1 Start 2 Complete Take five minutes to share your experiences #BecauseWeAllCare NHS and social care staff are doing everything they can to keep us well during these challenging times, but there might be things that can be improved. Your feedback can help services spot issues that are affecting care for you and your loved ones. Complete the survey Choose the area of care that you would like to tell us about (over the last year) GP services Pharmacies Dentistry Mental health support Hospital care e.g. A&E, inpatient care, outpatient clinics Social care e.g. care homes, and home care Other issue/service If other, please tell us which issue/service you're referring to. Does your experience include information about leaving hospital? Yes No Not sure Please tell us about your experience (For example: What went well? What could have been better?) If you'd rather be anonymous, avoid including things that can identify you. How easy was it to access the help and support you needed? Very easy Easy Neither easy nor difficult Difficult Very difficult N/A If you received care, how would you describe it? Very good Good Neither good nor bad Poor Very poor N/A How did you feel about the further treatment, care or support that you were offered? Very satisfied Satisfied Neither satisfied nor dissatisfied Dissatisfied Very dissatisfied N/A Does your feedback apply to a specific service? Yes No If yes, please tell us the name of this service. Tell us a bit about you By telling us more information about yourself, you will help us better understand how people's experiences may differ depending on their personal characteristics. However, if you do not wish to answer these questions you do not have to. Please tell us which gender you identify with. - None -ManWomanNon-binaryPrefer to self-describePrefer not to say Please describe Is your gender different to the sex that you were assigned at birth? Yes No Please tell us which sexual orientation you identify with - None -AsexualBisexualGayHeterosexual/StraightLesbianPansexualPrefer not to sayOther If other, please tell us more Please tell us which age category you fall into. - None -13 to 1516 to 1718 to 2425 to 4950 to 6465 to 7980+Prefer not to sayPlease note that we cannot accept responses from anyone aged under 13 years. Please select your ethnicity from the list below. - None -ArabAsian / Asian British: BangladeshiAsian / Asian British: ChineseAsian / Asian British: IndianAsian / Asian British: PakistaniAsian / Asian British: Any other Asian / Asian British backgroundBlack / Black British: AfricanBlack / Black British: CaribbeanBlack / Black British: Any other Black / Black British backgroundGypsy, Roma or TravellerMixed / Multiple ethnic groups: Black African and WhiteMixed / Multiple ethnic groups: Black Caribbean and WhiteMixed / Multiple ethnic groups: Asian and WhiteMixed / Multiple ethnic groups: Any other Mixed / Multiple ethnic backgroundWhite: British / English / Welsh / Scottish / Northern IrishWhite: IrishWhite: Any other White backgroundAny other ethnic groupPrefer not to say If other, please tell us more Do you consider yourself to be a carer? Yes No Prefer not to say Do you consider yourself to be have a disability? Yes No Prefer not to say Do you consider yourself to have a long term health condition? Yes No Prefer not to say Pick the area that best describes where you live - None -Barking and DagenhamBarnetBarnsleyBath and North East SomersetBedford BoroughBexleyBirminghamBlackburn with DarwenBlackpoolBoltonBournemouthBracknell ForestBradford and DistrictBrentBrighton and HoveBristolBromleyBucksBuryCalderdaleCambridgeshireCamdenCentral BedfordshireCheshire EastCheshire WestCity of LondonCornwallCounty DurhamCoventryCroydonCumbriaDarlingtonDerbyDerbyshireDevonDoncasterDorsetDudleyEalingEast Riding of YorkshireEast SussexEnfieldEssexGatesheadGloucestershireGreenwichHackneyHaltonHammersmith and FullhamHampshireHaringeyHarrowHartlepoolHaveringHerefordshireHertfordshireHillingdonHounslowHullIsle of WightIsles of ScillyIslingtonKensington and ChelseaKentKingston Upon HullKingston upon ThamesKirkleesKnowsleyLambethLancashireLeedsLeicesterLeicestershireLewishamLincolnshireLiverpoolLutonManchesterMedwayMertonMiddlesbroughMilton KeynesNewcastle upon TyneNewhamNorfolkNorth East LincolnshireNorth LincolnshireNorth SomersetNorth TynesideNorth YorkshireNorthamptonshireNorthumberlandNottinghamNottinghamshireOldhamOxfordshirePeterboroughPlymouthPortsmouthReadingRedbridgeRedcar & ClevelandRichmond upon ThamesRochdaleRotherhamRutlandSalfordSandwellSeftonSheffieldShropshireSloughSolihullSomersetSouth GloucestershireSouth TynesideSouthamptonSouthendSouthwarkSt HelensStaffordshireStockportStockton-on-TeesStoke-on-TrentSuffolkSunderlandSurreySuttonSwindonTamesideTelford & WrekinThurrockTorbayTower HamletsTraffordWakefieldWalsallWaltham ForestWandsworthWarringtonWarwickshireWest BerkshireWest SussexWestminsterWigan and LeighWiltshireWindsor, Ascot & MaidenheadWirralWokinghamWolverhamptonWorcestershireYork Consent * I give permission for my response to be stored by Healthwatch in accordance with their privacy statement so that they can use it help improve the delivery of health and care services across the country and in the area in which I live. Tick this box if you're happy to give consent. Please see our Privacy Terms & Conditions for more information. Would you be happy for us to contact you about your experience for media purposes or to use your story as a case study in our material? Yes No If yes, please leave your name and email address. Name Email address Submit
