Our purpose is to listen to your views and share them with the government, and those running the services, to ensure they take action. Your views could make a big difference to services across North Somerset. Everyone has the right to expect a high standard of care. In order to ensure these standards are met we need your feedback. We make your feedback anonymous and share it with the relevant services so they know what is working and what isn't. You can review as many services as you like, and you can leave feedback every time you visit. Share your views It only takes a few minutes to share your experiences of health or social care services. Your feedback can help services spot issues that are affecting care for you or your loved ones. Name the service you would like to leave feedback on * For Example, the name of your Doctors Surgery, the Hospital you visited or the name of the Pharmacy you get your medication from – feel free to include an address or postcode Choose the area of care that you would like to tell us about * GP Services NHS Dental services Pharmacy services Care home services Mental health services Other Select the area(s) of care that you would like to share your views on from the list above. (Please tick all that apply) If other, please tell us which service you are referring to Please tell us about your experience * Please tell us the details of your experiences / views (For example what went well? What could have been better?) How easy was it to access the help and support you needed? Very easy Easy Neither easy nor difficult Difficult Very difficult Not applicable How would you describe the care you received? Very good Good Neither good nor bad Poor Very poor Not applicable 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 Not applicable 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. Your name * Please enter your name. Your email address * Please enter your email address. Please tell us which gender you identify with - None -ManWomanNon-binaryPrefer not to sayPrefer to self-describe Please describe Please describe yourself as you wish to Is your gender different to the sex you were assigned at birth? Yes No Prefer not to say 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 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 describe your ethnicity Do you consider yourself to be a carer? Yes No Prefer not to say Do you consider yourself to 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 Consent * I give permission for my response to be stored by Healthwatch North Somerset, in accordance with their privacy statement, so that they can use it to improve the delivery of health and care services across North Somerset Tick this box if you're happy to give consent. Please see our Privacy Terms & Conditions for more information. Submit
