1. Name (Optional)

THANK YOU for agreeing to take part in this important survey exploring Black and Minority Ethnic Carers’ experiences of GP services in Croydon. This survey has been created by Healthwatch, an organisation that works to improve local health and social care services and push for change, based on what you tell us. We want everyone in Croydon to receive the best care possible, and would love to hear your thoughts on how you think GP services can be improved. This survey should only take a few minutes to complete. Please be assured that all the answers you provide will be kept in the strictest confidence. Your views will make a difference. Please reply by 4 August 2017.
Please tick the box that applies to you below

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* 1. Please indicate your age range below:

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* 2. What is your gender?

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* 3. What is your ethnicity?

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* 4. Are you registered with a GP in Croydon? If so, which surgery?

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* 5. Do you have a long-standing health condition?

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* 6. If you answered yes to question 5, what is your condition(s)?

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* 7. Are you a Carer?

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* 8. What is the health condition / disability of the person you care for?

About who you care for:

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* 9. Do you care for an adult, or a child (under 18)?

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* 10. How many people are you a Carer for?

About your caring role:

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* 11. How many hours of unpaid care do you provide each week (rough estimate)?

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* 12. Do you think caring has affected your health?

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* 13. How easy do you find it to see your GP?
On a scale of 0-5 , with 5 being very easy and 0 not easy at all how easy do you find it to see your GP?

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* 14. How recently have you seen your GP?

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* 15. Is there a particular GP you usually prefer to see or speak to?

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* 16. How often do you see or speak to the GP you prefer?

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* 17. Has your GP recognised that you are a Carer?

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* 18. Has your GP recognised any Young Carers in your family?

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* 19. How good has your GP been at each of the following

  Very good Good Adequate Poor Very poor Doesn’t apply
Giving you enough time
Listening to you
Explaining any health conditions, tests and treatments for you
Referring you for tests and treatments
Helping you manage your condition/illness
Involving you in decisions about your care
Supporting any Young Carers in your family

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* 20. Has your GP provided you with the following? Please tick as appropriate

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* 21. Do you have confidence in the GP you saw or spoke to?

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* 22. What do you think would improve your health as a Carer?

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* 23. What expectations do you have of your GP in helping you to maintain your Health and Wellbeing? You can select more than one option.

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* 24. What expectations do you have of your GP in assisting your caring role? You can tick more than one option

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* 25. If you had any difficulties in trying to get the help and support you need to maintain your health as well as your caring role, please tell us here.

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* 26. If you feel that your GP has done well to support your health and help you in caring please tell us here

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* 27. Overall, how satisfied have you been with your GP surgery?

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* 28. As a patient, what improvements would you like to see in the services provided by your GP?

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* 29. In order to assist you as a carer, what improvements would you like to see in the services provided by your GP?

Thank you.
Your comments are much appreciated and will help us to provide information as to how services provided by your GP in Croydon might further support your health and assist your caring role. Please reply by 4th August 2017.

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