HQIP / HQIP Declaration of Interests form

HQIP Declaration of Interests form

All interests that might unduly influence an individual’s judgement and objectivity in the conduct of or award of HQIP business should be declared. If in doubt, please declare all interests.

Particular consideration should be given to interests involving payment or financial inducement or any reputational interest that might affect the business under consideration or award of any contract linked to HQIP business.

The ‘Process for declaring interests and dealing with conflicts of interest’ document should be read in conjunction with this form (please also see below for a summary table of HQIP definitions of declaration of interest). This form provides details regarding the type of interest that should be declared.

The time period for relevant interests is 12 months before involvement in HQIP business.

HQIP definitions of declaration of interest

This section should be read in conjunction with the HQIP ‘Process for declaring interests and dealing with conflicts of interest’.

Personal financial interest: Anything of monetary value, including payments for services, business interests, equity interests, including stocks, stock options or other ownership interests and intellectual property rights, including patents and copyrights and royalties arising from such interests.
Non personal financial interest: Where there is or appears to be opportunity for personal financial gain or financial gain to a direct family member.
Personal non financial interest: Where there is opinion on the matter, work programme or service under consideration.

Please complete and submit this form.

I declare that I have read and understood the HQIP ‘Process for declaring interests and dealing with conflicts of interest’ and that I wish the following interests to be recorded in accordance with the relevant provisions of the process document. I am aware that failure to declare relevant interests may result in being asked to step down from the role/activity being undertaken.

Full name (required)

Email (required)

Today's date (required)

My declaration relates to (required)

If you selected 1. National Clinical Audit and Patient Outcomes Programme, please specify (required)

Declarations (Please state 'None' if there is nothing to declare)

Data Protection Act

For the purposes of the Data Protection Act 2018 and GDPR, your personal data will be processed (including the collection, retention, use and disclosure) (both electronically and manually) by HQIP (or a third party appointed by the Company for such purposes) for purposes relating to your employment and the management, security and administration of the activities of the organisation.

Our privacy policy is regularly updated on the HQIP website and provides further detail on the bases and purposes for processing your information. It also states how you can exercise your individual rights.