaire

Get involved

Thank you for taking the time to tell us about your experience.

There are 10 questions in this form, we believe it should take approximately 30 – 60 mins to complete.
Within a few weeks of completing the research form, the Trust’s user insights team will email you with your £25.00 voucher (from One4all that can be used at many stores) as a thank you for your time.
Please ensure that you don’t include any identifiable information into this form e.g., people’s names.
You don't have to answer any questions that you don't feel comfortable with. If there are any questions that you would rather not answer, please write ‘Not comfortable answering this question’
Completing this form may be emotional and could bring back memories which can be difficult to revisit. We recommend that you give yourself at least an hour after completing the form to do something for yourself, such as taking a walk, reading a book, or listening to music. You may also want to let a family member or friend know that you are completing this form, and plan to chat with them about it after to help yourself decompress. You can find support resources and information on how to contact a Mental Health First Aider below.

A bit about the research project

This research project is focused on understanding how to improve experiences for end-of-life care for adult patients, and those important to them in our hospitals , particularly in the last days, hours and moments of life and after death. We know that what people need and value at the end of their life can vary from individual to individual. We are looking to understand your experience and views and what you think could be improved.
Within this research project, we are not focusing on the medical care provided at the end but more on the experience around end-of-life care. We are looking to understand how you felt about the care the person you knew received. This is a subjective experience, there is no right or wrong answer, and nothing is too big or too small to talk about. It could be about the communication you had between healthcare professionals (doctors and/or nurses) or what you would want to change within a hospital setting to give your loved ones a better experience.

About this research form

We know that this can be an emotional topic. If you feel emotional and would like to stop filling out the form, please do. You can also reach out to Jodie, our Mental Health First Aider, for up to two days after you have completed the research form to set up a chat. Please email her at j.chan@imperial.ac.uk or call her at 07561 873711.
There are no right or wrong answers, we just want to learn from your expectations, experiences and needs.
There may be some things that you share within this form that this research project is not able to influence - like medical care or issues relating to economic support or family life. If you have any questions or concerns about the clinical/medical care that your loved one received, please contact the PALS team or the complaints team.
Patient advice and liaison service (PALS):
If you have any suggestions, comments or concerns about your care or that of your loved one please contact our PALS team for advice:
- 020 3312 7777 (10.00 – 16.00, Monday to Friday)
- Via email at imperial.pals@nhs.net
The PALS team will listen to your concerns, suggestions or queries and is often able to help solve problems on your behalf.
Alternatively, you may wish to complain by contacting our complaints department:
- Complaints department,
  Fourth floor,
  Salton House,
  St Mary’s Hospital,
  Praed Street,
  London W2 1NY
- Email: ICHC-tr.Complaints@nhs.net
- Telephone: 020 3312 1337 / 1349

Please remember that the people looking at the answers provided in this form are not clinical staff members; we are researchers and can't comment on or answer why anything has happened. This research project is about understanding user needs and experiences.

Research form

* Required information

Please enter your participant code that you have been provided by the research team here

Please note you can write a maximum of 300 words for each question.

If this is not enough for you to tell us everything you feel we need to know please contact us on imperial.userinsights@nhs.net

Was there anything about the end-of-life (in the last hours and days of their life) experience at the hospital that didn't work well or could have been improved either for you, or for your loved one? * Was there anything about the end-of-life experience (in the last hours and days of their life) at the hospital that you found particularly helpful or positive for you, or for your loved one? What (if anything) could have helped you and your loved one to prepare for the end-of-life experience that was wanted? Did you and your loved one discuss any preferences for things they may have liked to happen or not liked to have happen in the last hours and days of their life. If yes, what were they?* How did you share these preferences (if at all) with the hospital and staff? e.g. completing or creating a care plan or through a chat with a member of staff Were there any particular religious or cultural practices and preferences that were important to your loved one in the last hours and days of life or after death?* How did the hospital staff support you to make sure any particular religious or cultural preferences were carried out (if at all)? Please explain how they did or did not support you. Can you describe the support you received from the hospital (if any) in the hours and days after your loved one died? Based on your experience, what would an ideal end-of-life experience in an Imperial hospital look like for you and why? Do you have any expectations or needs? Please explain.* We want to make sure people can easily give feedback about their experience of end-of-life care at the trust. At which points, if any, of this experience would you have wanted to give feedback?* Is there anything else you would like to tell us?

You have now come to the end of the research form. Thank you so much for your time. We will use your insights to help Imperial College Hospitals understand which areas of the service they can improve and how.

How was the experience of taking part in this study for you? Is there anything that we could improve?

Last updated 1 Sep 2023