Any information you give us on this form will be used in accordance with data protection regulations. If you give us your name or other contact details, we will not disclose those to any third party without your express permission. We may use your experiences to highlight to decision makers in health and social care how services could be improved, but you would not be identifiable as an individual.

  • Current Start
  • Complete

Take five minutes to share your experiences 

NHS and social care staff are doing everything they can to keep us well during these challenging times, but there might be things that can be improved for you and your loved ones.

Please take five minutes to share your story with us.

To understand how we will use your information read the 'How we use this information' at the end of the page.

Complete the survey

What type of service would you like to share your views on
Including vaccinations
i.e. District Nursing, 0-19 services, Children's Community Paediatric Service, Podiatry, Bladder and Bowel, Treatment Room services etc
Please select the options that you'd like to talk to us about. You can pick more than one.
If GPs, please tell us which practice you are referring to
If Dentists, please tell us which practice you are referring to
If Pharmacies, please tell us which pharmacy you are referring to
If Hospitals, please tell us which hospital you are referring to
If Community services, please tell us which services
Please tell us which mental health service you are referring to
Please tell us which service you are referring to
Please tell us which service
What went well? What could have been better and how it could be improved?
Did you have a wait to get through on the phone, or a delay in your appointment? Did someone go that extra mile to help?
How easy was it to access the help and support you needed?
How would you describe your experience of care?
1 star poor to 5 star excellent
In relation to this experience please select what best describes you

Tell us a bit about you

It would really help to know a little more about you so that we can better understand how people's experiences may differ. These questions are completely voluntary.

Please tell us your gender
Please tell us which sexual orientation you identify with
Please select your ethnicity
Please select any of the following that apply to you
Which of the following best describes your financial status?

How we use this information

The information you share with us helps us spot trends to identify areas for improvement. We may use quotes in our reports, but we will not use any information that will identify you.

As well as your feedback, we also ask you to volunteer some personal information. This helps us to help us understand how different groups experience local health and social care services and supports our focus on improving equality, diversity and inclusion. 

If you are sharing information on behalf of another person, make sure that you have their permission to do so, or the information you do share should be anonymous.

Find out more about how we handle your information in our privacy statement

Sharing your story with providers of services

We value your comments and monitor all feedback closely for themes and trends. We share information regularly with the providers of services, and the decision-makers in Halton’s health and social care system to aid learning and improvement.

When we share feedback, we routinely remove names and specific details to prevent someone’s identity from being revealed. If you are happy for your feedback to be shared with the service provider in full detail, making it easier for them to investigate, learn from or respond to (whether positive or negative), please let us know by ticking one of the two options below:

Please enter your contact details

Can we stay in touch? 

We'd love to tell your story and keep you updated about our work and the difference sharing your experiences with us can make.

Please select
Please select
Please enter your name and contact details / email address.
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.