Thank you for taking the time to complete this questionnaire. It should take around 10 minutes to complete. Please note that Health & Wellbeing is abbreviated to H&W throughout the survey.

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* 1. What is the name of your Council?

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* 2. Please enter your name and role within the Council here

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* 3. Does your Council have the General Power of Competence?

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* 4. The following statements relate to the value of the H&W Project, WSALC’s role in supporting and promoting the work and to how appropriate it is deemed to be by local councils. Please mark how much the Council agrees with these statements.

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
The report and leaflet on H&W circulated to local councils was of interest to the Council
The report and leaflet on H&W circulated gave the Council ideas/inspiration on what could be done to support H&W in the community
It is NOT appropriate for local councils to support the H&W of the community
The Council would like to do more to support the H&W of the community
Local councils can play a key role in supporting health and wellbeing in their communities
There is value in the ongoing work of WSALC on H&W in the local council sector
If it was easier to set up and run relevant services, the Council would do more to support H&W
Parishes within Horsham & Mid Sussex CCG only – The CCG’s Weekly Patient Roundup shared via email is of value to local councils or  councillors (e.g. the ‘Save our NHS’ Campaign)

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* 5. Has the Council had an agenda item on the H&W Report and leaflet since they have been shared with member councils?

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* 6. The Council has taken action(s) to support H&W since the report and leaflet have been circulated

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* 7. The Council has made plans to take action(s) to support H&W since the report and leaflet have been circulated

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* 8. The Council plans to make provision in the budget for 2018/19 to undertake H&W work

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* 9. Please list here any barriers which the Council considers to prevent or restrict the H&W services it can be involved in or deliver

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* 10. The following questions relate to the Alzheimer’s Society Dementia Friends initiative - you can select more than one answer for each row

  Yes – true before the WSALC H&W Project Yes - true since the WSALC H&W Project Is something members/the Council is planning to do No
Member(s) of the Council have become Dementia Friends
The Council has had Dementia Friends Information Session(s) for councillors
The Council has had Dementia Friends Information Session(s) for staff
The Council has provided a venue or promotion for a Dementia Friends Information Session(s) for members of the community
The Council is/is planning to become a member of the Local Dementia Action Alliance

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* 11. Please add any further comments you have on local councils supporting dementia in your area in this box

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* 12. The following questions relate to local GP surgeries and Patient Participation Groups (PPGs) - you can select more than one answer for each row (Please note that many parishes do not have a GP surgery within their boundary, but residents can join the PPG of the surgery that they are registered with)

  Yes – true before the WSALC H&W Project Yes - true since the WSALC H&W Project Is something members/the Council is planning to do No
Member(s) of the Council are members of the PPG at a local surgery
The Council has provided a venue for meetings of a PPG
The Council has facilitated meetings of a PPG, group of PPGs or helped bring together PPGs with other providers

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* 13. If the answer to any part of Question 12 is yes, please state the name of the GP surgery the Council has worked with

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* 14. Please add any further comments you have regarding PPGs in your area in this box

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* 15. The following questions relate to the promotion of health and wellbeing, and communications with Public Health and the CCGs - you can select more than one answer for each row

  Yes – true before the WSALC H&W Project Yes - true since the WSALC H&W Project Is something the Council is planning to do No
The Council uses its website, noticeboard, newsletter and/or social networking sites to promote healthy living
The Council uses its website, noticeboard, newsletter and/or social networking sites to promote health and wellbeing events run by the CCG, Health & Wellbeing Hub or other providers
The Council has participated in consultations on H&W with the County Council Public Health, or the CCG – for example extending access to GP services
Parishes within Horsham & Mid Sussex CCG only – The Clerk shares the CCG Weekly Patient Roundup with members

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* 16. Please add any further comments on health promotion and communications with Public Health and the CCGs in this box

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* 17. The following questions relate to a variety of health and wellbeing services - you can select more than one answer for each row

  Yes – true before the WSALC H&W Project Yes - true since the WSALC H&W Project Is something the Council is planning to do No
The Council runs or supports transport schemes to transport residents to medical appointments or groups that support H&W
The Council runs or supports friendship groups or lunch clubs
The Council has rooms/facilities/carparks which are used by healthcare service providers
The Council works with, or supports charities/the voluntary sector in H&W
The Council works with charities or the health sector to raise awareness of hearing loss, or to support those with hearing loss
The Council clusters with other town or parish councils to provide services to support H&W
Councillors attend/are invited to local H&W events
The Council has given a grant for the social prescriber or care co-ordinator at the local surgery
Parishes within Coastal West Sussex CCG only - The Council has been invited to meetings of the Local Community Network (LCN)

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* 18. If the answer is yes to any of Question 17, please list here the organisations that the Council works with

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* 19. Do you have any other information or comments relating to any of the items in Questions 17 or 18?

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* 20. Which TWO of the following does the Council believe are the top H&W priorities, where it could support and make a difference to the community? Please select TWO boxes.

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* 21. With regard to Question 20, would the Council like to be put in touch with another council or organisation to talk about possible solutions to this? (This is for WSALC to gather information - we will not necessarily be pursuing this)

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* 22. Would the Council be interested in clustering with neighbouring councils in the provision of services to support H&W?

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* 23. If you have any other comments on items that have not been covered by this survey, please add them here

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