National Cannula Supply Status Survey

1
Hospital / Trust Name:* This field is required.
2
Lead Contact Name:* This field is required.
First Name
Last Name
3
Lead Contact Email:* This field is required.
example@example.com
4
Average Weekly Cardiac Case Volume:* This field is required.
5
Current Status of Cannula Supply:* This field is required.
Stable supply (>4 weeks stock)
Low Stock (2-4 weeks stock); concerns over future lists
Critical Shortage (<2-week stock); imminent risk of case cancellations
6
Any other description:
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Large
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Small
Ok
Ok
7
Have you already cancelled or postponed cases due to lack of supply?
Please Select
Please Select
Yes
No
Yes or No
If Yes, please specify the number of cases and the specific cannula type missing, otherwise write 'no' here:
8
Have you successfully transitioned to an alternative manufacturer? (e.g. LivaNova, Edwards)* This field is required.
Yes, fully transitioned
Partially (using a mix of what is available)
No, alternatives are also on backorder
No, surgical preference/compatibility issues
9
Please add comments, suggestions or provisions your Trust has undertaken to mitigate shortages:
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Should be Empty: