If you would like to revisit your report at a later stage, please click the “Save” button at the bottom of the page and enter your email address before leaving the browser window.
In order for you and the team to be paid correctly and on time please ensure full names as per the staff report and start and finish times are completed.
Maximum number of staff members reached.
Please fill in the number of rooms running on the day.
Please fill in the room numbers and start/end times of the consultations in each room then confirm the total number of patients who are seen, cancelled, or did not attend. We are relying on your accuracy so that our financial information and feedback to the Trust is robust. For all patients treated, please ensure the numbers correspond with the patient clinical outcomes you return to 18 Week Support
Please accurately record reasons for patients being cancelled. If patients are cancelled for clinical reasons, this should be captured on the patient cancellation outcome form which must be signed by the relevant doctor.
Maximum number of patients reached.
It is the responsibility of the Nurse in Charge to ensure that all 18 Week Support staff are orientated to the clinical environment and are clear on the clinical pathways for the service.
Maximum number of items reached.
Maximum number of complaints reached.
Have the patient satisfaction surveys been collected and posted from your site?
Maximum number of issues reached.
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