Are you registered with a GP? Yes No Was it an easy process to sign up? Yes No Have you had any cervical, breast or bowel screenings? Cervical Breast Bowel Other… Enter other… Is there any reason you’re not registered with a GP? If you were ill, where would you go for help? Do you feel healthy? Strongly Agree Agree Somewhat Disagree Strongly Disagree Not Sure What are some of the things you do to keep you and your family healthy? Healthy eating Regular exercise Enough sleep Regular social connection Getting outdoors Practicing mindfulness Getting regular health check-ups Staying up to date with vaccines Other… Enter other… Have you used any NHS services in the past 5 years? Yes No What were those services? GP Services NHS Dental Service Pharmacy Services Accident and emergency / minor injury units Hospital inpatient (day treatment or overnight) Hospital Outpatients' appointments Optician Mental Health Services Ambulances and Paramedics Patient Transport Service (PTS) NHS 111 Other… Enter other… Can you describe that experience to me? Why is this? No need to engage in any NHS services Wasn’t sure how/which NHS service to access Not registered with a GP Wasn’t referred to the service needed via the GP Facilities were not accessible (e.g., mobility) Language barriers Fear of discrimination Childcare difficulties meant it was difficult to access NHS services Transportation issues Other… Enter other… In future, more NHS systems will be going online. Do you think this will make it easier or harder for you to use NHS services? Much easier Easier Slightly easier Slightly harder Harder Much harder What support, if any, do you need from the NHS to use their online services? Is there an area of healthcare you’d like more information about? Is there anything else you’d like to tell us about the NHS? Which of the following options best describe how you think of yourself? Man (including trans man) Woman (including trans woman) Non-binary Other… You can use this space to describe your gender in your own terms. Is your gender identity the same as it was at birth? Yes No Your age group 0-12 13-15 16-17 18-24 25-49 50-64 65-79 80+ Prefer not to say Not known Ethnicity Ethnicity - 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 BackgroundMixed / Multiple ethnic groups: Asian and WhiteMixed / Multiple ethnic groups: Black African and WhiteMixed / Multiple ethnic groups: Black Caribbean and WhiteMixed / Multiple ethnic groups: Any other Mixed / Multiple ethnic groups backgroundWhite: British / English / Northern Irish / Scottish / WelshWhite: IrishWhite: Gypsy / Traveller / Irish Traveler White: RomaWhite: Any other White backgroundPrefer not to sayNot knownOther ethnic group… Please use this space to describe your ethnicity Sexual Orientation Heterosexual / Straight Gay Man Gay Woman / Lesbian Bisexual Asexual Prefer not to answer Prefer to self descibe Please use this space to describe your sexual orientation Do you have a disability? Yes No Prefer not to say Not known Town or area you live in Town or area you live in - None -ChaddertonColdhurstDelphDenshawDiggleDobcrossFailsworthGlodwickGrasscroftGreenfieldHathershawHollinwoodLeesMoorsideOldhamRoytonSaddleworthSpringheadShaw and CromptonWaterheadWestwoodOther… Please state your Town or area Submit Leave this field blank
