Leicester, Leicestershire and Rutland Recovery Package Survey

This survey is for people living with and beyond cancer in Leicester, Leicestershire and Rutland. Your answers will help shape how the Recovery Package will be delivered to people living with and beyond cancer across the area.

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* 1. What matters most to you as a person living with cancer?

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* 2. Where in your local community do you think is the best place to offer health and wellbeing events such as the HOPE programme?

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* 3. Would you like to receive information and advice via:

Face to face

Text message

Social media - such as Facebook or Twitter

An app on your phone

Other (please specify)

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* 4. Do you currently access support? If so, how? Please tick all that apply.

Healthcare Professionals

Online communities

Family and friends

Support groups

Other (please specify)

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* 5. Where would you go to get advice on where to look for information and support? Please tick all that apply.

Cancer Nurse Specialist

Macmillan information leaflets

NHS or Macmillan websites

Other (please specify)

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* 6. What kind of health and wellbeing offerings would be helpful to you in the community?
Please tick all that apply and/or add your own suggestions.

Relaxation therapies such as arm and hand massage, reflexology, yoga and tai chi.

Mindfulness meditation sessions to help reduce stress.

Swimming – to help with overall health and fitness

Gym membership – to help with overall health and fitness

Pamper days – for example hair dressing, manicures, pedicures

Events to relax – cinema/theatre

Counselling sessions to talk through your concerns

Advice about your finances

Meeting with others who have or have had cancer

My ideas:

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* 7. Would you be happy to receive information, advice and support via a Facebook Group or other social media? Please tick.
If not, why not?

Yes

If not, why not?

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* 8. Do you use video on your smart phone (if you have one) to talk to friends and family e.g. Skype, Facetime etc.?

Would you be happy to speak to a health care professional via video if you had a concern?

Yes

If not, why not?

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* 9. Would you be happy for a trained volunteer to talk through the concerns you may have in the form a Holistic Needs Assessment?

Yes

If not, why not?

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* 10. What is your gender?

Male

Female

Prefer not to say

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* 11. Has your gender (sex) changed since birth?

Yes

Prefer not to say

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* 12. Are you pregnant or have you given birth in the last 26 weeks?

Yes

Prefer not to say

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* 13. What is your age?

Under 16

16 - 24

25 - 34

35 - 59

60 - 75

76 +

Prefer not to say

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* 14. Do you consider yourself to have a disability or suffer from poor health?

Yes, I have a disability

Yes, I am in poor health

Prefer not to say

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* 15. If you have selected "yes" please tell us which condition:

Physical

Partial or total loss of vision

Learning disability/ difficulty

Partial or total loss of hearing

Mental health condition or disorder

Long standing illness or disease

Speech impediment or impairment

Other (please specify)

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* 16. What is your ethnicity?

African

Arab

Bangladeshi

Caribbean

Chinese

Gypsy/ Traveller

Indian

Irish

Pakistani

Polish

Somali

White British: English, Northern Irish, Scottish, Welsh

Prefer not to say

For mixed or other ethnicities, please tell us here:

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* 17. What is your religion or belief?

No religion

Bha’i

Buddhist

Christian

Hindu

Jain

Jewish

Muslim

Sikh

Prefer not to say

Other (please specify)

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* 18. What is your sexual orientation (preference)?

Bisexual (relationship with either sex)

Gay (male to male relationship)

Heterosexual (male to female relationship)

Lesbian (female to female relationship)

Prefer not to say

Other (please specify)

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* 19. If you would like to make any other comments about this survey or the work that the NHS and Macmillan in undertaking across Leicestershire, Leicester City of Rutland, please do so here:

Leicester, Leicestershire and Rutland Recovery Package Survey

Question Title

* 1. What matters most to you as a person living with cancer?

Question Title

* 2. Where in your local community do you think is the best place to offer health and wellbeing events such as the HOPE programme?

Question Title

* 3. Would you like to receive information and advice via:

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* 4. Do you currently access support? If so, how? Please tick all that apply.

Question Title

* 5. Where would you go to get advice on where to look for information and support? Please tick all that apply.

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* 6. What kind of health and wellbeing offerings would be helpful to you in the community?Please tick all that apply and/or add your own suggestions.

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* 7. Would you be happy to receive information, advice and support via a Facebook Group or other social media? Please tick. If not, why not?

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* 8. Do you use video on your smart phone (if you have one) to talk to friends and family e.g. Skype, Facetime etc.? Would you be happy to speak to a health care professional via video if you had a concern?

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* 9. Would you be happy for a trained volunteer to talk through the concerns you may have in the form a Holistic Needs Assessment?

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* 10. What is your gender?

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* 11. Has your gender (sex) changed since birth?

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* 12. Are you pregnant or have you given birth in the last 26 weeks?

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* 13. What is your age?

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* 14. Do you consider yourself to have a disability or suffer from poor health?

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* 15. If you have selected "yes" please tell us which condition:

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* 16. What is your ethnicity?

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* 17. What is your religion or belief?

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* 18. What is your sexual orientation (preference)?

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* 19. If you would like to make any other comments about this survey or the work that the NHS and Macmillan in undertaking across Leicestershire, Leicester City of Rutland, please do so here:

* 6. What kind of health and wellbeing offerings would be helpful to you in the community?
Please tick all that apply and/or add your own suggestions.

* 7. Would you be happy to receive information, advice and support via a Facebook Group or other social media? Please tick.
If not, why not?

* 8. Do you use video on your smart phone (if you have one) to talk to friends and family e.g. Skype, Facetime etc.?

Would you be happy to speak to a health care professional via video if you had a concern?