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Erewash Local Place-PCN Alliance Group Community Survey - Autumn 2022

We Want to Hear from You about Your Physical and Mental Health & Wellbeing

We're working together to help to improve the physical and mental health & wellbeing of adults living in Erewash.  Health services, social care, the Borough Council and voluntary & community sector partners want to hear from you about what could help to improve your physical and mental health & wellbeing.
 
To do this we would like you to fill in this survey – it's all about letting us know the things that are most important to you.  It shouldn't take very long to complete, and of course everything you tell us is anonymous and confidential.  You can either complete the survey online or on paper.  And as a thank you for taking part in the survey, we will be giving everyone who takes part the chance to win a £10 voucher.  If you want to be in the draw for a prize then make sure you leave your email address at the end of the survey.
 
Please complete and return the survey by 5pm on Friday 6th January 2023. 
 
Once all the surveys have returned, we will be working together with Erewash people and partners to set our local priorities that we will work on together.  Please let us know at the end of the survey if you would like to be involved in the work.  All survey findings will be published on the Erewash Voluntary Action CVS 'News' website page: https://www.erewashvoluntaryaction.org.uk/news.
 
Thank you for taking part, and for helping us to understand what adults in Erewash need to live their best lives.
 
GDPR Statement - Erewash Voluntary Action CVS is working with health services, social care, Erewash Borough Council and voluntary & community sector partners to gather information about the physical and mental health & wellbeing of adults living in Erewash.  Erewash Voluntary Action complies with GDPR.  By completing this survey and providing your details you are giving us permission to hold your data physically and digitally.  We will only ever use this data for the purposes set out above.  Should you wish to remove your data from our records, please contact Kyle Robinson-Payne by emailing: kyle@erewashcvs.org.uk. 
SECTION A - ABOUT YOUR PHYSCIAL AND MENTAL HEALTH AND WELLBEING
Please tell us about your current physical and mental health and wellbeing
1.How would you describe your physical and mental health and wellbeing? (Please choose only one).(Required.)
2.Do you have any physical or mental health conditions or illnesses lasting or expected to last 12 months or more?
3.Has your physical and mental health and wellbeing changed over the last 12 months?(Required.)
4.If yes, why do you think that is? Please tell us in the box below...
5.Who helps you keep well?
6.What helps, or negatively affects, your physical and mental health and wellbeing? (Please tell us in the box below)
7.What would help to improve your physical and mental health and wellbeing? (Please choose up to three, ranking them 1, 2 and 3 - with 1 being the most important to you).(Required.)
1
2
3
Access to transport
Better access to GP/health care services 
Better access to local service/activities
Better housing
Better links to my local community
Better local surroundings - such as parks and green spaces
Feeling safe - at home/in your community
Financial stability
Lifestyle changes, such as help to stop smoking, move more, eat a healthy balanced diet or reduce alcohol intake?
More time with family and friends
Training opportunities
8.Thinking about question 7, please let us know more in the box below, giving any examples of what would help to improve your physical and mental health and wellbeing...
9.Anything else you'd like to add? Please tell us in the box below...
10.Whereabouts in Erewash do you live? (Please tick one)
SECTION B - EQUALITY MONITORING FORM (STRICTLY CONFIDENTIAL)
11.Your age
12.Do you have a disability of any kind? Please tick all that apply:
13.How would you describe your racial or ethnic group? (please tick one)
14.Your faith or religion
15.Sexual Orientation
16.Gender: How do you identify?
17.Have you gone through/do you intend to go through any part of a process to change from the sex you were described as at birth to the gender you identify with?
18.As a thank you for taking part, we want to offer you the chance to win a £10 voucher.  If you would like to be entered into the draw then please leave your phone number or email address in the box below.  
19.If you would like to be involved in this work in the future, then please leave your name and phone number or email address in the box below.
Thank you for completing this online survey.
Current Progress,
0 of 19 answered