Reviewing access to NHS community outpatient services in Harrow

Future provision of NHS community outpatient services in Harrow

Survey about health services in Harrow
Thank you for taking the time to read about our thoughts on the future provision of four community outpatient services in Harrow. You can read this here.

·        Community neurology (Headache clinic)

·        Community gastroenterology

·        Community children’s out-patients (paediatrics)

·        Community ear, nose and throat (ENT)

We would like to know what you think of the scennarios presented within the document.

Any feedback you can provide us through this survey helps us to improve access and equity of services for all patients.

There are several surveys currently being shared by NHS NW London as a series of services are asking for feedback and being reviewed ahaed of new services being procured.

This survey will be open until 20 June 2023 and should not take more than five minutues to fill in.

Thank you
Which service you use and would like to comment on.

Community neurology (headache clinic)Community gastroenterology (stomach and bowels)Community out-patients paediatrics (children)Community ear, nose and throat (ENT)
Please let us know your thoughts about this service going forward, based on what you have read in our scenarios document. (If you would like to comment on more than one service - please state in the box below)
Equality and diversity monitoring form

Your responses are anonymous and are used to help us to improve the services we deliver in NW London
Why we are asking you to complete this form

NHS North West London is committed to promoting equality and eliminating unlawful discrimination, and we are aiming to achieve diversity in the range of people we involve. You do not have to answer these questions, and we understand that some of this information is personal and sensitive in nature. However, gathering this data helps us to know if we are succeeding in involving different groups of people, and to change our approach if some groups are not represented.

Data protection

The information you provide is anonymous and will not be stored with any identifying information about you. We may use anonymised statistics and data to inform discussions about improving the diversity of our patient safety partners and inclusivity of participation opportunities, but no information will be published or used in any way which allows an individual to be identified. All details are held in accordance with the Data Protection Act 1998.

The information that we are asking you to provide is informed by our duties under the Equality Act 2010, and includes information about your age, race, sex and sexual orientation.
General Data Protection Regulation (GDPR)
Please indicate your consent for your responses to be shared with partner organisations and NHS North West London. Please note: if consent is not given, the responses cannot be utilised in this process.

I consent for the information in this form to be shared with partner organisations, and NHS North West LondonI do not consent for the information in this form to be shared
1. Which borough in North West London do you live in?

BrentEalingHammersmith & FulhamHarrowHillingdonHounslowKensington & ChelseaWestminsterPrefer not to say
2. If you do not live in the NW London, please can you tell us where you live and why you are completing this survey?
3. What age group do you belong to?

18 to 2526 to 3536 to 4546 to 5556 to 6565+Prefer not to say
3a - please let us know if you are completing this survey on behalf of someone else?

Parent/Guardian/CarerI am completing for myself
4. Are your day-to-day activities limited because of a health problem or disability which has lasted, or is expected to last, at least 12 months (include any problems related to old age)?

Yes, limited a lotYes, limited a littleNoPrefer not to say
5. If you answered yes, please indicate your disability:

Vision (due to blindness or partially sighted(Hearing (due to deafness or partial hearing)Mobility, such as difficulty walking short distance, climbing stairs, lifting and carrying objectsLearning, concentrating or rememberingMental healthStamina or difficulty breathingSocial or behavioural issues (e.g. due to autism/ASD or ADHD)Prefer not to sayOther
6. What is your ethnic group?

Choose one of the sections and select the appropriate box to indicate your ethnic group.
Asian or British Asian

BangladeshiChineseIndianPakistaniOther
Black or Black British

AfricanCaribbeanOther
MIxed

White and Black AfricanWhite and Black CaribbeanWhite and AsianOther
White

Welsh/English/Scottish/Northern Irish/British IrishGypsy or Irish Traveller
Please write in any other ethnic group
Prefer not to say

prefer not to say
7. What is your gender?

FemaleMalePrefer to self identifyPrefer not to say
8. What is your marital or civil partnership status?

DivorcedFormerly in a registered civil partnership which is now dissolvedIn a registered civil partnershipMarriedNever married and never registered a civil partnershipSeparated but still in a registered civil partnershipSeparated, but still legally marriedWidowedPrefer not to say
9. What is your religion?

No religionAtheistBuddhistChristian (including Church of England, Catholic, Protestant and all other Christian denominations)HinduJewishMuslimSikhPrefer not to sayOther
10. Which of the following options best describes your sexual orientation?

Hetrosexual/straightLesbianGayBisexualPrefer to self identifyPrefer not to say
11. Do you look after, or give any help or support to family members, friends, neighbours or others because of either long-term physical or mental ill-health/disability, or problems related to old age?

NoYes, 1-19 hours per weekYes, 20-49 hours per weekYes, 50 hours a week or morePrefer not to say
Provide your email address if you wish to be contacted regarding your submission:
e.g name@example.com
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Future provision of NHS community outpatient services in Harrow

Equality and diversity monitoring form

General Data Protection Regulation (GDPR)