Hospital Rooms Equal Opportunities Monitoring Form

Hospital Rooms Equal Opportunities Monitoring Form
Policy

Our vision is for Hospital Rooms to be a successful, caring and welcoming place for our staff and the communities we serve. We are committed to a culture where respect and understanding is fostered and the diversity of people’s backgrounds and circumstances are positively valued. You can read our Equality & Diversity policy here.

Monitoring

This Equal Opportunities Monitoring Form helps to keep us accountable to this vision, helping us to continually improve our recruitment practices, to understand the composition of our existing and prospective workforce, and to redress areas of under-representation. Hospital Rooms needs your help and co-operation to do this but filling in this form is voluntary. Please note that responses are anonymous and any information you share in this survey will not impact on any decisions made about your individual appointment or progression.

In accordance with data protection principles, we take care to ensure that all applicant data is appropriately and securely stored and handled. This form will be kept separate from the selection process and will be deleted six months after the closing date for the role you have applied for.

If you have any questions about this form, you can contact our team on info@hospital-rooms.com.
Which opportunity are you applying for?*
Socio-economic background

These questions relate to your socio-economic background, including your schooling and professional family history.
A state-run or state-funded schoolSelective on academic, faith or other groundNon-selectiveIndependent or fee-paying schoolAttended school outside the UKI don’t knowI prefer not to answer
If you finished school after 1980, were you eligible for Free School Meals at any point during your school years? Free School Meals are a statutory benefit available to school-aged children from families who receive other qualifying benefits and who have been through the relevant registration process. It does not include those who receive meals at school through other means (e.g. boarding school).

YesNoThis question does not apply to me (finished school before 1980 or went to school overseas)I don’t knowI prefer not to answer
Degree level or Degree equivalent or above (for example first or higher degrees, postgraduate diplomas, NVQ/SVQ Level 4 or 5 etc.)Qualifications below degree level (for example an A-Level, SCE Higher, GCSE, O-Level, SCE Standard/Ordinary, NVQ/SVQ, BTEC etc.)This question does not apply to meNo qualificationsI don’t knowI prefer not to answer
Modern professional occupations such as: teacher, nurse, physiotherapist, social worker, musician, police officer (sergeant or above), software designer.Clerical and intermediate occupations such as: secretary, personal assistant, clerical worker, call centre agent, nursery nurse.Senior managers or administrators (usually responsible for planning, organising and co-ordinating work, and for finance) such as: finance manager, chief executive.Technical and craft occupations such as: motor mechanic, plumber, printer, electrician, gardener, train driver.Semi-routine manual and service occupations such as: postal worker, machine operative, security guard, caretaker, farm worker, catering assistant, sales assistant.Routine manual and service occupations such as: HGV driver, cleaner, porter, packer, labourer, waiter/waitress, bar staff.Middle or junior managers such as: office manager, retail manager, bank manager, restaurant manager, warehouse manager.Traditional professional occupations such as: accountant, solicitor, medical practitioner, scientist, civil / mechanical engineer.Long term unemployed (claimed Jobseeker’s Allowance or earlier unemployment benefit for more than a year).RetiredThis question does not apply to meI don't knowI prefer not to answerOther
Ethnicity

The following categories have been devised by the UK governments Census of population and are recommended by the Equality and Human Rights Commission. Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong.
EnglishWelshScottishNorthern IrishIrishBritishGypsy or Irish TravellerOther
White and Black CaribbeanWhite and Black AfricanWhite and AsianOther
IndianPakistaniBangladeshiChineseArabOther
AfricanCaribbeanOther
I prefer not to answer
Additional monitoring questions.

These questions relate to your gender, gender identity, age, sexual orientation, belief, Disability Status and caring responsibilities.
MaleFemaleGender Non-binaryGender FluidI prefer not to answer
YesNoI prefer not to answer
16–2425–2930–3435–3940–4445–4950–5455–5960–6465+I prefer not to answer
AsexualHeterosexualGay woman/lesbianGay manBisexualI prefer not to answerOther
No religion or beliefBuddhistChristianHinduJewishMuslimSikhI prefer not to answerOther
NoYes, please select from the options belowI prefer not to answer
Cognitive or learning disabilitiesHearing impairment / deafMental health conditionPhysical disabilitiesVisual impairmentOther long term / chronic conditionI prefer not to answer
ADHDAutismDyslexiaDyspraxiaDyscalculiaDysgraphiaTourette SyndromeOther neurodevelopment conditionI prefer not to answer
YesNoI prefer not to answer
Primary carer of a child/children (under 18)Primary carer of disabled child/childrenPrimary carer of disabled adult (18 and over)Secondary carer (another person carries out the main caring role)Other caring responsibilitiesI prefer not to answer
Should be Empty:

Hospital Rooms Equal Opportunities Monitoring Form

Socio-economic background

Ethnicity

Additional monitoring questions.