GIRFT Sickle Cell Disease, Thalassaemia and Rare Inherited Anaemia Questionnaire - Page 1 of 17 - NHS England

Page 1 of 17

Trust/Team Identification

1. What is the name of the Trust this questionnaire pertains to?

Trust (Required)

2. What type of centre is this trust?

(Required) Specialist Haematology Team (SHT) Local Haematology Team (LHT)

3. How many hospital sites are involved in care of this patient group across your trust?

Please enter number (Required)

4. What is the full name of the person completing this questionnaire (the respondent)?

Please enter full name (Required)

5. What is the role of the respondent?

(Required) Haematologist Clinical Nurse Specialist (CNS) Data manager Service manager Other (please specify in the box below)

If other, please specify

6. What is the contact email address of the respondent?

Please enter email address (Required)

7. Name of the lead consultant for Sickle Cell Disease (SCD).

Please enter name (Required)

8. Name of lead consultant for Thalassaemia/Rare Inherited Anaemias (RIA),

Please enter name (Required)