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. Click here to find out why we ask about your gender, sexual orientation, and other demographic information. What service would you like to leave feedback on? E.g. the name of a GP practice/pharmacy/hospital * 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 Hospital 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 your experience? Very good Good Neither good nor bad Poor Very poor Not applicable Tell us about the person who received the care or treatment If you received the care or treatment, please tell us about you. If you are filling out the form on behalf of someone else, please tell us about them. By sharing this information with us, you will help us better understand how people's experiences may differ depending on individual characteristics. Your personal details will not be passed on to local services. Your name Please enter your name. Your email address * Please enter your email address. Please tell us which age category you fall into * - Select -13 to 1516 to 1718 to 2425 to 3435 to 4445 to 5455 to 6465 to 7475 to 8485 or overPrefer not to sayPlease note we cannot accept responses from anyone aged under 13 years Please tell us which gender you identify with * - Select -ManWomanNon-binaryIntersexPrefer not to sayPrefer to self-describeNot known Is your gender the same as the sex you were assigned at birth? * Yes No Prefer not to say Not known Please tell us which sexual orientation you identify with * - Select -AsexualBisexualGay manHeterosexual / StraightLesbian / Gay womanPansexualPrefer to self-describePrefer not to sayNot known Please select your ethnicity from the list below * - Select -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 * Please describe Please describe yourself as you wish to If other, please tell us more Please tell us your religion or belief * - Select -BuddhistChristianHinduJewishMuslimSikhOther religionNonePrefer not to sayNot known Please tell us your marriage or civil partnership status * - Select -SingleCohabitingIn a civil partnershipMarriedSeparatedDivorced or dissolved civil partnershipWidowedPrefer not to sayNot known Please tell us your pregnancy or maternity status * Currently pregnant Currently breastfeeding Given birth in the last 26 weeks Prefer not to say Not known Not applicable You can select more than one option. 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 Please tell us the first part of your postcode (e.g. BS48) * Where did you hear about Healthwatch North Somerset? Social media Google or another search engine Through your GP or local surgery At a hospital In a care home At a dental practice A poster or leaflet Word of mouth Other 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
