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In just three minutes, you can make a difference.

Share your views on health or social care services. Tell us what works and what needs improvement.

It's confidential, quick and won't affect your care. But your experience will help us tell NHS and social care services how to make your care better.

This survey is also available in Easy Read.

We’d love to keep you updated about our work and the difference sharing your experiences with us can make. 

Complete the survey

1. Choose the area of care you would like to tell us about?

Please select the options that you'd like to talk to us about. You can pick more than one.

What went well? What could have been better?
eg. the GP surgery name or hospital department

Tell us a bit about you

It would really help to know a little more about you so that we can better understand how people's experiences may differ. These questions are completely voluntary.

8. Please tell us your gender
10. Please tell us which sexual orientation you identify with
11. Please select your ethnicity
12. Please select any of the following that apply to you
Tell us which local authority/borough area you live in? 
(Start writing the name of your local authority/borough and select from the options available)

How we use this information

The information you share with us is completely confidential and will not affect your care. 

We use this information to help us spot trends to identify areas for improvement. We may use quotes in our reports, but we will not use any information that will identify you. 

Find out more about how we handle your information in our privacy statement

Can we stay in touch? 

We'd love to tell your story and keep you updated about our work and the difference sharing your experiences with us can make. 

Using your story for media

To highlight the care issues that people tell us about, we use people’s stories to show what is working and what needs to change. Sometimes the media (newspapers, radio or TV) ask to use our stories in their own materials too. 
Would you be happy for us to contact you to talk further about your experience to see if we can use it as a case study?

Your local Healthwatch

Would you be happy for your local Healthwatch to contact you about your submission?

Name