28/03/2022, 00:08 Membership renewal 2022

Membership renewal 2022

This form helps us to know where we can provide support to ensure that you are an effective and
future proofed hospital radio station. It should take no more than 20 minutes to complete. Due to
lost contacts and the many changes in the sector we are collecting more information than usual
this year. This is a one off and will pay dividends in time we can save you with better guidance
and information over the coming year. We thank you for your cooperation.

Please answer as honestly as possible. The information you provide will be treated in confidence
and is intended to tailor our support to ensure struggling stations receive the help they need and
stations doing well are supported to excel. If you are unable to provide exact figures then
'guesstimates' are fine.

If you are struggling with this form please contact Mike Sarre 0300 121 0511 or email
membership@hbauk.com as we want to ensure no one experiences barriers to
membership

Once you have filled in this form in your will be invited to make payment.

*Required

1. Email *

Section 1: Name & structure

These questions help us understand your relationship with the governing bodies and whether you are making the
move to include public health broadcasting.

2.
Official Full Name of Organisation (e.g. as recorded on Register of Charities) *

3.
Working name or abbreviations (if different from above)

4.
Form of Organisation: *

Mark only one oval.

Unincorporated association

Part of an NHS Trust

Company limited by guarantee

Charitable Incorporated Organisation

 https://docs.google.com/forms/d/1nyFsxOwEhswrGB2S4PXnnLTv5fBTLwK1F8AFQnTJJQ0/edit 1/12
28/03/2022, 00:08 Membership renewal 2022

5.
What type of charity status do you hold? *

Mark only one oval.

Not a charity/unregistered charity

Registered charity

Subsidiary of another charity

6.
Charitable objects (choose all that apply) *

Tick all that apply.

Broadcasting for the relief of sickness (or similar)

Broadcasting with the goal of public health education (or similar)

Public studio contact details locating their nearest station.

The details you provide here will be published to your entry on the map. We may
HBA currently maintains a searchable database map of hospital radio stations to
also publish this data elsewhere as we see fit.
assist potential volunteers, patients, visitors and other interested parties in

7. Telephone number *

8. Email address *

9. Website *

10. 11. Mailings

Tick all that apply.

Please add my studio address to the newsletter mailing list

Address *

https://docs.google.com/forms/d/1nyFsxOwEhswrGB2S4PXnnLTv5fBTLwK1F8AFQnTJJQ0/edit 2/12
28/03/2022, 00:08 Membership renewal 2022
Correspondence contacts These details will only be used by HBA for the purposes of contacting you about
HBA business such as AGMs. They will be held securely on our password
protected database. Most of our information on conference, awards, service,
grants and competitions is shared via our newsletter - please confirm for each
address whether you would like to receive this. For information on how we store
your data please see
https://www.hbauk.com/privacy-notice
Primary contacts

Due to difficulties in contacting stations during COVID, we are now asking for a minimum of 2 primary contacts to be
registered with us. Please make sure to provide an address that is checked regularly. Please do not enter your studio
address/number or any duplicate addresses/ phone numbers.

12. 13. 14. 15. Mailings

Tick all that apply.

Please add this address to the newsletter mailing list Name of

16. 17. 18. contact 2 *

Name of contact 1 *
Telephone number *

Telephone number *
Email address *

Email address *

https://docs.google.com/forms/d/1nyFsxOwEhswrGB2S4PXnnLTv5fBTLwK1F8AFQnTJJQ0/edit 3/12
28/03/2022, 00:08 Membership renewal 2022

19. Mailings

Tick all that apply.

Please add this address to the newsletter mailing list Treasurer

20. 21. email *

Mailings Tick all that apply.

Please add this address to the newsletter mailing list

Additional contact details

We would highly recommend that you encourage all of your volunteers to register as affiliate members at
https://www.hbauk.com/member-station-affiliate-signup as your fee covers benefits for them too.

Please visit your station record to add more station administrators and check the details of you sports'
correspondent. You can find your station record past the member's login page at
https://www.hbauk.com/update-your-station-details as only station administrators can update your information
we recommend registering as many of your management team as possible.

Please provide information about each hospital and other healthcare

Establishments served establishment served by the station.
Please add additional audiences in the 'Any other comments' box at the end.

22. 23. 24. 25. Trust *

Site name 1 * Number of beds *

Town/City *

https://docs.google.com/forms/d/1nyFsxOwEhswrGB2S4PXnnLTv5fBTLwK1F8AFQnTJJQ0/edit 4/12
28/03/2022, 00:08 Membership renewal 2022

26. 28. 29. 30. 31.

Transmission system (select all that apply) * Tick all that apply.

Hospedia
HTS Hospicom
Premier
Patient Pal
Community FM
LPAM
LPFM
Induction loop
Wired
Via internet to personal device
Other
27.
Link from studio to site 1 * Town/City 2

Tick all that apply.

Own cabling
Hospital's cabling
FM radio link Trust
Internet stream
Intranet stream
Other:

Number of beds site 2

Site name 2

https://docs.google.com/forms/d/1nyFsxOwEhswrGB2S4PXnnLTv5fBTLwK1F8AFQnTJJQ0/edit 5/12
28/03/2022, 00:08 Membership renewal 2022

32.
Transmission system 2 (select all that apply)

Tick all that apply.

Hospedia
HTS Hospicom
Premier
Patient Pal
Community FM
LPAM
LPFM
Induction loop
Wired
Via internet to personal device
Other

33.
Link from studio to site 2

Tick all that apply.

Own cabling
Hospital's cabling
FM radio link
Internet stream
Intranet stream
Other:

This information is to help ascertain what help you might need or where you
Support & representation data
may be able to help other stations thrive. We appreciate many of the responses We will also use this information to promote and raise awareness of hospital
may be estimates. broadcasting.

34.
How many hours of live request shows do you broadcast each week? *

35.
How many requests (on average) do you receive from patients each week? *

36.
How many hours of curated content do you broadcast each week? (Voice
tracked, live, pre-recorded, or shared programming) *

https://docs.google.com/forms/d/1nyFsxOwEhswrGB2S4PXnnLTv5fBTLwK1F8AFQnTJJQ0/edit 6/12
28/03/2022, 00:08 Membership renewal 2022

37.
How many cumulative hours do your volunteers spend with patients each week? If
COVID is preventing this please enter 0. *

38.
On average, how many training sessions did your volunteers each attend this
year? *

39.
How many requests have you received (per week on average) from loved ones
outside the hospital? *

40.
How many times have you broadcast health messages on behalf of the
government/NHS over the last 12 months? *

41.
 Please write up to 3 of your favourite pieces of feedback received from patients this
year:

42.
How would you rate your relationship with your hospital management? *

Mark only one oval.

12345

Terrible, they don't see our value Excellent, we are treated like part of the trust

43.
In the past reporting year how much sponsorship/advertising revenue have you
received? *

https://docs.google.com/forms/d/1nyFsxOwEhswrGB2S4PXnnLTv5fBTLwK1F8AFQnTJJQ0/edit 7/12
28/03/2022, 00:08 Membership renewal 2022

44.
How many messages do you put out each week on behalf of the hospital
comms team? *

45.
Does your website link feature on the hospital Wifi login page/landing page? *

Mark only one oval.

Yes

No

46.
How much do you feel valued by ward staff? *

Mark only one oval.

12345
Very much so, we are welcomed & supported 47.
Not at all, they can be an obstacle
Please provide up to 3 quotes from your trust or ward staff:

48.
Please confirm which of the following policies you have in place (or actively
share on behalf of the Trust if appropriate) *

Tick all that apply.

Health & safety

Volunteering
Privacy/ data protection
Safeguarding
Equal opportunities
None of the above

https://docs.google.com/forms/d/1nyFsxOwEhswrGB2S4PXnnLTv5fBTLwK1F8AFQnTJJQ0/edit 8/12
28/03/2022, 00:08 Membership renewal 2022

49.
To what extent do you feel your hospital radio retains its focus on the best
interests of patients in need *

Mark only one oval.

12345
Patient experience is at the heart of everything we do Our focus frequently drifts

50. We are confident we have the correct... *

Tick all that apply.

... insurance in place

...Ofcom license
...PPL license
...PRS license
None of the above

51.
Do you have an action plan in place to increase diversity and inclusion in your
 station? *

Mark only one oval.

Yes

No

52.
Please enter your income for your most recent reporting year *

53.
Please enter your expenditure for your last reporting year *

https://docs.google.com/forms/d/1nyFsxOwEhswrGB2S4PXnnLTv5fBTLwK1F8AFQnTJJQ0/edit 9/12
28/03/2022, 00:08 Membership renewal 2022

54.
With regard to volunteering, which statement best matches your current
situation? *

Mark only one oval.

We have all the active volunteers we need and have succession planning for those who
might leave soon.

We have all the active volunteers we need but may struggle when key people leave.

We are managing with the number of active volunteers we have but are struggling to
recruit more.

We are struggling for active volunteers and struggling to recruit

We are unable to operate due to a lack of active volunteers

55.
To what extent do you agree with the statement "We currently have enough
volunteers to run the service we want"? *

Mark only one oval.

 12345

We are desperate for volunteers We have plenty of excellent volunteers

56.
Does your station have a representative/s who get involved with hospital radio
beyond your station? (Tick as many) *

Tick all that apply.

We attend conference
We attend online HBA events
We are part of our own local network
We are active members of the HBA Facebook group
We don't get involved (please explain why below)
Other:

57.
Please note any areas in which you've tried out new ideas this year

*Tick all that apply.

Content
Technology
Equity, Diversity & Inclusion
Fundraising
N/A

https://docs.google.com/forms/d/1nyFsxOwEhswrGB2S4PXnnLTv5fBTLwK1F8AFQnTJJQ0/edit 10/12
28/03/2022, 00:08 Membership renewal 2022

58.
What has been your net gain/loss in volunteer numbers in the past reporting
year? (Number followed by gain/loss) *

59.
Do you have a process for soliciting and responding to patient feedback? *

Mark only one oval.

Yes

No

60.
Overall, where do you feel your station is on the scale of 'at risk', 'surviving' and
'thriving'? *
 Mark only one oval.

12345

At risk Thriving

Please add any final thoughts or information in the final box below. Once you
check and submit this information it will take a few weeks to update on our
system. If you have provided all the necessary information then you will receive a
Final confirmation message with details of how to proceed to payment for your
thoughts membership. Please remember the more information you provide, the better
representation and support we can offer in return.

61.
Is there anything else at all you would like to tell us that may help us support
your station or others?

62.
On behalf of the station named above I confirm that we wish to apply for
membership of the Hospital Broadcasting Association and certify that we are, or
aspire to become, a bona-fide hospital broadcaster. *

Mark only one oval.

Yes

https://docs.google.com/forms/d/1nyFsxOwEhswrGB2S4PXnnLTv5fBTLwK1F8AFQnTJJQ0/edit 11/12
28/03/2022, 00:08 Membership renewal 2022

This content is neither created nor endorsed by Google.

Forms
https://docs.google.com/forms/d/1nyFsxOwEhswrGB2S4PXnnLTv5fBTLwK1F8AFQnTJJQ0/edit 12/12