Survey Toolkit Final jc 2

1. Survey toolkit Last updated July 2021

2. Introduction • This toolkit provides support for conducting patient and /or staff surveys at The Christie • These can be: • National surveys e.g. National Inpatient Survey • Local surveys e.g. patient satisfaction • Surveys which are part of Research need to be separately approved via Ethics committee

3. Survey toolkitContent • Before you start • Approval process • Survey design • Questionnaire design • Information Governance • QICA team support

4. Before you start • Is your survey really necessary? • Why are you doing the survey? • If you are thinking of making changes, are those in charge committed to acting on the survey findings • Is it possible to get the information any other way? • Other departments may have the information, other surveys may have been done. See our HIVE pages for a list of existing / previous surveys. Remember: patients at the Christie and their families are under a lot of stress and we should only be asking for their time to complete a questionnaire if it is necessary

5. Survey types National surveys • When a patient survey is part of a national audit or project, this still needs to be registered. • The QICA team may already have the details. You can check with the-christie.clinical.audit@nhs.net before completing the proposal form • The QICA team can still provide support for national surveys if needed Christie patient surveys • All surveys carried out with Christie patients need to be registered using our survey proposal form • Use this Survey Toolkit to help design, carry out and complete your survey • Support can be provided by the QICA team if required Staff surveys • Surveying staff views can be useful as a part of quality improvement, clinical audit or service evaluations that are registered by the QICA team • Check with Workforce / Human resources if you are thinking of carrying out any other type of staff survey.

6. Approval process • All patient and staff surveys need to be registered. • This is to ensure : • A simple survey proposal form can be found here • All surveys are of a high quality • The Trust has a central record of survey activity • Identify any potential overlap and links between different projects Think about • Topics you will cover – what will you do with the information you have gathered. • Who is the target population and who will you select from the target population. • How long will it take to get to the required number of respondents • Who is available to help with the survey : be realistic – distributing questionnaires and inputting results can be time consuming

7. Approval to completion process What happens once we receive your proposal form: • A member of the QICA team will review the content • We will be in touch if there are • Any questions • If we can identify any similar projects or possible stakeholders to involve • Once approved, you will receive a notification email, with the project number. • Please see a copy our report template. When you send us a copy of your findings / report once the project is complete, we will update our registration database. • If the report is not received by the expected due date, a reminder will be sent. You can advise any reasons for delay and request more time if required to complete.

8. Survey Design : Patient selection How you are going to select your patients • Unless your patient group is very small, we advise approaching a sample. The size will depend on the patient group, the questions and your capacity • Aim to have results you can draw conclusions from – this can typically be 50-100 responses. In clinic, face to face with patients or at the end of a tel/video consultation List from Data Insights or CWP Using own database of patients if you are selecting from a clinic, ask all patients over a range of dates / times, so that you can maximise the spread of patient types. E.g. all patients over a 2 week period could be given a paper form or consented to receive an electronic form via SMS or email. a request can be made to data insights via Tech Bar [link to form] to provide a list of patients who fulfil your criteria e.g. New breast patients seen between January to June 2021 decide on how you will select patients in a non-biased, systematic way if possible e.g. every 10th patient

9. Survey Design : Patient selection How you are going to select your patients • Consider the following response rates for past Christie surveys, to help determine the numbers you might need to approach/contact • *Note – SMS / Email – pre consented in table above is based on a small sample 15/19 patients, and the SMS was sent out straight after the consultation Completion rates are higher when patients are asked first, especially for SMS / email You MUST consent patients to participate in a survey if you are collecting patient identifiable data (PID). However, we would not recommend collecting PID.

10. Paper questionnaire (via Post or by hand in clinic) • On-line survey – via SMS, Email or QR code • Face to face with a member of staff (collect results on-line or on paper) Survey Design : Data collection • Method of Data collection There are a number of different ways to carry out your survey. All of the following methods can be supported at The Christie for registered projects. Contact the QICA team for further support. If you are planning a postal mailing to patients, we can supply a Freepost return address – there may be a charge depending on your sample size An SMS batch mailing is also an option, but may incur a cost depending on sample size Prior to sending a postal survey or a batch SMS/Email, patient status must be verified and any deceased patients removed from the list. This can be done by carrying out a Death Trace query (via the Data Insights team)

11. Survey Design : Data collection

12. Questionnaire Design • All Christie surveys must have: • Christie logo • Introduction to explain its anonymous, confidential and voluntary – see example wording for covering letters to patients or an SMS to patients • Instructions on how to send back the survey Take a look at our further Tips and examples for survey and Questionnaire design • Example questionnaires at The Christie At The Christie we have conducted many patient surveys. • Paper surveys - A selection of previous paper surveys • On-line surveys – Take a look at an Example survey, show casing some of the standard template questions you could consider Please Contact the QICA team if you would like advice on your questions

13. Questionnaire Design • General questionnaire design advice – other sources • NHS England guide bitesize-guide-writing-an-effective-questionnaire.pdf (england.nhs.uk) • At The Christie we use SNAP surveys software, but Survey Monkey also has some useful tips and advice on their pages. Six Rules for Writing Survey Questions (snapsurveys.com) Survey Best Practices & Design Guidelines | SurveyMonkey • Please ask about using SNAP for your survey, before utilising Survey Monkey • Survey Monkey is not considered secure for patient identifiable information

14. Information Governance • It is the responsibility of the project lead (i.e. the lead person carrying out the survey, interview, or focus group) to ensure that the Trust's Information Governance and Data Protection policies are adhered to at all times. Further information can be found on the Trust's intranet: HIVE - INFORMATION GOVERNANCE AND SECURITY OPERATING FRAMEWORK (xchristie.nhs.uk) • You must consider: • If you are doing a postal survey or unsolicited SMS/email you must do everything you can to ensure that a questionnaire isn't sent to someone who has died. If you submit a data request via the Tech Bar, with your patient list, the data insights team can then run a death trace for you. • National Data opt out – if patients have consented, there is no need to check they have not opted out. Similarly, if all results are anonymised, there is no need to check their Opt out status. For all other situations, you must check that the patients in your sample have not opted out, before you contact them • Surveys are confidential and voluntary • Your survey should not collect PID. If this is needed, patients must be consented • Results must always be anonymised when reporting

15. Share learning! Celebrate success!Reporting and publishing surveys Share learning internally first but…. • Worth considering if you might want to publish your survey results at the outset, to ensure all elements of best practice included • Likely to need evidence of governance and ethical considerations have been addressed (eg QICA approval of project) • Christie report template can be used for your local reporting. • Consider how you will communicate the results back to patients • Christie website or social media • Noticeboards You said, we did

16. Survey Checklist Final checks before you start your survey: Have you? • Patient selection • Checked you are asking/approaching the right patients • Included enough patients to get your preferred final sample • Run a death trace (if applicable) • Checked patients have not opted out of surveys • Consented participation (if applicable) • Advised patients its anonymous & confidential • Provided a freepost envelope (if applicable) • Questionnaire • Piloted your questions with a couple of patients • Tested any QR codes and survey links work (if applicable) • Checked spelling and layout • Results • Decided who will data entry (if needed) • Determined how you will analyse results • Set a deadline to close off results • Set a realistic deadline for project completion • If you want to publish, have you checked your survey methodology will be acceptable • Decided how you will feedback results to patients (aggregated)

17. QICA team • Contact the QICA team for help with all aspects of surveys at: • the-christie.clinical.audit@nhs.net • You can also find further information on Surveys and Quality improvement on our QICA pages on HIVE : • Hive - departments - Quality improvement and clinical audit • Christie QICA toolkit 2020 • QICA project list and summary • E-learning, templates and more • QICA Project proposal form