Hospital Rooms Project EOI

NHS Expression of Interest Form

To express your interest in working with Hospital Rooms, please submit the form below.
Name of Trust
Address of Trust

Street

Street Address Line 2

CityCounty

Postcode
Name of Applicant

TitleFirst NameLast Name
Role of Applicant
Email address of Applicant
Phone number of Applicant

Area CodePhone Number
Will the Applicant be the Lead Contact for the Hospital Rooms project?
Name of Lead Contact

TitleFirst NameLast Name
Role of Lead Contact
Email address of Lead Contact
Phone number of Lead Contact

Area CodePhone Number
Applicant Lead Contact
Lead Contact Lead Contact

Please tell us about the mental health service you would like Hospital Rooms to work with.

Please tell us about the mental health service you would like Hospital Rooms to work with: what type of service is it and what are the demographics of your service users? What else would you like us to know about your service users? (100 words)0/100
Why would you like to work with Hospital Rooms? What difference would it make to your unit?

(100 words)0/100
Tell us about how you have made staff and service users aware of the application for this project and any feedback you have garnered.

(100 words)0/100
Please describe your spaces and capacity to support Hospital Rooms in delivering the elements of the project.

The elements include, and are not limited to, research and development sessions, artist visits, creative workshops and installation. (100 Words)0/100
Please briefly tell us about any creative activity that is currently available to service users.

(100 words)0/100

Name of Art Lead

TitleFirst NameLast Name
Email address of Art Lead
Phone number of Art Lead

Area CodePhone Number
Name of Communications Lead

TitleFirst NameLast Name
Email address of Communications Lead
Phone number of Communications Lead

Area CodePhone Number
Name of Estates Lead

TitleFirst NameLast Name
Email address of Estates Lead
Phone number of Estates Lead

Area CodePhone Number
Building Plans and Elevations

If relevant to your application, please share a transfer link to any building plans and elevations of the service buildings.
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Name of Safeguarding Lead

TitleFirst NameLast Name
Email address of Safeguarding Lead
Phone number of Safeguarding Lead

Area CodePhone Number
Name of Lived Experience Representative or Peer Support Worker

TitleFirst NameLast Name
Email address of Lived Experience Representative or Peer Support Worker
Phone number of Lived Experience Representative or Peer Support Worker

Area CodePhone Number
Name of Quality Improvement, Service Evaluation, or Research Lead

TitleFirst NameLast Name
Email address of Quality Improvement, Service Evaluation, or Research Lead
Phone number of Quality Improvement, Service Evaluation, or Research Lead

Area CodePhone Number

Please provide detail of how you will support Hospital Rooms in evaluating the project before, during, and after.

(100 words)0/100
Are you aware of how much budget the Trust is able to provide towards the project cost? If not, please describe the internal process that will be undertaken to confirm budget.

(100 words)0/100
Name of Finance Lead

TitleFirst NameLast Name
Email address of Finance Lead
Phone number of Finance Lead

Area CodePhone Number
Please confirm that you will support Hospital Rooms in grant applications and fundraising if necessary.

i.e. providing relevant information on demographics, reach, outcomes (100 words)0/100
Please tell us about how you are implementing the Patient & Carers Race Equality Framework towards and to stay accountable to eradicating racial bias against Black, Asian, and Minority Ethnic communities in mental health services.

(100 words)0/100
Is there anything else you’d like to tell us?

(100 words)0/100
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