Consent form
Thank you for agreeing to take part in the Children & Young People's Expert Reference Group. This is to help us discuss, check and challenge pieces of work from the NHSE Quality Transformation Programme, Mental Health, Learning Disability & Autism (MHLDA). It will also ensure the voices and experiences of children and young people are considered when making changes to current NHS England inpatient provisions.
Meetings
In the meetings we will be taking notes about what you say to us, noting down quotes in your words as well as noting down themes from conversations. We plan to use these notes to present this information back to different parts of the NHSE Quality Transformation Programme (MHLDA). These notes will be shared with the NHSE Lived Experience Advisory Group and staff within the NHSE Quality Transformation Team. If reports are requested from this group we would not disclose your name or other identifying factors. If there was occasion when we may potentially want to use your name we would seek further consent from you and this would be entirely optional. We might also want to share some of your quotes on social media but would not do any of this in a way that could identify you.
Anonymity
We will keep your personal information anonymous. This means that we will not share you name, date of birth, or contact details with anyone outside of Common Room. We may share details such as age and general location, e.g. West Yorkshire. We may use initials of first names in meeting notes to differentiate between individuals comments if necessary, but not details that would make individuals identifiable. We will also share demographic details such as ethnicity, gender etc but these details will be taken from the separate anonymous Diversity monitoring form so would not be linked to your name at all.
Safeguarding
Common Room takes safeguarding its participants seriously and has a safeguarding policy which all staff work to. As part of this policy, we work to the following confidentiality statement.
Common Room Confidentiality Statement
- Common Room offers confidentiality to children, young people and adults we engage with through our work, including staff members. This means we will not normally share information about you to anyone outside the organisation without your agreement. We will keep information about you secure only until it is no longer needed and share this on a need-to-know basis.
- There may however be times when we need to share information about you with external partners or organisations when we are concerned that you or someone else are in danger or at risk of significant harm. Wherever possible we will try to discuss this with you and gain your consent before giving out any information. However, if we are unable to do this and feel that telling you would increase the risk, we may choose to do so without your consent.
- If you are unsure or would like to know more about the above, please ask one of the workers or email
liz.neill@commonroom.uk.com
Storage of personal data
Meeting notes will be securely stored by Common Room for a period of up to 5 years when they will be deleted (unless required for safeguarding investigations). You have a right to remove your consent at any time in this period. If you do remove your consent however, it may not be possible to delete those that have already been shared or published.
Final versions of materials developed from this activity will be kept on file to be used internally for reference only in the development of new resources.
What next?
If you have any questions about any of the above please contact liz.neill@commonroom.uk.com.
We need your consent to say that you agree to take part in this activity as outlined above.
Please fill in your details below and tick the boxes below to say you give your consent to take part.
If you are under 16 years old please ensure your parent/guardian completes this [hyperlink to parent form] form also.