Survey purpose
The [INSERT NAME OF STAFF NETWORK] Staff Network Executive team would like to capture and understand the needs of our members to help develop and design our business plan, including priorities and events, and capture our successes to date, and where we can improve to help us become the best staff network possible for our members.
Your responses are strictly confidential and will help us to keep our membership information up to date, including the diversity of our network. Where any data is shared, it will be anonymised, and used only to understand how to further develop our staff network and our organisation, [INSERT ORGANISATION NAME]. All data will be held in accordance with our Information governance policy and the Data Protection Act.
[This survey is an example only. Please adapt to your organisational requirements and ask your organisation’s information governance team to check any personal details and demographic information being collected before sending to your members.]
Personal details
1. What is your job title?
2. Select your Agenda for Change NHS Band (or equivalent if not Agenda for Change):
- Bands 1–3
- Band 4
- Band 5
- Band 6
- Band 7
- Band 8 (8a – 8d)
- Band 9
- VSM/ESM
- Other (please specify in the next question)
3. If selected ‘other’ in question above, please specify here.
4. Which directorate do you work in? [these are examples only – ensure these are tailored to your organisation’s structure]
- Commercial
- Delivery
- Finance
- Medical
- Nursing
- Operations
- Strategy
- Transformation
- Vaccinations and Screening
- Workforce
- Other (please specify in the next question).
5. If selected ‘other’ in question above, please specify here.
6. How long have you been working for the NHS?
- 0–6 months
- 6–12 months
- 1–2 years
- 3–5 years
- 5–10 years
- 10 years +
7. If you are a member of another NHS staff network, please select which one(s) [these are examples only – ensure these are tailored to your organisation’s staff networks]
- Black, Asian and minority ethnic
- Carers
- Christian
- Disability
- Hindu
- Intergenerational (age)
- Jewish
- LGBT+
- Men’s
- Menopause
- Muslim
- Women’s
- Other (please specify in the next question)
8. If selected ‘other’ in question above, please specify here.
Demographics
9. What age bracket are you in?
- 18–24 years
- 25–34 years
- 35–44 years
- 45–54 years
- 55–64 years
- 65+ years
10. Which of the following best describes you?
- Female
- Male
- Trans
- Prefer not to say
- Prefer to self-describe (please specify in the next question)
11. If selected ‘prefer to self-describe’ in question above, please specify here.
12. Which ethnicity best describes you?
- White – English/ Welsh/ Scottish/ Northern Irish/ British
- White – Irish
- White – Gypsy or Irish Traveller
- White – Any other White background
- Mixed/ Multiple ethnic background – White and Black Caribbean
- Mixed/ Multiple ethnic background – White and Black African
- Mixed/ Multiple ethnic background – White and Asian
- Mixed/ Multiple ethnic background – any other Mixed/ Multiple ethnic background
- Asian/ Asian British – Indian
- Asian/ Asian British – Pakistani
- Asian/ Asian British – Bangladeshi
- Asian/ Asian British – Chinese
- Asian/ Asian British – any other Asian background
- Black/ African/ Caribbean/ Black British – African
- Black/ African/ Caribbean/ Black British – Caribbean
- Black/ African/ Caribbean/ Black British – Any other Black background
- Other ethnic group – Arab
- Other ethnic group – any other ethnic background (please specify in the next question)
13. If selected ‘other ethnic group’ in question above, please specify here.
14. Do you define yourself as disabled?
- Yes
- No
- Prefer not to say
Making the most of our staff network
15. What do you think our staff network has done well during the last 12 months?
16. How could our staff network improve?
17. What do you think our three main strategic priorities/areas of focus should be for the next 12 months?
18. What support offers would you like us to prioritise for our members?
- Leadership development
- Career development/progression
- Flexible working arrangements
- Health and wellbeing
- Inclusive recruitment
- Mentoring
- Networking events
- Diversity training and awareness
- Other specific support (please specify in the next question)
19. If you selected ‘other specific support’ in question above, please specify here.
20. If you are not already proactively involved in managing the network, are you interested and able to do so?
- Yes
- No
- Unsure