Continuing as a member of the CQC Public Engagement Network

To continue participating in the Network, please provide key details about your organisation and how it meets the eligibility criteria.

Who is eligible to become a member?

In short, membership of the Public Engagement Network is open to not-for-profit organisations that represent the perspectives of people who experience health inequalities. Both small and large organisations are welcome as members, whether you’re working nationally or locally. You can read the eligibility criteria here.

Can I have a conversation with a member of the team before continuing?

If you would like to have a conversation with a member of the team before filling out this form, please contact Mu’minah Iqbal via email or call 07442517280  and they will help you. If you would like accessibility support to fill out the sign up form, please don’t hesitate to reach out at the same email address and phone number.

Provide details of Public Engagement Network eligibility

Company

This field is for validation purposes and should be left unchanged.

Your contact details

Name(Required)

First Last

Job Title(Required)

Email(Required)

Organisation Details

Organisation name(Required)

Website URL(Required)

Charity Number

If applicable

Address(Required)

Address Line 1 Address Line 2 Address Line 3 (City) Postcode

Which communities experiencing inequalities does your organisation want to amplify the voices of through membership of the Public Engagement Network?(Required)

Please select all that apply and choose the closest matches.

Children and young people

Older people

Looked after and accommodated children and young people

Transgender and non-binary people

People who are married or in a civil partnership

People who are pregnant or recently gave birth

People with learning disabilities and learning difficulties

Autistic people

Deaf people

People with visual impairments

People with mobility related disabilities

People experiencing serious mental illness

People from racial and ethnic minority groups.

Bangladeshi people

Chinese people

Indian people

Pakistani people

Black African people

Black Caribbean people

Mixed race people

Gypsy or Irish Traveller people

Roma people

Arab people

People seeking asylum and refuge

People who don’t speak English as a first language

People who don’t speak English fluently

Christian people

Muslim people

Jewish people

Hindu people

Sikh people

Buddhist people

Women

Men

Lesbian, gay and bisexual people

Carers

People experiencing homelessness and insecure housing

People living nomadically

People in contact with the criminal justice system

Sex workers

Victims of modern slavery

Survivors of domestic violence

Survivors of sexual violence

People experiencing socio-economic inequality

People experiencing digital exclusion

People with low or no literacy

People experiencing drug and alcohol dependency

People living in coastal areas

People living in rural areas

People living in areas of socioeconomic inequality

Other

Approximately how many children and young people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many looked after and accommodated children and young people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many older people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many transgender and non-binary people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people who are married or in a civil partnership did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people who are pregnant or recently gave birth did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people with learning disabilities or learning difficulties did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people who are pregnant or recently gave birth did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many autistic people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people with visual impairments did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Deaf people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people experiencing serious mental illness did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people with mobility related disabilities did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people from racial and ethnic minority groups did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Chinese people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Bangladeshi people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Indian people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Pakistani people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Black Caribbean people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many mixed race people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Black African people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Gypsy or Irish Traveller people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Roma people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Arab people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people seeking asylum or refuge did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people who don't speak English fluently did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people who don't speak English as a first language did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Christian people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Muslim people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Jewish people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Hindu people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Sikh people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many Buddhist people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many women did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many men did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many lesbian, gay and bisexual people did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many unpaid carers did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people experiencing homelessness and insecure housing did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people living nomadically did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many sex workers did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many victims of modern slavery did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people in contact with the criminal justice system did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many survivors of domestic violence did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many survivors of sexual violence did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people experiencing socio-economic inequality did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people experiencing digital exclusion did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people with no or low literacy did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people experiencing drug or alcohol dependency did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people living in coastal areas did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people living in rural areas did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

Approximately how many people living in areas of socioeconomic inequality did your organisation directly engage with, support, or hear from in the past 12 months? Please provide your best estimate.

If you selected 'other', please tell us about which communities experiencing inequalities your organisation wants to amplify the voices of through membership of the Public Engagement Network.

Please confirm that you meet the eligibility criteria by ticking the boxes below.(Required)

You are a not-for-profit organisation

Your aims, objectives and methods of working are written down in a publicly available document or webpage

Your work has a focus on health and social care

Your organisation works in England

Your organisation is committed to meaningful participation, advancing equality and treating others with dignity and respect

Your organisation does not have an affiliation with any political parties

Your organisation does not primarily deliver CQC-regulated services

Consent and data use(Required)

I agree for my data to be used by the Care Quality Commission and the Voices for Health Equity Partnership (led by National Voices and supported by Innovation Unit and Collaborate CIC) for the purposes of administering and developing the Public Engagement Network. If you have any questions, please contact info@nationalvoices.org.uk. If you would like any further information, please refer to National Voices’ Privacy Policy, available at www.nationalvoices.org.uk/privacy-policy.

I agree