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* 1. Please tell us the name of the ward that your friend or relative died on.

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* 2. In your opinion, was hospital the right place for your friend / relative to receive care at the end of their life?

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* 3. Please tell us why

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* 4. Do you feel your friend / relative's care needs were met during the last few days of their life?

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* 5. Please tell us more about this

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* 6. Were you involved in discussions with staff about your friend / relative's care during the last few days of their life?

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* 7. Please tell us more about this

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* 8. Did you feel supported by staff at the RUH in the days before your friend / relative died?

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* 9. Please tell us more about this

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* 10. Did you feel supported by the staff in the Bereavement and Medical Examiner office in the days after your friend / relative died?

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* 11. Please tell us more about this

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* 12. If you think that there was anything that was done well at the RUH, or that made a difference to you or your friend or relative, please tell us more here.

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* 13. If you think the RUH could have done more to support you and your relative / friend, please tell us more here.

If you have any concerns about the care and support provided, please contact our Patient Support and Complaints Team on 01225 825656 / ruh-tr.psct@nhs.net

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