Apply now for Patient Lead Patient Lead Application Name(Required) First Last Email(Required) Please confirm you are aged 18 years or over.(Required) Yes Please confirm which Hounslow GP surgery you are registered with (as this role is specifically open to patients registered with a GP surgery in Hounslow)(Required) 4. Are you happy to be a named point of contact for patients in your PCN who may have queries about the agreed priorities. Do you have any questions or concerns about this?(Required)5. Are you happy to connect with and manage a two-way communication with Healthwatch, Patient Participation Groups in your PCN and community groups so a diverse range of voices are informing your input, including those considered ‘hard to reach’. Do you have any questions or concerns about this?(Required)6. Why are you interested in this role (3000 characters max)?(Required)7. Why do you think you would be good at this role (no more than 3000 characters)?(Required)8. Do you have any conflicts of interest related to the NHS or Social Care? If so, please explain briefly what these are.(Required)For example, do you work for the NHS, are a decision maker in a service provider funded by the NHS, or have a commercial interest in the NHS, e.g. you work on the board of a company that sells products or services to the NHS? 9. Is there anything you are worried about in this role, that you would like additional information, training or support with?10. Do you require any reasonable adjustments to do this role, and if so what are they?11. Is there anything else you’d like to tell us that is pertinent to this role and your application?
