Mersey Care services during the COVID-19 pandemic Survey

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* 1. Are you taking this for yourself or someone you care for? If it’s for someone else we will refer the questions to ‘you’.

For yourself

Someone you care for

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* 2. When did you last use a Mersey Care service ? If you have not used a Mersey Care Service since February 2020 please go to question 4.

Date

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* 3. Which services of Mersey Care have you used (if any)?

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* 4. Have you experienced any changes to your healthcare due to the pandemic?

Yes

No (skip to question 6)

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* 5. If yes, how would you rate the communication received about the changes?

Very poor

Poor

Fair

Good

Excellent

Very poor

Poor

Fair

Good

Excellent

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* 6. If this relates to a specific service please tell us the name of this service (leave blank if you’d prefer not to say)

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* 7. Could you tell us more about your experience of these changes?

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* 8. Overall, how was your experience of our service?

Very poor

Poor

Fair

Good

Excellent

Very poor

Poor

Fair

Good

Excellent

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* 9. How much of an impact has the pandemic had on your mental health or wellbeing?

No impact

Little impact

Some impact

Significant impact

Very significant impact

No impact

Little impact

Some impact

Significant impact

Very significant impact

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* 10. Have you been able to access support for your mental health or wellbeing during this time?

Yes - from family and/or friends

Yes - from a community, voluntary or charity group/organisation

Yes - from Mersey Care NHS Foundation Trust service

Yes - online or from an app

Yes - other

No - chose not to

No - did not know where to get support

I haven’t needed any support

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* 11. Would you like to tell us more about this? If you feel you need urgent help now please contact your GP or call the Samaritans free on 116 123.

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* 12. Mersey Care NHS Foundation Trust is dedicated to involving patients in their own care. We would like your feedback and any suggestions on how we can improve.

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* 13. Is there anything else you’d like to tell us?

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* 14. By telling us more information about yourself, you can help us better understand how people's experiences may differ depending on their personal characteristics. However, if you do not wish to answer these questions you do not have to.
Please tell us which age category you fall into?

13 - 17 years

18 - 24 years

25 - 34 years

35 - 44 years

45 - 54 years

55 - 64 years

65 - 74 years

75+ years

I’d prefer not to say

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* 15. Please tell us which gender you identify with

Female

Male

Non-binary

Other

I’d prefer not to say

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* 16. Is your gender different to the sex that was assigned to you at birth?

Yes

I’d prefer not to say

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* 17. Please select your ethnic background

Arab

Asian / Asian British: Bangladeshi

Asian / Asian British: Chinese

Asian / Asian British: Indian

Asian / Asian British: Pakistani

Asian / Asian British: Any other Asian / Asian British background

Black / Black British: African

Black / Black British: Caribbean

Black / Black British: Any other Black / Black British background

Gypsy, Roma or Traveller

Mixed / Multiple ethnic groups: Asian and White

Mixed / Multiple ethnic groups: Black African and White

Mixed / Multiple ethnic groups: Black Caribbean and White

Mixed / Multiple ethnic groups: Any other Mixed / Multiple ethnic background

White: British / English / Northern Irish / Scottish / Welsh

White: Irish

White: Any other White background

Another ethnic background

I’d prefer not to say

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* 18. Please tell us which sexual orientation you identify with

Asexual

Bisexual

Gay

Heterosexual / Straight

Lesbian

Pansexual

Other

I’d prefer not to say

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* 19. Please tell us about your religion or beliefs

Buddhist

Christian

Hindu

Jewish

Muslim

Sikh

No religion

Other

I’d prefer not to say

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* 20. Please tell us about your marital or civil partnership status

Single

Married

In a civil partnership

Separated

Divorced / dissolved civil partnership

Widowed

I’d prefer not to say

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* 21. Are you currently pregnant or have you been pregnant in the last year?

Yes

I’d prefer not to say

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* 22. Do you (or the person you are taking the survey for) consider yourself to be a carer, have a disability or a long term health condition? (Please select all that apply)

Yes, I consider myself to be a carer

Yes, I consider myself to have a disability

Yes, I consider myself to have a long term condition

None of the above

I’d prefer not to say

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* 23. Do you consider yourself to be confident at using a computer or mobile phone for looking for information online?

Yes, I would be confident to do this by myself

Yes, I would be confident to do this with support and/or training

No, I would not be confident to do this

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* 24. Do you consider yourself to be confident at using a computer or mobile phone for sending a message to another person via email or online messaging service?

Yes, I would be confident to do this by myself

Yes, I would be confident to do this with support and/or training

No, I would not be confident to do this

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* 25. Do you consider yourself to be confident at using a computer or mobile phone for using an online consultation service for your appointments (where appropriate)?

Yes, I would be confident to do this by myself

Yes, I would be confident to do this with support and/or training

No, I would not be confident to do this

Mersey Care services during the COVID-19 pandemic

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* 1. Are you taking this for yourself or someone you care for? If it’s for someone else we will refer the questions to ‘you’.

Question Title

* 2. When did you last use a Mersey Care service ? If you have not used a Mersey Care Service since February 2020 please go to question 4.

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* 3. Which services of Mersey Care have you used (if any)?

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* 4. Have you experienced any changes to your healthcare due to the pandemic?

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* 5. If yes, how would you rate the communication received about the changes?

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* 6. If this relates to a specific service please tell us the name of this service (leave blank if you’d prefer not to say)

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* 7. Could you tell us more about your experience of these changes?

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* 8. Overall, how was your experience of our service?

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* 9. How much of an impact has the pandemic had on your mental health or wellbeing?

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* 10. Have you been able to access support for your mental health or wellbeing during this time?

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* 11. Would you like to tell us more about this? If you feel you need urgent help now please contact your GP or call the Samaritans free on 116 123.

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* 12. Mersey Care NHS Foundation Trust is dedicated to involving patients in their own care. We would like your feedback and any suggestions on how we can improve.﻿

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* 13. Is there anything else you’d like to tell us?

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* 14. By telling us more information about yourself, you can help us better understand how people's experiences may differ depending on their personal characteristics. However, if you do not wish to answer these questions you do not have to. Please tell us which age category you fall into?

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* 15. Please tell us which gender you identify with

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* 16. Is your gender different to the sex that was assigned to you at birth?

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* 17. Please select your ethnic background

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* 18. Please tell us which sexual orientation you identify with

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* 19. Please tell us about your religion or beliefs

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* 20. Please tell us about your marital or civil partnership status

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* 21. Are you currently pregnant or have you been pregnant in the last year?

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* 22. Do you (or the person you are taking the survey for) consider yourself to be a carer, have a disability or a long term health condition? (Please select all that apply)﻿

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* 23. Do you consider yourself to be confident at using a computer or mobile phone for looking for information online?

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* 24. Do you consider yourself to be confident at using a computer or mobile phone for sending a message to another person via email or online messaging service?

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* 25. Do you consider yourself to be confident at using a computer or mobile phone for using an online consultation service for your appointments (where appropriate)?

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* 26. Do you have access to:

* 12. Mersey Care NHS Foundation Trust is dedicated to involving patients in their own care. We would like your feedback and any suggestions on how we can improve.

* 14. By telling us more information about yourself, you can help us better understand how people's experiences may differ depending on their personal characteristics. However, if you do not wish to answer these questions you do not have to.
Please tell us which age category you fall into?

* 22. Do you (or the person you are taking the survey for) consider yourself to be a carer, have a disability or a long term health condition? (Please select all that apply)