Questionnaire

Please give your feedback by 1 October. Thank you for filling out this form.
1. Do you agree with the priorities we have chosen for Surrey?
Reducing stigma and improving well-being by:
a) Increasing awareness of mental health problems in older people.
b) Providing information on what people can do to help themselves.
Improving the quality of people's lives by:
c) Providing early diagnosis, treatment and support in the community.
d) Providing intermediate care for older people with mental illness or dementia in general Hospital.
e) Improving the quality and effectiveness of inpatient care for older people with mental illness or dementia in general hospital.
f) Improving the quality of long-term care.
g) If you have answered No to any of these can you tell us why?
h) Please give us any comments on how Local Health, Social Care and Community Services could be improved over the next 5 years for older people with mental health issues?
2. Do you agree with our proposals to ensure whenever possible assessment, treatment and care is provided in people's own homes rather than in hospital or residential care.
If No, please tell us why?
3. Do you agree with our proposal to put more money into treating people with low and moderate needs.
If No, please tell us why?
4. Do you agree with our proposal to release money needed for increased prevention and improved care services in the community by reducing inpatient beds in mental health and general hospitals?
If No, please tell us why?
5. We would like residents of Surrey to feel in control of their mental health needs and to live as independently as they can.
If you were receiving healthcare in your own home / in the community over a long period of time, please rank the following in order of importance, with 1 the most important and 7 the least important:
Is there anything else that would be particularly important to you?
6. We believe health services should be focused on the individual receiving them and be provided in a range of settings. These settings can include: health centres, people's homes, pharmacies and GP practices.
Please rank the following in order of importance, with 1 the most important and 9 the least important:
Other (please describe):

Personal Information

All information collected is anonymous and confidential and cannot be traced back to individuals. You do not have to give us your personal details if you would rather not, this will not affect the results of this consultation in any way. This information will only be used to illustrate the degree to which the people we have received feedback from represent the make up of Surrey as a whole and to understand if any of the feedback, e.g. dissatisfaction, is particular to specific groups of people.

Equality and Diversity Monitoring
NHS Surrey and Surrey County Council are committed to tackling all forms of unlawful or unfair discrimination. We aim to provide equality of access and opportunity both as an employer and with respect to services we deliver. In order to develop policies and practices that are fair to all, we need to ensure that we are hearing views from all groups within our society.

7. Please provide some details about yourself and tick all that apply. I am:
8. What is the first part of your postcode?
9. How old are you?








10. What is your gender?
11. Do you consider yourself to have a disability as defined by the Disability Discrimination Act 1995 (2005)?

A person has a disability for the purposes of this Act if s/he has a physical or mental impairment, which has a substantial and long-term adverse effect on her/his ability to carry out day-to-day activities.

12. How would you describe your ethnic group?





 

 




 




 



 
Please state to what faith you belong?
13. Please tick the box that describes you most clearly


14. If you are worried about someone else's memory or mental health are they:







15. If you care for someone with mental health issues are they: