Emotional Wellbeing and Mental Health

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Emotional Wellbeing and Mental Health"

Transcription

1 Emotional Wellbeing and Mental Health A survey to help plan the services we offer to children and young people to promote and support their emotional wellbeing and mental health. Children and young people s emotional wellbeing and mental health impacts upon every area of their lives, from their educational achievements, their relationships with peers and the adults they come into contact with, to the choices they make in life everyday. Children and young people with good emotional and mental health are better able to contribute and achieve in life, and good mental health is also important for good physical health. As they grow up, children and young people may have some experiences that impact on their emotional wellbeing and mental health. Some are able to cope independently or with the support of a friend and family, while others may need a bit more help. To ensure that children and young people achieve the best chance of a happy and healthy life Surrey County Council, NHS Surrey and Surrey Clinical Commissioning Groups have agreed to look at planning a broader range of services for emotional wellbeing and mental health. About this survey The purpose of this survey is to understand what good emotional wellbeing and mental health should look like in Surrey, to identify the gaps and issues in our current service provision, and to plan what arrangement of services we need to put in place to meet the needs of children and young people, now and in the future. The findings from this survey will be used together with other information to help plan a broader emotional wellbeing and mental health service to children and young people. 1

2 Who is this survey for? If you are a parent or carer, a family member, or a professional that works with children and young people either directly or indirectly, we would like to hear your views. If you are a commissioner or provider organisation we would also like to hear from you. We welcome both individual responses and collective responses on behalf of a group or organisation. We are engaging children and young people through a variety of other appropriate channels. Timeframes Please complete this survey by 30 July We will share the findings of this survey with participants in September - October 2012 Confidentiality This is a strictly confidential survey and no participant will be personally identified by their responses. The information collected in Section A will be used for the sole purpose of communicating the findings of the survey. Participants can opt out of receiving further information if they wish. Returns Please return this survey to: Tina Fenwick Strategic Commissioning Children, Schools and Families Directorate Fairmount House Bull Hill Leatherhead Surrey KT22 7AX. 2

3 If you would like to request the survey in an alternative format, please contact Tina Fenwick (tel: , This survey will take approximately minutes to complete. Please allow yourself enough time. 3

4 What do we mean by emotional wellbeing and mental health? Emotional wellbeing and mental health is broad ranging. It includes being happy and coping with life s ups and downs, being healthy, staying safe, enjoying and achieving, and economic wellbeing. The National Child and Adolescent Mental Health Support Service (CAMHS) defines emotional wellbeing as: "A positive state of mind and body, feeling safe and able to cope, with a sense of connection with people, communities and the wider environment" SECTION A About You 1. I am responding to this survey as a: Parent or Carer Other Family Member (e.g. sibling) Professional (including strategic or operational) School representative Provider representative (including third sector) GP If you are a parent, carer or other family member please skip questions 2 to 6 on and go to question 7 on page 6. 4

5 SECTION A1 About You Professionals, school and provider representatives and GPs only. 2. Personal Information Name Organisation Title Role Address 3. I would like to be kept informed about the findings of this survey Yes No Comments / Preferences about receiving information 4. Which geographic location are you representing? Countywide North West North East South West South East Other (please specify) 5

6 5. Is this an individual or collective survey response? I am responding to this survey as an individual I am responding on behalf of my organisation, service or team (please specify): 6. Please write a summary sentence or statement explaining: Your organisation, service or team s core business What difference does your organisation, service or team make to children and young people to promote their emotional wellbeing and mental health? How do you do that? Who do you work with? Who are your key partners? 6

7 SECTION A2 About you Parents and Carers If you are a professional or a GP please skip questions 7 to 11 and go to question 12 on page 8 7. Is this an individual or collective survey response? I am responding to this survey as an individual parent or carer I am responding as the named contact for a collective response from a group of parents and carers. Group / organisation: 8. Where do you live? Elmbridge Epsom and Ewell Guildford Mole Valley Reigate and Banstead Runnymede Spelthorne Surrey Heath Tandridge Waverley Working Outside of Surrey 7

8 9. How many children and adults live in your household? Adults (including you) Children and Young People If you would prefer not to answer this question please skip to question I would like to be kept informed about the findings of this survey Yes No 11. If yes, please provide your contact details. Name Address Postcode Address Telephone 8

9 SECTION B What does good emotional wellbeing and mental health look like in Surrey? To ensure that children and young people in Surrey have the best chance of a happy and healthy life and are able to cope with life s ups and downs, we think it is important that they have: 12. Do you broadly agree that these are the right outcomes for children and young people in Surrey to promote their emotional wellbeing and mental health? Strongly Agree Agree Neither agree nor disagree Disagree Strongly Disagree I have comments to make Comments (please be specific): 9

10 13. What else do you think is important? What specific things would you see or hear about in your community if all children and young people are given the best chance of a happy and healthy life? Please be specific and concise

11 SECTION C people Understanding the needs of children and young The following groups of children and young people are at risk of poor emotional wellbeing and mental health. Young carers Gypsy roma traveller children Children from black and minority ethnic groups Children and young people with Special Educational Needs (SEN) and/or Disability Children at risk of abuse or neglect Children in Care or 'Looked After Children' Young people who use drugs frequently. Children and young people not participating in education, training or employment Vulnerable children and young people Children in poverty 14. Are there any other groups of children and young people who you think are at risk of poor emotional wellbeing and mental health, not included above? Please describe these groups below and explain why you think they are at risk. 11

12 15. What do you think are the most important factors for promoting good emotional wellbeing and mental health? Please tick up to 8 from the list below. Social skills and Problem Solving Skills Autonomy and a sense of independence A sense of purpose and future Secure early relationships Social support and social networks Being a planner, belief in control Humour Religious faith Capacity to reflect At least one good parent-child relationship Good standard of living Good morale In a school with positive policies for behaviour, attitudes, and anti-bullying Range of positive activities/leisure activities A sense of public contribution Friendships Affection Sense of belonging in the family and wider community Self-esteem Clear, firm and consistent discipline A positive home environment Healthy diet Support for education Healthy lifestyle Easy temperament Supportive long-term Economic wellbeing relationships Good communication skills Good housing Optimism, being positive about the future 12

13 16. What do you think are the most important warning signs to identify early and address? Please tick up to 8 from the list below. Specific learning difficulties Communication difficulties Delays in development Difficult temperament Physical illness Lower than expected academic attainment Low self-esteem Parental conflict Family breakdown Inconsistent or unclear discipline Hostile or rejecting relationships Failure to adapt to a child s changing needs Physical, sexual or emotional abuse Parental psychiatric diagnosis Parental criminality, alcoholism or personality disorder Death and loss including loss of friendship Socio-economic disadvantage Homelessness A disaster in the wider community Discrimination Other significant life events 13

14 SECTION D Services 17. What kinds of support and services are you aware of, either locally to you or across the county, that work well to promote emotional wellbeing and mental health? This could be any service, support, intervention, in any setting, delivered by any agency or organisation. Please be specific and concise What is it about these services that make them effective at promoting emotional wellbeing and mental health? For each service you have identified please tick up to three features or characteristics from the list below: Service 1 Service 2 Service 3 Value for money Timely and efficient Child centred Meets needs effectively Knowledgeable, friendly and welcoming staff Good relationships Consistent Appropriate Safe Responsive Good communication Informal Flexible Location Other (please specify) 14

15 19. Do you have any suggestions about how services could be improved to promote emotional wellbeing and mental health? This could include stopping services that don t work. Please be specific and concise. 20. Is there anything else you would like to tell us? 15

16 SECTION F Equality and Diversity Equality legislation requires that all public authorities can demonstrate that they engage effectively with specific groups of people when consulting with staff or the public to review or develop policy and procedures. In order to develop policies and practices that are fair to all, we need to ensure that we are hearing views from all groups within our society when we are consulting. Monitoring service users can help us understand if certain groups of people are not using a service and we can then take steps to understand why and improve the accessibility of the service. 21. Are you willing to answer some quality and diversity questions? Yes No If you have selected Yes please skip to question 22. Thank you for participating in this survey. Your views are important to us and they will help us develop and improve services to promote emotional wellbeing and mental health. We will share the findings of this survey with participants in September - October

17 22. How would you describe your ethnic group? Please tick one box Arab Asian or Asian British Bangladeshi Asian or Asian British Indian Asian or Asian British Pakistani Black or Black British African Black or Black British Caribbean Mixed White and Asian Mixed White and Black African Mixed White and Black Caribbean White British White Irish White Traveller (including Gypsy, Roma, or Irish traveller) Any other White background Chinese Other I would rather not answer If Other please give details: 23. Are you Male Female Trans gender female to male Trans gender male to female I would rather not answer 24. Which age band do you fall into? Under and over 17

18 I would rather not answer 25. Which of the following religious or faith group do you identify with? Buddhist Christian (includes Protestant, Catholic, Methodist and Evangelical) Hindu Jewish Muslim Sikh No religious/faith group Any other religion/faith - please give details I would rather not answer Any other religion/faith 26. Do you consider yourself to have a disability? Yes No Don't know I would rather not answer 27. Do you consider yourself to have a permanent and substantial condition or impairment but do not consider yourself to be disabled? Yes No Don't know I would rather not answer 28. What is your marital or same-sex civil partnership status? Never married and never formed a civil partnership Married Separated but still legally married Divorced 18

19 Widowed Living with partner In a civil partnership Separated but still legally in a civil partnership Formerly in a civil partnership which is now legally dissolved Surviving partner from a civil partnership I would rather not answer 29. Are you? Bisexual Gay man Heterosexual Lesbian woman would rather not answer THANK YOU Thank you for participating in this survey. Your views are important to us and will help us develop and improve services to promote emotional wellbeing and mental health for children young and people. 19

Application form Please complete all sections of this form using dark ink. We do not accept curriculum vitae in place of completed application forms.

Application form Please complete all sections of this form using dark ink. We do not accept curriculum vitae in place of completed application forms. Application form Please complete all sections of this form using dark ink. We do not accept curriculum vitae in place of completed application forms. Job applied for: Location of job: DELETE/TICK WHERE

More information

Collecting data on equality and diversity: examples of diversity monitoring questions

Collecting data on equality and diversity: examples of diversity monitoring questions Collecting data on equality and diversity: examples of diversity monitoring questions Subject Page Age 3 Disability 4-5 Race/Ethnicity 6-7 Gender or sex, and gender reassignment 8-9 Religion and belief

More information

Compliments, Comments & Complaints. This leaflet tells you how to compliment, comment or complain about our Services. www.wakefield.gov.

Compliments, Comments & Complaints. This leaflet tells you how to compliment, comment or complain about our Services. www.wakefield.gov. Compliments, Comments & Complaints This leaflet tells you how to compliment, comment or complain about our Services www.wakefield.gov.uk Comments, Compliments and Complaints We welcome your views We are

More information

APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT APPLICATION FOR EMPLOYMENT Please complete in black ink This form has two parts. The application form must be completed and returned as part of your application for the advertised appointment. If you have

More information

Job application form including guidance notes

Job application form including guidance notes Join us Cumbria County Council Job application form including guidance notes Helpful tips Please read through the guidance notes and recruitment brochure before completing your application form. Use black

More information

FREELANCE TRAINER APPLICATION FORM

FREELANCE TRAINER APPLICATION FORM FREELANCE TRAINER APPLICATION FORM PERSONAL DETAILS: Full Name: Address: Contact (day) (eve) (mobile) (e-mail) QUALIFICATIONS and MEMBERSHIP: Please detail your academic or professional qualifications

More information

The CILEx Compensation Fund Claims Application Form

The CILEx Compensation Fund Claims Application Form The CILEx Compensation Fund Claims Application Form Please complete this form to make a claim for a loss you have incurred. When you have filled in the form, please send it to us at: The CILEx Compensation

More information

Prevent unauthorised deductions Antenatal care. Failure to allow time off for trade union activities/safety rep duties

Prevent unauthorised deductions Antenatal care. Failure to allow time off for trade union activities/safety rep duties Fees and Remissions Although this form is not part of the ET1 it must be returned with the claim form if you are making your claim by post. This will assist our staff in confirming that the correct fee

More information

Claims Management Claim Form. When you have filled in the form, please send it to us at:

Claims Management Claim Form. When you have filled in the form, please send it to us at: For our use only.../... Claims Management Claim Form When you have filled in the form, please send it to us at: Solicitors Regulation Authority Claims Management The Cube 199 Wharfside Street Birmingham

More information

Application form trainee solicitors

Application form trainee solicitors Application form trainee solicitors for training contracts commencing in 2018 PERSONAL DETAILS Title: Name (in full): Telephone number(s): Email address: Home address (including postcode): Please give

More information

TEACHER APPLICATION FORM

TEACHER APPLICATION FORM TEACHER APPLICATION FORM Please note this post involves working with children or vulnerable adults so appointment will be subject a Criminal Records Bureau disclosure. See supporting information for further

More information

Application Form Foundation Degree in Business 2 years Full-Time (Part-Time attendance)

Application Form Foundation Degree in Business 2 years Full-Time (Part-Time attendance) Application Form Foundation Degree in Business 2 years Full-Time (Part-Time attendance) Please read the online course leaflet page for details of the entry requirements. Personal Details Surname First

More information

The Community Law Partnership. Application for Employment

The Community Law Partnership. Application for Employment The Community Law Partnership Solicitors Housing Law Advice Application for Employment The Community Law Partnership is an Equal Opportunities Employer. We invite applications from men and women from all

More information

Haringey Council - Test of Tenant Opinion

Haringey Council - Test of Tenant Opinion TENANT NAME ADDRESS LINE 1 ADDRESS LINE 2 ADDRESS LINE 3 TOWN/CITY POSTCODE Survey Reference number: 123456 If you would prefer to complete this questionnaire online, please visit www.m-e-l.co.uk/haringey.aspx

More information

A CLAIM FOR DISCRETIONARY HOUSING PAYMENTS (DHP) Claim Ref:

A CLAIM FOR DISCRETIONARY HOUSING PAYMENTS (DHP) Claim Ref: A CLAIM FOR DISCRETIONARY HOUSING PAYMENTS (DHP) Claim Ref: SECTION 1 INFORMATION If you are getting Housing Benefit and Local Council Tax Support but you are still having problems meeting your rent and

More information

Pharmaceutical Needs Assessment (PNA) Consultation Response Form

Pharmaceutical Needs Assessment (PNA) Consultation Response Form Pharmaceutical Needs Assessment (PNA) Consultation Response Form Hertfordshire Health and Wellbeing Board is consulting on the draft Hertfordshire PNA and welcome all views and comments. The consultation

More information

Application form for employment

Application form for employment Position: Ref no: (For office use only) Thank you for your interest in employment with Eden Project Ltd. Please complete this application form in as much detail as possible. We will be using the information

More information

Referral Form. What benefits does the applicant receive? allocated?

Referral Form. What benefits does the applicant receive? allocated? Please return to Christopher Davies Heantun Housing Association 3 Wellington Road Bilston West Midlands WV14 6AA 01902 571131 christopher.davies@heantun.co.uk Referral Form Personal details: Name of applicant:

More information

NHS Scotland Application Form

NHS Scotland Application Form Candidate identification number (office use only): Please ensure you complete the application form in full as we cannot accept CVs. Please complete with black ink and block capitals. This form will be

More information

PLEASE READ THIS FORM IN FULL BEFORE COMPLETING IT

PLEASE READ THIS FORM IN FULL BEFORE COMPLETING IT Application Form PLEASE READ THIS FORM IN FULL BEFORE COMPLETING IT Please complete all sections of this form when applying for the grant. Please send your completed application form and relevant documentation

More information

St Albans Rent Secure Scheme Referral Form

St Albans Rent Secure Scheme Referral Form St Albans Rent Secure Scheme Referral Form Please provide the following information along with the supporting documents listed on the eligibility criteria to enable the STARSS co-ordinator to make an initial

More information

Job Application form

Job Application form Job Application form Post Applied for: Closing Date: form Job Reference: form Please complete this form in black ink. Applications received after the closing date will not normally be considered. THE INFORMATION

More information

Consultation on Proposed Changes to the Non-Residential Social Services Contributions Policy ONLINE CONSULTATION QUESTIONNAIRE

Consultation on Proposed Changes to the Non-Residential Social Services Contributions Policy ONLINE CONSULTATION QUESTIONNAIRE Consultation on Proposed Changes to the Non-Residential Social Services Contributions Policy ONLINE CONSULTATION QUESTIONNAIRE Introduction The Council are reviewing our policy about the contributions

More information

Branch Sales Assistant Application Form

Branch Sales Assistant Application Form NI Ref No: Branch Sales Assistant Application Form Please use block capitals, black ink and write clearly throughout All About You Email Address Contact Numbers: Mobile Home National/Social Insurance Number

More information

Fast Track Pathway Tool for NHS Continuing Healthcare

Fast Track Pathway Tool for NHS Continuing Healthcare Fast Track Pathway Tool for NHS Continuing Healthcare DH INFORMATION READER BOX Policy Clinical Estates HR / Workforce Commissioner Development IM & T Management Provider Development Finance Planning /

More information

SPECIALIST TENANCIES MANAGER PERSON SPECIFICATION

SPECIALIST TENANCIES MANAGER PERSON SPECIFICATION SPECIALIST TENANCIES MANAGER PERSON SPECIFICATION The Selection Panel has identified this comprehensive specification for the ideal candidate and will use this to examine the internal candidate(s) who

More information

Barking Abbey School Teacher Application Form

Barking Abbey School Teacher Application Form Job position applied for Closing Date Where or how did you hear about the vacancy? PERSONAL DETAILS Your preferred title: First name or names: Last name: Address: Home phone number: Work phone number:

More information

JOB APPLICATION FORM

JOB APPLICATION FORM JOB APPLICATION FORM App Form No: Job Ref No: For office use only Please refer to the Guidance Notes for Applicants for help in completing this form 1. Personal Information Title Forename(s) Surname Address

More information

Colchester Borough Council. Equality Impact Assessment Form - An Analysis of the Effects on Equality. Section 1: Initial Equality Impact Assessment

Colchester Borough Council. Equality Impact Assessment Form - An Analysis of the Effects on Equality. Section 1: Initial Equality Impact Assessment Colchester Borough Council Equality Assessment Form - An Analysis of the Effects on Equality Section 1: Initial Equality Assessment Name of policy to be assessed: Internal Communications Strategy 2015

More information

IMPORTANT NORTHERN IRELAND FIRE & RESCUE SERVICE PROCESSES THE INFORMATION PROVIDED ON THIS FORM FOR THE PURPOSES OF MEETING ITS LEGAL OBLIGATIONS.

IMPORTANT NORTHERN IRELAND FIRE & RESCUE SERVICE PROCESSES THE INFORMATION PROVIDED ON THIS FORM FOR THE PURPOSES OF MEETING ITS LEGAL OBLIGATIONS. IMPORTANT ALL SECTIONS OF THIS APPLICATION FORM SHOULD BE COMPLETED. IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE SUFFICIENT INFORMATION FOR THE APPLICATION TO BE ASSESSED, AND CARE SHOULD BE TAKEN

More information

Civic Government (Scotland) Act 1982

Civic Government (Scotland) Act 1982 Corporate Resources Legal Services Civic Government (Scotland) Act 1982 Application pack to substitute a vehicle for that designated as a taxi licence or a private-hire car licence This application pack

More information

TempDIRECT. Application for Employment. Personal Details. Availability. Hours. Location

TempDIRECT. Application for Employment. Personal Details. Availability. Hours. Location TempDIRECT Application for Employment Personal Details Title (select as appropriate): Dr Mr Mrs Miss Ms Other (please specify) Surname(s): First name(s): Previous surname(s): Address: Post Code: Email

More information

Consultation on standards for pharmacy professionals

Consultation on standards for pharmacy professionals Consultation on standards for pharmacy professionals April 2016 F The text of this document (but not the logo and branding) may be reproduced free of charge in any format or medium, as long as it is reproduced

More information

Director - Business Development, Partnerships & Communications - Application pack

Director - Business Development, Partnerships & Communications - Application pack Director - Business Development, Partnerships & Communications - Application pack Thank you for downloading this application pack! In this document you will find: Information about Future First; our history,

More information

Draft Milton Keynes Drug and Alcohol Strategy. Consultation Paper. What is a strategy?

Draft Milton Keynes Drug and Alcohol Strategy. Consultation Paper. What is a strategy? Draft Milton Keynes Drug and Alcohol Strategy Consultation Paper What is a strategy? A strategy helps organisations such as Milton Keynes Council to plan what it needs to achieve in a specific area of

More information

Housing List Application

Housing List Application Answer all questions on this form fully & truthfully or your application will be delayed. Please use a black pen and write in BLOCK CAPITALS. If you need help filling in this form please contact 020 7364

More information

Surrey Emotional Wellbeing and Mental Health Services for Children and Young People Needs Assessment Refresh

Surrey Emotional Wellbeing and Mental Health Services for Children and Young People Needs Assessment Refresh Surrey Emotional Wellbeing and Mental Health Services for Children and Young People Needs Assessment Refresh January 2014 Updated April 2014 Authors: Tina Fenwick Commissioning Projects Officer, Children

More information

TEACHER JOB APPLICATION FORM

TEACHER JOB APPLICATION FORM TEACHER JOB APPLICATION FORM To be completed in black ink. All relevant sections must be completed. A Curriculum Vitae must not be submitted in place of any information on this form. 1. VACANCY INFORMATION

More information

Three Rivers Housing Association Customer Survey

Three Rivers Housing Association Customer Survey Three Rivers Housing Association Customer Survey Q1. Address Q2. Postcode Tenancy Ref (if known) Q3. Daytime Phone Number Q4. Evening Phone Number Q5. Mobile Phone Number Q6. Do you have internet access?

More information

Compensation for a personal injury following a period of abuse (physical and/or sexual)

Compensation for a personal injury following a period of abuse (physical and/or sexual) Criminal Injuries Compensation Authority Tay House 300 Bath Street Glasgow, G2 4LN Freephone: 0800 358 3601 For office use only Reference number: Compensation for a personal injury following a period of

More information

Completed application Forms MUST be received no later than 12.00 noon on

Completed application Forms MUST be received no later than 12.00 noon on Job reference number APPLICATION FORM Thank you for your interest. This Application Form should be completed in full using BLACK INK. Applicants will be assessed only on the information provided in the

More information

Islington Housing Services in partnership with London Metropolitan University delivering an accredited course on housing issues

Islington Housing Services in partnership with London Metropolitan University delivering an accredited course on housing issues Islington Housing Services in partnership with London Metropolitan University delivering an accredited course on housing issues Please return the completed form by Wednesday 22 June 2013, 10.00am Application

More information

Review of Drug & Alcohol Services In Derby

Review of Drug & Alcohol Services In Derby Review of Drug & Alcohol Services In Derby Take part from 9 June until 20 July 2014 To take part: Please read the background information contained within this document. If you have any questions about

More information

Project Manager s Introduction

Project Manager s Introduction Dear prospective volunteers, Project Manager s Introduction It is fantastic that you are interested in helping us support young and vulnerable people in Cheshire. Nightstop is a way of volunteering from

More information

DIPLOMA IN DENTAL HYGIENE AND DENTAL THERAPY APPLICATION FORM FOR ADMISSION IN Jan 2016

DIPLOMA IN DENTAL HYGIENE AND DENTAL THERAPY APPLICATION FORM FOR ADMISSION IN Jan 2016 DIPLOMA IN DENTAL HYGIENE AND DENTAL THERAPY APPLICATION FORM FOR ADMISSION IN Jan 2016 Please complete clearly in BLACK ink Use the information on the website to ensure that you complete this form correctly

More information

Policy on Planned Preventative Maintenance

Policy on Planned Preventative Maintenance Policy on Planned Preventative Maintenance V1/15.01.09 Policy Title: Executive Summary: Planned Preventative Maintenance This policy provides guidance to ensure that a fit for purpose Planned Preventative

More information

Dear Applicant, We look forward to hearing from you. Kind Regards. Admissions

Dear Applicant, We look forward to hearing from you. Kind Regards. Admissions Dear Applicant, Please print the following application form (4 pages), complete all fields and send it to Admissions at the above address along with the 40.00 non-refundable Campus Fee. This application

More information

JOB DESCRIPTION ASSET MANAGEMENT OFFICER

JOB DESCRIPTION ASSET MANAGEMENT OFFICER JOB DESCRIPTION ASSET MANAGEMENT OFFICER Responsible to: Asset Manager Role of Property Team The Asset Management team provides a comprehensive property maintenance service to tenants including capital

More information

A-Z Hospitals NHS Trust (replace with your employer name)

A-Z Hospitals NHS Trust (replace with your employer name) Department of Health will be issuing new guidance relating to the monitoring of equality in April 2013. The equality and diversity sections within NHS Jobs application forms will be reviewed and updated

More information

You must have completed both modules of your PCV Theory test which includes: Hazard Perception Multiple Choice Driver CPC case studies test

You must have completed both modules of your PCV Theory test which includes: Hazard Perception Multiple Choice Driver CPC case studies test Date as download Dear Applicant, Thank you for your enquiry about training to become a bus driver with Yourbus, an Application form and D4 Medical Examination Report is enclosed with this letter. In order

More information

Version 2 November 2014 ADULT INFORMATION FORM. scouts.org.uk

Version 2 November 2014 ADULT INFORMATION FORM. scouts.org.uk Version 2 November 2014 ADULT INFORMATION FORM. scouts.org.uk This form is to be used by any person over 18 years of age who wishes to help with Scouting, or become a member of Scout Network. The form

More information

If the person is at immediate risk call emergency services first on 999.

If the person is at immediate risk call emergency services first on 999. Children, Adults and Health Safeguarding Alerter Form About this form Please ensure that this form is completed as fully as possible and returned the same day. Gaps in information may put people at further

More information

APPLICATION FORM ver.cgm CRC Please note: Before commencing the application form, please read the guidance notes

APPLICATION FORM ver.cgm CRC Please note: Before commencing the application form, please read the guidance notes 1. APPLICATION FORM ver.cgm CRC Please note: Before commencing the application form, please read the guidance notes OFFICE USE ONLY Candidate Ref:. DDA Application for employment as Vacancy Ref Section

More information

Moving learning disability clinics from Mansion House. Engagement document 2 24 May 2016

Moving learning disability clinics from Mansion House. Engagement document 2 24 May 2016 Moving learning disability clinics from Mansion House Engagement document 2 24 May 2016 This document explains the background to plans by Leicestershire Partnership NHS Trust to move a number of learning

More information

SCREENING TEMPLATE. The purpose of the policy is to set out in summary how spiritual care services are recognised and provided within the BHSCT.

SCREENING TEMPLATE. The purpose of the policy is to set out in summary how spiritual care services are recognised and provided within the BHSCT. SCREENING TEMPLATE For further information on screening, please refer to the Guidance tes, which are also available in hard copy from the Health and Social Inequalities Team. 1 SCREENING TEMPLATE For further

More information

YELDALL MANOR APPLICATION FORM

YELDALL MANOR APPLICATION FORM YELDALL MANOR APPLICATION FORM The information given on this form will not be passed to anyone else, except where this is necessary to process your application. Please write clearly and complete as much

More information

Handout: Risk. Predisposing factors in children include: Genetic Influences

Handout: Risk. Predisposing factors in children include: Genetic Influences Handout: Risk The more risk factors to which a child is exposed the greater their vulnerability to mental health problems. Risk does not cause mental health problems but it is cumulative and does predispose

More information

Recruitment Pack. Debt and Benefits Advisor. Wellingborough Homes. August 2015

Recruitment Pack. Debt and Benefits Advisor. Wellingborough Homes. August 2015 Recruitment Pack Debt and Benefits Advisor Wellingborough Homes August 2015 Wellingborough Homes 9f Silver Street Wellingborough NN8 1BQ Email : Recruitment@whomes.org www.wellingboroughhomes.org Contents

More information

Thank you for your interest in volunteering with the Avon and Somerset Constabulary.

Thank you for your interest in volunteering with the Avon and Somerset Constabulary. Human Resources Department, South Gloucestershire District Concorde House, Harlequin Office Park, Fieldfare, Emersons Green, Bristol, BS16 7FN Telephone: 0117 928 6099 Facsimile: 0117 928 6150 E-mail:

More information

APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT APPLICATION FOR EMPLOYMENT PLEASE COMPLETE IN BLACK INK INCORPORATING Reference Number: POSITION APPLIED FOR: PERSONAL DETAILS Title: Surname: First Name: Home Address: Post Code: Email Address: Contact

More information

UWM Counseling and Consultation Services Intake Form

UWM Counseling and Consultation Services Intake Form UWM Counseling and Consultation Services Intake Form Dear Student, Date Affix Label Here (Office Use Only) Thank you for giving us the opportunity to better serve you. Please help us by taking a few minutes

More information

Surrey County Council Full Equality Impact Assessment

Surrey County Council Full Equality Impact Assessment 1. Context of the Service or Policy Surrey County Council Full Equality Impact Assessment Service or Policy being assessed Surrey Arts Assessor: Karl Newman Date July 2008 What are the aims of the service

More information

JOB DESCRIPTION INCOME MANAGEMENT OFFICER

JOB DESCRIPTION INCOME MANAGEMENT OFFICER JOB DESCRIPTION INCOME MANAGEMENT OFFICER PURPOSE OF ROLE To contribute to the AHP Group s (Aberdeenshire and Moray Housing Partnerships) Income Management process and our aim of providing a supportive;

More information

If you have not heard from us by then, please consider your application unsuccessful.

If you have not heard from us by then, please consider your application unsuccessful. Governance and Executive Support Assistant Chief Executive Section Job Type: Full time 37 hours per week Location: Hull, East Yorkshire Salary: 25,000 per annum Start Date: ASAP Duration: 6 months fixed

More information

APPLICATION FOR GENERAL MEDICAL SERVICES WITH THE CHARTER MEDICAL CENTRE

APPLICATION FOR GENERAL MEDICAL SERVICES WITH THE CHARTER MEDICAL CENTRE Your GP will be: APPLICATION FOR GENERAL MEDICAL SERVICES WITH THE CHARTER MEDICAL CENTRE Dr From AUG 2015 PLEASE COMPLETE THIS FORM IN CAPITAL LETTERS Have you been registered at this practice before?

More information

job pack www.creative-bridge.com

job pack www.creative-bridge.com job pack October 2015 Management Accountant Welcome Hello, and welcome to Creative Bridge. Creative accounting is generally frowned upon of course, but we re looking for a management accountant who is

More information

Job application form

Job application form Job application form Application to join our team Office use Office use Test Interview Offer Outcome London Midland is on a journey of improvement: new investment, new plans, new future. We re investing

More information

Registering as a dentist with the General Dental Council (Overseas qualified)

Registering as a dentist with the General Dental Council (Overseas qualified) www.gdc-uk.org www.gdc-uk.org Registering as a dentist with the General Dental Council Application Form This application form, accompanying documents and registration fee should be posted to: Registration

More information

Ethnic diversity and migration data sheet

Ethnic diversity and migration data sheet Ethnic diversity and migration data sheet Last updated: June 2016 Produced by: Strategy, Engagement and Organisational Development Contact: policy@rushmoor.gov.uk Summary: According to the 2011 Census,

More information

The Best People: The Best Services

The Best People: The Best Services The Best People: The Best Services This form and its guidance are available in alternative formats (see back page) or you can apply online at www.leics.gov.uk/jobs Free internet access is available at

More information

Sample Give and Let Live survey questions

Sample Give and Let Live survey questions Sample Give and Let Live survey questions Here are some closed questions you might think about using in your questionnaire. The questions you ask will depend on who your target audience is if everyone

More information

Discrimination on grounds of ethnicity, race, gender, sexuality or disability

Discrimination on grounds of ethnicity, race, gender, sexuality or disability Emotional health and wellbeing Why is it important? Emotional ill health is the result of who we are and what happens to us in our lives. For children, this may include poor attachment, poor parenting,

More information

Fostering Recruitment Team London Borough of Barnet Building 4, North London Business Park Oakleigh Road South London N11 1NP

Fostering Recruitment Team London Borough of Barnet Building 4, North London Business Park Oakleigh Road South London N11 1NP Fostering Recruitment Team London Borough of Barnet Building 4, North London Business Park Oakleigh Road South London N11 1NP Phone: 020 8359 6274 Email: fostering@barnet.gov.uk Background information

More information

Please note that it is not possible to use bold or rich texts when completing this application form

Please note that it is not possible to use bold or rich texts when completing this application form Application Form For Teaching posts Please note that it is not possible to use bold or rich texts when completing this application form Vacancy title: Closing date: Please complete all sections of this

More information

NHS Family doctor services registration GMS1

NHS Family doctor services registration GMS1 NHS Family doctor services registration GMS1 Patient s details Please complete in BLOCK CAPITALS and tick as Appropriate Mr Mrs Miss Ms Surname Date of birth d d m m y y First names NHS No. Male Female

More information

www.helptobuysw.org.uk

www.helptobuysw.org.uk Help to Buy South West Application Form Please circle the correct answers Would you consider buying a home? Would you consider renting a home? Yes / No Yes / No I/We can confirm that our household income

More information

Capita HR Solutions. HR Services Director

Capita HR Solutions. HR Services Director Capita HR Solutions HR Services Director August 2013 Contents The Company... 3 Job Description... 4 The Rewards... 6 Advertisement... 7 How to Apply... 8 Equality & Diversity Monitoring form... 9 Capita

More information

Vacancies. Advice Workers- Edinburgh 2 Full Time (Job share might be considered) (36.25 hours a week/ 20,931 per annum )

Vacancies. Advice Workers- Edinburgh 2 Full Time (Job share might be considered) (36.25 hours a week/ 20,931 per annum ) Vacancies Advice Workers- Edinburgh 2 Full Time (Job share might be considered) (36.25 hours a week/ 20,931 per annum ) FAIR is an advice and information service for people with learning disabilities and

More information

Department for Transport / Office of Rail Regulation

Department for Transport / Office of Rail Regulation Department for Transport / Office of Rail Regulation Director, Strategic Roads Network Monitor Candidate Information Brief October 2014 431223 1 About the Strategic Roads Network Monitor The Government

More information

Care Programme Approach (CPA)

Care Programme Approach (CPA) Care Programme Approach (CPA) The Care Programme Approach (CPA) is used to plan many people s mental health care. This factsheet explains what it is, when you should get and when it might stop. The Care

More information

Gambling Therapist. Residential Treatment Centre for Compulsive Gamblers. 35 hours per week to include Saturdays on a rota basis

Gambling Therapist. Residential Treatment Centre for Compulsive Gamblers. 35 hours per week to include Saturdays on a rota basis Gambling Therapist Residential Treatment Centre for Compulsive Gamblers 35 hours per week to include Saturdays on a rota basis 22,945 plus OLW 1755 and 6% pension. Would you like to make a difference to

More information

Statistics about Bourne, South Kesteven. People Statistics. 32UG012 Bourne Parish is within South Kesteven LAD or UA. Resident Population and Age

Statistics about Bourne, South Kesteven. People Statistics. 32UG012 Bourne Parish is within South Kesteven LAD or UA. Resident Population and Age Statistics about Bourne, 32UG012 Bourne Parish is within LAD or UA People Statistics Resident Population and Age The resident population of Bourne as measured in the 2001 Census, was 11,933 of which 48.3

More information

INCIDENT MANAGEMENT POLICY

INCIDENT MANAGEMENT POLICY INCIDENT MANAGEMENT POLICY Version 3.0 Ratified By Date Ratified 10 December 2014 Board Paula Wedd, Head of Quality and Safeguarding Author(s) Pam Hughes Head of Business Solutions Cheshire and Merseyside

More information

in Havering How to become a foster carer for Havering rise to the challenge reap the rewards

in Havering How to become a foster carer for Havering rise to the challenge reap the rewards in Havering How to become a foster carer for Havering Introduction Thank you for expressing an interest in becoming a foster carer for Havering. We are always looking for new people to join our group of

More information

Employment Application Form

Employment Application Form Office Use Only Employment Application Form We welcome applications from all people with the relevant skills and potential for the job. Please answer the questions in this form as honestly and fully as

More information

Tamworth Borough Council Housing Application Form

Tamworth Borough Council Housing Application Form Tamworth Borough Council Housing Application Form Please read this form carefully and complete all sections. An incomplete form will be returned to you for completion. The information you give us will

More information

Fortrose Medical Practice

Fortrose Medical Practice Fortrose Medical Practice GP Partners: Dr Sandy MacGregor, Dr Will Fraser, Dr Iain Forth & Dr Jude Watmough Associate GP: Dr Shona Forth Station Road Fortrose Ross-shire IV10 8SY Phone: Fax: Email: Website:

More information

Statistics about Sleaford, North Kesteven. People Statistics. 32UE057 Sleaford Parish is within North Kesteven LAD or UA. Resident Population and Age

Statistics about Sleaford, North Kesteven. People Statistics. 32UE057 Sleaford Parish is within North Kesteven LAD or UA. Resident Population and Age Statistics about Sleaford, 32UE057 Sleaford Parish is within LAD or UA People Statistics Resident Population and Age The resident population of Sleaford as measured in the 2001 Census, was 14,494 of which

More information

Telephone Numbers Including full STD code. Preferred Contact Number: address:

Telephone Numbers Including full STD code. Preferred Contact Number:  address: JOB APPLICATION FORM Please complete this form accurately, giving as many details as possible of your skills and experience relating to this job application. You are welcome to attach additional details

More information

Fostering young lives. Providing foster care to children and young people.

Fostering young lives. Providing foster care to children and young people. Fostering young lives Providing foster care to children and young people. What is foster care? Foster care is the care of a child or young person who is not able to live with their own family. The reasons

More information

62 BATTLE ROAD ERITH, KENT DA8 1BJ TEL: 01322 432997 Fax: 01322 442324 DR K S NANDRA

62 BATTLE ROAD ERITH, KENT DA8 1BJ TEL: 01322 432997 Fax: 01322 442324 DR K S NANDRA 62 BATTLE ROAD ERITH, KENT DA8 1BJ TEL: 01322 432997 Fax: 01322 442324 DR K S NANDRA Patient Participation Group Report March 2013 The Bulbanks Medical Centre Patient Participation Group currently has

More information

Job Application Form

Job Application Form Job Application Form Continuation sheets may be attached. Please complete in black ink or type to help with photocopying for the Selection Panel. If you require any help in completing this form, or have

More information

Ref no. office use only: Post applied for: Location:

Ref no. office use only: Post applied for: Location: Ref no. office use only: Post applied for: Location: Before completing this form please carefully read the accompanying guidance notes and job description. You can return the form by email or by post.

More information

FURTHER EDUCATION Place of education Type of training Qualification

FURTHER EDUCATION Place of education Type of training Qualification APPLICATION FORM POSITION APPLIED FOR HOW DID YOU HEAR OF THIS VACANCY? (Name of publication, web site, agency or source) PERSONAL DETAILS Surname: First Names: Title: Previous Names: Home Address: Post

More information

Changing children s lives

Changing children s lives What is adoption? 01 What is adoption? Through adoption you can give a child a permanent, caring home and a sense of belonging, with the love and security of a stable family life guaranteed until they

More information

DOE SECTION 75 EQUALITY OF OPPORTUNITY SCREENING ANALYSIS FORM

DOE SECTION 75 EQUALITY OF OPPORTUNITY SCREENING ANALYSIS FORM DOE SECTION 75 EQUALITY OF OPPORTUNITY SCREENING ANALYSIS FORM Section 1 Introduction This form is intended to help you to consider whether a new policy (either internal or external) or legislation will

More information

Leicester Charity Link Grant application form

Leicester Charity Link Grant application form Leicester Charity Link Grant application form Client reference (for office use only) 20a Millstone Lane, Leicester LE1 5JN t: 0116 222 2200 f: 0116 222 2201 w: www.charity-link.org e: info@charity-link.org

More information

Our plans for urgent care in Worcestershire. Have your say February 2014

Our plans for urgent care in Worcestershire. Have your say February 2014 Our plans for urgent care in Worcestershire Have your say February 2014 1 Introduction In April 2013, GP practices across Worcestershire came together to form clinical commissioning groups (CCGs). We are

More information

MILLRISE MEDICAL PRACTICE NEW PATIENT REGISTRATION/HEALTH QUESTIONNAIRE

MILLRISE MEDICAL PRACTICE NEW PATIENT REGISTRATION/HEALTH QUESTIONNAIRE MILLRISE MEDICAL PRACTICE NEW PATIENT REGISTRATION/HEALTH QUESTIONNAIRE PLEASE COMPLETE THIS FORM IN BLOCK CAPITALS. To register with the Practice please complete this questionnaire as fully as possible.

More information

Finance and Business Development Manager 21 hours per week 22,000 pro rata Actual salary 12,745

Finance and Business Development Manager 21 hours per week 22,000 pro rata Actual salary 12,745 Finance and Business Development Manager 21 hours per week 22,000 pro rata Actual salary 12,745 An exciting opportunity has arisen for finance and Business Development Manager with sound financial skills,

More information