City & Hackney Community Engagement Project Community Member Questionnaire

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* 1. Tell us a little about yourself.
Prompts:
Where were you born?
Do you have family living here?
What is most important to you?
Who do you turn to for help?

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* 2. What, if any, previous association have you had of St Joseph's Hospice?

In-Patient

Service User (attended a group, psychological therapies etc)

Volunteer

Community member (engaged with the hospice in this role)

No previous association

Family/Friend was a patient/service user

Please provide any further details below:

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* 3. What do you think we do at the hospice?
Prompt: Can you name 3 or more services?

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* 4. What do you think might stop someone from your community from using the hospice?
Prompt: Are there barriers such as cultural issues, communication barriers, lack of knowledge about the benefits of hospice, transportation, etc?

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* 5. How could the hospice make someone from your community feel welcome?
Prompts:
What services should we offer?
What should the hospice look like?
What should staff be like?
How could we encourage you to come here?

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* 6. If you or a family member were seriously ill, in what way could we help you?
Prompts:
How would we meet your religious, cultural or spiritual needs?
What kind of help would make it easier for you/your family?
Would you prefer services in the hospice or in your neighbourhood?

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* 7. Is there anything else you would like to talk about?