Give us your ideas Step 1 of 7 14% Are you happy to give us your details or would you prefer to remain anonymous?*Yes, I am happy to give you my detailsI would prefer to remain anonymous Please tell us about youAddressName*Address Street Address City Postcode*Email* PhoneSocial MediaYour Twitter Account (including the @ symbol)Contacting youWhat is your preferred method for us contacting you?*By emailBy postI do not want to be contacted by youBy registering for a free myFed account, you can receive regular e-mail updates on latest news from the ELR GP Federation. Would you like us to create a myFed account for you for free?*Yes pleaseNo thanksPlease check that you've given us your postal address if you would like us to contact you by postPlease check that you've given us at least one social media account Which of the following challenges does your submission address? (You can as many or as few of the choices as you like) How to improve quality of care How to improve efficiency of care How to improve the compassion of care A simple idea to make things work better How to support practices Something else What is your suggestion for improving quality of care?What is your suggestion for improving the efficiency of care?What is your suggestion for improving compassion of care?What is your idea for supporting practices?What is your idea for making things work better?What would you like to say to us?Does your suggestion directly concern one of our members? (that is a GP Practice in East Leicestershire and Rutland)?*YesNoIt applies to all of themAre you happy for us to tell the Practice directly about your suggestion?* Yes No Which GP Practice does your suggestion concernCountesthorpe Health CentreCounty PracticeDr Kilpatrick and PartnersEmpingham Medical CentreEnderby Medical CentreForest House Medical CentreGlenfield SurgeryHazelmere Medical CentreKibworth Health CentreKingsway SurgeryLatham House Medical PracticeLong Clawson Medical PracticeLong Street SurgeryMarket Harborough Medical CentreMarket Overton & Somerby SurgeriesNarborough Health CentreNorthfield Medical CentreOakham Medical PracticeRosemead Drive SurgerySevern SurgerySouth Wigston Health CentreThe Billesdon SurgeryThe Central SurgeryThe Croft Medical CentreThe Husbands Bosworth SurgeryThe Jubilee Medical PracticeThe Limes Medical CentreThe Masharani PracticeThe Uppingham SurgeryThe Wycliffe Medical PracticeWigston Central Surgery We're interested in hearing whether or not you agree that GP-led Primary Care has particular strengths and skills that can help the NHS rise to the challenges it faces. Do you think that GPs and their colleagues working in Primary Care can do so?* Yes they can Not particularly more than anyone else Not at all How and why do you think they can do so? We may like to refer to your comments in public. Is this OK with you?*Yes, I am happy for you to refer to my comments in public and use my nameYes, I am happy for you to refer to my comments in public, but please do not use my name publiclyNo, I would prefer to keep my comments private between ourselvesWe would like to ask you some questions which will help with our equalities monitoring. You do not have to answer any of these questions if you would prefer not to and they will not affect how we treat your comments or ideas in any way, however it will help with our equalities monitoring if you are able to do so*Yes, I am happy to provide information to support your equalities monitoringNo, I would prefer not to provide information to support your equalities monitoring Equalities MonitoringWhat is your gender?MaleFemaleDo you consider yourself to be transgender?YesNoIf you are transgender, what was your (assigned) gender status at birth?FemaleMaleThird ChoiceAge GroupUnder 1616-2425-3435-3940-4950-5960-7576 or AboveWhat is your ethnicity?AfricanAsian or Asian BritishBangladeshiBritishCaribbeanChineseIndianIrishMixed/dual heritageOtherOther AsianOther WhitePakistaniWhiteWhite & AsianWhite and Black AfricanWhite and Black CaribbeanWhite BritishWhite ScandinavianPrefer not to sayDo you consider yourself to have a disability? If Yes, please give detailsYesNoPrefer not to sayDetails of your disabilityDo you consider yourself to be:Heterosexual or straightGay or lesbianBisexualMarital or Same Sex Civil Partnership Statussingle - that is never married and never registered in a same-sex civil partnershipmarriedseparated but still legally marrieddivorcedwidowedin a registered same-sex civil partnershipseparated but still legally in a same-sex civil partnershipformerly in a same-sex civil partnership which is now legally dissolvedsurviving partner from a same-sex civil partnershipWhich of the following categories best describes your employment status?Employed - working full-timeEmployed - working part-timeNot employed - looking for workNot employed - not looking for workRetiredDisabled - not able to workself employed - sole traderself employed -small business ownerin full time educationin part time education or trainingin an apprenticeship Many thanks for giving us feedback. It is really appreciated. Δ This iframe contains the logic required to handle AJAX powered Gravity Forms.
