“About you” Monitoring templates and guidance for Kent County Council staff and partners

July 2017- December 2020

About this document

If you are responsible for managing a service, function, major project, work stream or consultation process, this guidance is for you. It explains how to consider if equality data collection is necessary and/or appropriate, how to collect it and what to do with the information when it is collected. If information is already being collected, this guide gives you the opportunity to review the scope and effectiveness of it.

Why do I need to ask ‘About You’ questions?

Kent County Council employs and provides services to people who have a variety of different needs. Equality is not about treating everyone the same, instead we need to make sure that we respond appropriately to different needs. We need to make sure that we understand and have taken account of the needs of people’s protected characteristics. In order to do this, we need to gather information regarding the impact of our services and functions on the different protected groups. We also need to make sure that we are using the information to inform service planning and improvement.

Where possible and appropriate, under the Equality Act 2010 the Council, is required to analyse the impact of services and policies on different groups, specifically in relation to:

Race Sex Gender identity/Transgender Disability Age Sexual Orientation Pregnancy and Maternity Religion and Belief

It is not enough to assume that equality of opportunity is being provided for protected groups, even if complaints are not received. KCC needs to be able to demonstrate that it has fully considered the impact of services, and the way they are being delivered, to different protected groups and, to do this, it needs to collect appropriate data and have monitoring arrangements in place.

Monitoring employment, service usage and satisfaction by protected groups is important to help KCC to show that the services it delivers are meeting the needs of all service users and potential service users and that its employment practices are fair.Equality monitoring is key to the effective performance management of the organisation and contributes to improvements in services and the way they are delivered.

How do I collect this information?

Monitoring can be undertaken in different ways and at different points. This may include:

Written surveys- An anonymous survey, sent to someone to understand their satisfaction after receiving a service is one of the most effective ways of capturing monitoring information. It can often have the highest rate of completion and return, as it gives people the opportunity to express their views on the service received.

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Face to face -Confidentiality is often an issue when asking equality monitoring questions in public offices. Customers should never be asked monitoring questions if they are in an environment where their responses will be overheard by other people or staff. It may be more suitable to ask someone to fill in a form themselves and place the completed form in a sealed envelope or response box and if the survey can be anonymous this increases completion rates.

Over the phone - If this information is being stored against personal details it is important that staff can explain why the information is being requested, how it will be stored and what it will be used for. You must also have the express consent of the person. Any data should be collected in a way that causes the least amount of inconvenience or delay and in a way that respects a person’s right to keep personal information private. Ideally it would be incorporated within other service related information being collected at the time, or when you are engaging with customers.

Questions could be added to the back of any forms or questionnaires already being completed, or included in any questions already being asked face to face, over the phone, or via the internet. In most cases the completion of equality questions should be very easy and take the customer no longer than a few moments to answer.

However, common sense needs to be applied here, as there will be some circumstances where this is not practical or sensible. For example, if you are only producing a small half page feedback card with only two or three quick questions relating to a service, it would not be sensible to then include a page of equality questions.

How does this information help?

By understanding more about the make-up of the communities in the county:

We can decide how best to provide accessible information and appropriate services to everyone, and see where there may be gaps. Assist in service planning – monitoring is vital for planning, targeting and measuring development in service provision. It can show inefficiencies in the way we organise services and indicate new opportunities to meet people’s needs. Is a way of identifying if any policies or services are adversely affecting people and is an important requirement of the Council’s Equality Impact Assessment process –(details can be found on the County Council website). It helps us make sure that we are seeking the views of everyone in society. Meets the criteria for accessing financial and other resources from external sources, many funding organisations now require assurance from bidders that they meet equalities and diversity requirements. We also have a statutory duty to show that we are eliminating unlawful discrimination and promoting equality of opportunity. As an organisation, we need to consider the impact that race, gender, transgender, disability, age, sexual orientation and religion or belief may have on the life chances of members of our communities.

The business itself needs to check that monitoring is relevant to what is being done, and that information collected will be used:

to provide the right services as part of the analysis of the impact/ satisfaction of services as part of the performance management framework

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The template can be amended to include only the questions you need to ask. The data that you collect should be relevant to what you are doing and done in a proportionate way..What questions do I need to ask?

There are 10 ‘About You’ questions, which are based on the protected characteristics of the participants. They are standard questions that have been agreed by a number of different partners and authorities, which include the national census 2011.

When asking the question about age, you have the option to ask for an absolute age, or to give a range of ages from which the respondent can choose. Both options have their advantages and disadvantages. The one you choose will depend on your target audience and the aim of your project. If you want to ask an absolute question about age, delete the age-range question, cut and paste the question and change the wording to read: “How old are you?”

Gender Identity/ Transgender monitoring

Many transgender people are extremely protective about the privacy of their gender identity and gender reassignment history, however it is important that we understand the presence and experiences of the transgender community in all we do.

Under the Data Protection Act 1998, data relating to an individual’s gender reassignment (which includes a change of gender status and name) is classed as ‘sensitive information’, and therefore attracts a higher degree of protection than usual, especially when a Gender Recognition Certificate is held.

It is important that if you do monitor and collect this information, monitoring data about transgender people must not be linked to named service users. Instead it should be anonymous and only the aggregated data results, not the raw data, should be shared across your organisation. Confidentiality must be in place and be seen to be in place.

Respondents under the age of 16 are not asked about their gender identity or sexual orientation. However, if the activity you are undertaking requires you to find out this information, please read the following guidance: Kent’s Trans Inclusion Guidance to Schools and Settings. http://www.kelsi.org.uk/support-for-children-and-young-people/inclusion-support-service-kent/supporting-gender-variant-children-and-trans*-young-people-in-schools-and-settings Supporting transgender users of our services.http://knet/directorate/SCHW-documents/Documents/Supporting%20Transgender%20Users%20of%20Our%20Service.pdf

Or seek advice from diversityinfo@kent.gov.uk. Do respondents have to answer the questions?

Respondents do not have to answer any of the questions that you are asking. They can choose either the “I prefer not to say” option, or leave it blank.

How do I use these templates?

There are five versions of the About You templates at the end of this document: 4

Respondents over the age of 16 – covers one side of A4 Respondents over the age of 16 – covers two sides of A4 Children and young people under the age of 16 - covers one side of A4 Children and young people under the age of 16 - covers two sides of A4 with graphics Easy-read version for people with learning difficulties.

Once you have decided which template you need to use, make a copy of the file, and add your own questions before the ‘About You’ questions.

Don’t forget to remove the questions that you are not going to ask and update the question numbers in the template, then delete the instruction pages and the About You templates you won’t be using. Please think about your audience and adjust the font size to suit.

You may find when copying from one document to another that word will put black borders around the tables. These borders should not be there. You can take them out by highlighting the tables and selecting format, borders and shading, then remove the borders. You may also find that the page margins need adjusting to fit the tables to the page. Adjust the margins by selecting the margins tab under page setup, and set them to top 1.6, bottom 1.6, left 2.0 and right 1.3.

Procurement (Monitoring voluntary and community groups, businesses and other organisations)

Equality monitoring in relation to procurement enables you to ensure that contracts are delivered in a way which promotes equality of opportunity. As the number of contracts with private and voluntary organisations for goods, works and services increases equality and diversity must be considered as an integral part of each contract.

At the tender and project initiation stages you should be clear about equality considerations and ensure that these are included. They can be formally considered within the contract management process. You need to develop and agree monitoring information at the start of any relationship with the organisation, whether that is a funding agreement or a contract.

You will need to decide what you actually want to monitor. For example, how useful will information solely about the organisation be? Would more detailed information about the beneficiaries of the service be more useful? It is important to recognise that, dependant on how representative the organisation is, this may impact on its ability to deliver services. In respect of this you should understand the make up of their workforce and ensure they have equality policies in place and are aware of our policies.

Where can I find out more?

Visit the equality and diversity areas of our website and intranet::

http://www.kent.gov.uk/your_council/priorities,_policies_and_plans/policies/equality_and_diversity.aspx

http://knet2/policies-and-procedures/equality-and-diversity Other useful websites include:

http://www.stonewall.org.uk/media/current_releases/3491.asp

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Contact the Equality and Diversity Teamdiversityinfo@kent.gov.uk

How do I analyse ‘About You’ information?

The point of equality monitoring is to take action where the information shows it is necessary. It is important that the data collected is analysed and ensure that any issues are addressed. The outcome of any monitoring exercise needs to be compared to any actual targets set and baseline data. It will also need to form part of the service/business planning process.

When analysing the information, you are looking for signs of positive or negative differences between different groups. For example, if you are looking at take-up rates, look to see how the rates compare for different groups. Look for any trends or differences linked with other factors i.e. greater take up at different times of year for particular groups, low representation of people who live in a particular area etc.

You should also look for links between different categories, for example more younger Asian people using a service or older disabled people showing lower satisfaction rates etc. By doing this you will get an indication of how your service is being received by different groups and if there are any possible issues that need further investigation.

As a minimum, you need to compare your results to the demographic profile of Kent, to determine how representative your sample is. KCC’s Research and Evaluation Team hold a number of data sets that you could use to add another dimension to your analysis.

Most of the data that you need is available on the KCC website via the following link:www.kent.gov.uk/research .

We suggest that you look at the Area profiles which provide a range of statistics, including 2011 Census, Mid-year population estimates and benefits data for Kent and the individual local authority districts and comparisons to the South East and England.

Age and gender of total population are updated annually from the mid-year population estimates. They are always one year behind and are released at the end of June each year. For example, the 2015 figures will be available in June 2016.

The latest ethnicity and religion figures are from the 2011 Census and will not be updated until the next national census in 2021.

There is no single measure of disability. The definitions of disability vary, and often rely on an individual's perception of their own health. A condition that one person considers to be disabling is not necessarily considered in the same way by another person with the same condition. The Disability in Kent bulletin presents three different sources of data which can be used to measure a number of people with a disability or disabling health condition.

Currently, there is no data set on gender re-assignment or pregnancy and maternity at a local level. For this reason information on these two characteristics is not presented. There is limited information available on sexual orientation and civil partnerships within Kent.

If you have any questions please e-mail research@kent.gov.uk for assistance.

Differences need to be considered in any conclusions that you draw. You may also need to undertake further research to find out the views of those who have not taken part in your consultation or engagement exercise.

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You should also carry out some cross-tabulation analysis, where you compare the results of one question with another. For example, do men and women have the same views about a particular issue, or do older people think differently from younger people? By carrying out this type of analysis, you can find out more about how the Kent community feels about different issues, identify any gaps and make sure that the right people are getting access to the right services.

Proportion

Remember that some groups are small and this may affect or distort the results of any analysis. That does not mean that the findings from minority groups should be ignored, but it may mean that further thought must be given to the next steps if there appears to be a difference between the views of a minority group and others.

In presenting data, it is best practice to:

Concentrate on key indicators and highlight key findings. Present a mix of statistics, tables, and graphics Provide relevant explanations and include clear recommendations for action Produce equality reports on a regular basis together with other management

information (If an individual can be traced to the monitoring figures care must be taken to anonymise the data)

Consider the audience and ensure that the information presented is accessible and fit for purpose.

Establishing the reasons for differences

If you notice any differences, trends or gaps, you will need to identify if there are any known or obvious reasons for this. It is important not to jump to conclusions at this stage, if you are not certain of the cause, further investigation will be needed. This is necessary to find out the true cause of the differences, as it may be linked to an equality issue that you are not aware of. Your first point of investigation could be to look at any other relevant information that may give you more insight about the issues for example, complaints, monitoring information from other related services, staff views etc.

Gender Recognition Act 2004, Data Protection and Information Governance

Gender Recognition Act 2004

Under Section 22 of the Gender recognition Act 2004, data relating to an individual’s gender reassignment (which includes a change of gender status and name) is classed as ‘sensitive information’, and therefore attracts a higher degree of protection than usual, especially where a Gender Recognition Certificate is held. This is designed to protect a persons’ right to privacy and makes it a criminal offence to disclose information relating to a persons’ gender history where this information has been gained in an official capacity.

Data Protection Act 1998

The following section provides some general guidance on the data protection implications for equality monitoring. Equality monitoring can involve asking for and recording sensitive personal data about individuals.

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The data protection legislation exists to protect individuals against the misuse of that data, and all records - whether manual or computerised – will need to meet the requirements of the Data Protection Act 1998. If it is intended to store personal information about an individual with monitoring information, the requirements of the DPA must be met. If an individual can be traced to the monitoring figures, care must be taken to anonymise the data, it will be necessary to obtain the individuals’ explicit consent to hold and process the data.

The DPA will also apply to other personal data collected on the form and all staff should read and consider Kent County Council’s guidance on the Data Protection Act 1998 obligations and follow Kent County Councils Data Protection Act 1998 policy. The following information is specifically about equality monitoring and other requirements may apply to other data on the form. It may be possible to combine the DPA requirements and guidance on this should be sought from the Information Resilience and Transparency Team. It is a requirement that the data cannot be used for any other purpose than what it was collected for, and for which original consent was granted.

The requirements of the DPA should not be a barrier to the collection of equality monitoring data, but will require sensitivity and clarity. Therefore, in order to comply with the DPA, it is advised that monitoring forms contain the following:

A statement before any monitoring questions that completion of some or all monitoring data is voluntary and is not a condition of receiving the service, benefit, job etc;

An explanation of why your organisation is carrying out equality monitoring, i.e. what is its purpose, and how the information will be used; A statement that the information collected will be treated with the strictest confidence and access/use of it will be restricted to the purposes it was collected for;

Who the information will be shared with; Give an indication of how long you are going to store the information for and how it will

be held e.g. electronically.

Where an individual can be identified:

A statement signed by the service user, customer, employee, etc., giving written consent to the collecting, storing, and use of the data collected

When collecting information relating to equality, this statistical data should be separated from any personal information immediately on receipt. It should be held separately, and in a way that would mean that it could not be attributed to any individuals. This should be clearly explained when the information is being asked for, either in writing or verbally. Where a service is required to keep equality related information with personal details, normal data protection obligations apply. If you have any data protection queries, please contact the Information Resilience and Transparency Team (information.governance@kent.gov.uk).

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‘About you’ templates for:

respondents over the age of 16 – one side of A4 respondents over the age of 16 – two sides of A4

Select the template you want to use, then copy and paste it into your existing document, or use it as the starting point for your own survey.

Don’t forget to change the question numbers in the template. They should follow on from the last question number in your survey.

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USE FOR RESPONDENTS OVER 16 YEARS OF AGE (delete these words before using this template)

About You… We want to make sure that everyone is treated fairly and equally, and that no one gets left out. That's why we are asking you these questions. We won't share the information you give us with anyone else. We’ll use it only to help us make decisions, and improve our services.

If you would rather not answer any of these questions, you don't have to.

Qx. Are you...? Male Female I prefer not to say

Qx Is your Gender the same as your birth? Yes No I prefer not to say

Qx. How old are you? Qx. What is your postcode?

Qx. To which of these ethnic groups do you feel you belong? (Source: 2011 census)

White Mixed Asian or Asian British Black or Black British English White & Black Caribbean Indian Caribbean Scottish White & Black African Pakistani African Welsh White & Asian Bangladeshi Other* Northern Irish Other* Other* Irish Arab Chinese I prefer not to say Gypsy/Roma Irish Traveller Other*

*Other Ethnic Group - if your ethnic group is not specified in the list, please describe it here:

The Equality Act 2010 describes a person as disabled if they have a longstanding physical or mental condition that has lasted, or is likely to last, at least 12 months; and this condition has a substantial adverse effect on their ability to carry out normal day-to-day activities. People with some conditions (cancer, multiple sclerosis and HIV/AIDS, for example), are considered to be disabled from the point that they are diagnosed.

Qx. Do you consider yourself to be disabled as set out in the Equality Act 2010? Yes No I prefer not to say

Qx. If you answered Yes to Qxx, please tell us which type of impairment applies to you. You may have more than one type of impairment, so please select all the impairments that apply to you. If none of these apply to you, please select Other, and write in the type of impairment you have. Physical impairment Mental health condition Sensory impairment (hearing, sight or both) Learning disability Long standing illness or health condition, such as cancer, HIV/AIDS, heart disease, diabetes or

epilepsy Other, please specify: I prefer not to say

Qx. Do you regard yourself as belonging to any particular religion or belief? Yes No I prefer not to say

Qx. If you answered Yes to Qxx, which of the following applies to you? Christian Hindu Muslim Any other religion, please specify: Buddhist Jewish Sikh

Qx. Are you…? Heterosexual/Straight Gay woman/Lesbian Other

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Bi/Bisexual Gay man I prefer not to say

Thank you for providing this information, your feedback is important to us.

USE FOR RESPONDENTS OVER 16 YEARS OF AGE (delete these words before using this template)About You...

We want to make sure that everyone is treated fairly and equally, and that no one gets left out. That's why we’re asking you these questions.

We won't share the information you give us with anyone else. We’ll use it only to help us make decisions, and improve our services.

If you would rather not answer any of these questions, you don't have to.

Q Are you......? Please select one box.

Male Female I prefer not to say

Q We use the terms "transgender" and "trans" as inclusive umbrella terms for a diverse range of people who find their gender identity differs in some way from the sex they were originally assumed to be at birth.

Have you ever identified or do you identify as a transgender or trans person …Please select one box.

Yes No Other I prefer not to say

Q Which of these age groups applies to you? Please select one box. 0 - 15 25-34 50-59 65-74 85 + over 16-24 35-49 60-64 75-84 I prefer not to say

Q What is your postcode?

Q To which of these ethnic groups do you feel you belong? (Source: 2011 census) Please select one box. White English Asian or Asian British Indian

White Scottish Asian or Asian British Pakistani

White Welsh Asian or Asian British Bangladeshi

White Northern Irish Asian or Asian British other*

White Irish Black or Black British Caribbean

White Gypsy/Roma Black or Black British African

White Irish Traveller Black or Black British other*

White other* Arab

Mixed White and Black Caribbean Chinese

Mixed White and Black African I prefer not to say

Mixed White and Asian

Mixed Other* Other ethnic group*

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*If your ethnic group is not specified in the list, please describe it here:

The Equality Act 2010 describes a person as disabled if they have a longstanding physical or mental condition that has lasted, or is likely to last, at least 12 months; and this condition has a substantial adverse effect on their ability to carry out normal day-to-day activities. People with some conditions (cancer, multiple sclerosis and HIV/AIDS, for example) are considered to be disabled from the point that they are diagnosed.

Q Do you consider yourself to be disabled as set out in the Equality Act 2010? Please select one box. Yes No I prefer not to say

Q If you answered Yes to Qxx, please tell us the type of impairment that applies to you. You may have more than one type of impairment, so please select all that apply. If none of these applies to you, please select Other, and give brief details of the impairment you have.

Physical impairment. Sensory impairment (hearing, sight or both). Longstanding illness or health condition, such as cancer, HIV/AIDS, heart disease,

diabetes or epilepsy. Mental health condition. Learning disability. I prefer not to say. Other*

*If Other, please specify:

Q Do you regard yourself as belonging to any particular religion or belief? Please select one box. Yes No I prefer not to say

Q If you answered Yes to Qxx, which one applies to you? Please select one box. Christian Hindu Muslim Any other religion, please specify: Buddhist Jewish Sikh

Q Are you...? Please select one box. Heterosexual/Straight Gay woman/Lesbian Other Bi/Bisexual Gay man I prefer not to say

Thank you for providing this information.

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‘About you’ templates for:

respondents under the age of 16 – one side of A4

respondents under the age of 16 – two sides of A4, (this version includes some graphics)

Select the template you want to use, then copy and paste it into your existing document, or use it as the starting point for your own survey.

Don’t forget to change the question numbers in the template. They should follow on from the last question number in your survey.

Make sure that you have read the guidance and sought advice if you need to include questions on gender identity/ transgender and/or sexual orientation

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USE FOR RESPONDENTS UNDER 16 YEARS OF AGE (delete these words before using this template)

About You…We want to make sure that everyone is treated fairly and equally, and that no one gets left out. That's why we are asking you these questions. We won't share the information you give us with anyone else. We‘ll use it only to help us make decisions, and improve our services.

If you would rather not answer any of these questions, you don't have to.

Qx. Are you...? Male Female I prefer not to say

Qx We use the terms "transgender" and "trans" as inclusive umbrella terms for a diverse range of people who find their gender identity differs in some way from the sex they were originally assumed to be at birth.

Have you ever identified or do you identify as a transgender or trans person …Please select one box.

Yes No Other I prefer not to say

Qx. How old are you?

Qx. What is your postcode?

Qx. To which of these ethnic backgrounds do you feel you belong? (Your ethnic background is about lots of things, such as where your family comes from and the language you speak)

White Mixed Asian or Asian British Black or Black British

English White & Black Caribbean Indian Caribbean Scottish White & Black African Pakistani African Welsh White & Asian Bangladeshi Other* Northern Irish Other* Other* I prefer not to say Irish Arab Chinese Gypsy/Roma Irish Traveller Other*

*Other ethnic group – if your ethnic group is not specified in the list, please describe it here:

Qx. Would you say that you have a disability? (A disability is if you have a problem or an illness to do with your mind or body, and it makes it hard for you to do everyday things) Yes No I prefer not to say

Qx. If you answered Yes to Qxx, please tell us what problems you face. You may have more than one type, so please select all the problems that apply to you. If none of these apply to you, please select Other, and give brief details. A disability to do with your body (such as problems walking, moving and getting around). Problems with hearing or seeing, or both. Having a bad illness for a long time (such as cancer, epilepsy, HIV/AIDS or another serious sickness).

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Mental health problems (this is a problem to do with your mind and the way you feel; for example, if you feel upset, worried or angry a lot).

Learning difficulties. I prefer not to say. Something else, please specify:

Qx. Do you regard yourself as belonging to any particular religion or belief? Yes No I prefer not to say

Qx. If you answered Yes to Qxx, which one listed below applies to you? Christian Hindu Muslim Any other religion, please specify: Buddhist Jewish Sikh

Qx. Are you…? Heterosexual/Straight Gay woman/Lesbian Other Bi/Bisexual Gay man I prefer not to say

Thank you for providing this information

USE FOR RESPONDENTS UNDER 16 YEARS OF AGE (delete these words before using this template)

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About You…We want to make sure that everyone is treated fairly and equally, and that no-one gets left out. That's why we are asking you these questions. We won't share the information you give us with anyone else. We’ll use it only to help us make decisions, and improve our services.

If you would rather not answer any of these questions, you don't have to.

Qx. Are you…?

Male Female

I prefer not to say

Qx We use the terms "transgender" and "trans" as inclusive umbrella terms for a diverse range of people who find their gender identity differs in some way from the sex they were originally assumed to be at birth.

Have you ever identified or do you identify as a transgender or trans person …Please select one box.

Yes No Other I prefer not to say

Qx. How old are you?

Qx. What is your postcode?

Qx. To which of these ethnic backgrounds do you feel you belong? (Your ethnic background is about lots of things, such as where your family comes from and the language you speak)

White English Asian or Asian British Indian White Scottish Asian or Asian British Pakistani White Welsh Asian or Asian British Bangladeshi White Northern Irish Asian or Asian British other White Irish Black or Black British Caribbean White Gypsy/Roma Black or Black British African White Irish Traveller Black or Black British other White other Arab Mixed White and Black Caribbean Chinese Mixed White and Black African Other

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Mixed White and Asian Mixed other I would prefer not to say

Other ethnic group - if your ethnic group is not specified in the list, please describe it here:

Qx. Would you say that you have a disability?(A disability is if you have a problem or an illness to do with your mind or your body, and it makes it hard for you to do everyday things).

Yes No I would prefer not to say

Qx. If you answered Yes to Qxx, please tell us what problems you face. You may have more than one type, so please select all the problems that apply to you. If none of these apply to you, please select Other, and give brief details.

A disability to do with your body (such as problems walking, moving and getting around).

Problems with hearing or seeing, or both. Having a bad illness for a long time (such as cancer, epilepsy,

HIV or another serious illness). Mental health problems (this is a problem to do with your mind

and the way you feel; for example, if you feel upset, worried or angry a lot).

Learning difficulties. I prefer not to say.If you have a disability or a condition we have not listed, please tell us what it is here:

Qx. Do you regard yourself as belonging to any particular religion or belief?

Yes No I prefer not to say

Qx. If you have answered Yes to Qxx, which religion or belief is it?

Christian Buddhist Hindu Jewish Muslim SikhIf you belong to a religion not listed, please write it here:

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Qx. Are you…?

Heterosexual/Straight Gay young woman/Lesbian Other

Bi/Bisexual Gay young man I prefer not to say

Thank you for giving us this information

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Easy-read version for people with learning difficulties

Four sides of A4

Copy and paste the following pages into your existing document, or use it as the starting point for your own survey.

Don’t forget to change the question numbers in the template. They should follow on from the last question number in your survey.

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These questions are about you

We want to make sure that everyone is treated fairly and equally, and that no-one gets left out. That’s why we are asking you these questions.

We won’t share the information you give us with anyone else. We’ll use it only to help us make decisions, and improve our services.

If you would rather not answer any of these questions, you don’t have to.

Are you…?

Male Female

I prefer not to say

Is your gender the same as it was at your birth…?

Yes No

I prefer not to say

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How old are you?

I prefer not to say

What is your postcode?

Do you have a disability? (A disability is if you have a problem or an illness to do with your mind or body, and it makes it hard for you to do everyday things)

Yes No

I prefer not to say

If you have answered Yes to the question above, please tell us the disability or the impairment you have. You can tick more than one box.

Learning disability Mental health condition

Physical impairment

Sensory impairment (hearing, sight or both) Longstanding illness or health condition

(such as cancer, HIV/AIDS, heart disease, diabetes or epilepsy)

I prefer not to say

If you have a disability or a condition we have not listed, please tell us what it is here:

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To which of these ethnic groups do you belong? (Your ethnic group is about lots of things, such as where your family comes from and the language you speak)

White English White Scottish White Welsh White Northern Irish White Irish White Gypsy/Roma White Irish Traveller

White other

Mixed White and Black Caribbean Mixed White and Black African Mixed White and Asian Mixed other Asian or Asian British Indian Asian or Asian British Pakistani Asian or Asian British Bangladeshi Asian or Asian British other Black or Black British Caribbean Black or Black British African Black or Black British other Arab Chinese

I prefer not to say

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If your ethnic group is not listed, or you choose something that has an next to it, please tell us what it is here:

Do you belong to a religion or belief?

Yes No

I prefer not to say

If you have answered Yes to the question above, which religion or belief is it?

Christian Buddhist

Hindu

Jewish

Muslim

Sikh

If you belong to a religion that is not listed, please write it here:

Are you…?

Heterosexual /Straight Bi/Bisexual

Gay woman/Lesbian

Gay man

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Other I prefer not to say

Thank you for giving us this information.

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