Company Engagement Form

Our company engagement form allows you to register to attend a NHS Insights Briefing or access other support and signposting from UCLPartners.

  • Please use this form to help us to understand your innovation, and your progress to date. Please note it is a generic form for innovations of all types and all stages of development. Please feel free to leave blank any questions that are not applicable to you at this stage
  • Please do not disclose any unprotected intellectual property via this form
  • Data from this form will be used to assess whether, and how, we are able to support you
  • Your information may be shared across the Health Innovation Network
  • We will not share your information with other innovators or companies
  • You do not need to complete this form twice. If you’ve already completed it for any other Health Innovation Network please just share a copy with enterprise@uclpartners.com
  • If you have any queries please contact: enterprise@uclpartners.com

“*” indicates required fields

Relationship with sanctioned states
As a publicly-funded NHS organisation we are required to comply with national policy on sanctioned states. Please respond to these questions.


For more information please see https://www.gov.uk/government/collections/uk-sanctions-regimes-under-the-sanctions-act


This may be a Parent Company or Person with significant control.





































Summary of the Innovation
Please only include details of one innovation on this form.







Only complete this field if you selected 'Other' in the field above


Please provide a brief description of the innovation, including its intended purpose, functionality (how it works), clinical setting/pathway, and the opportunity (size of intended patient group)




Only complete this field if you selected 'Other' in the field above






Only complete this field if you selected 'Other' in the field above






Describe any engagement you have had with key stakeholders (e.g. clinicians, patients, commissioners)


Highlight existing, similar or equivalent technologies, products or services.
Outline how your innovation is different to existing technologies, products or services


It is important that innovations are acceptable (informed by what patients want) and accessible (usable) to the people who will use or be affected by them. Assurance that innovations are informed by patient views, improves safety, health outcome and saves money. In this section, briefly describe if and how patients, carers, and the public have been involved in your innovation, including any feedback patients have about your innovation.


Read more about what Health Inequalities is here. Find out the current NHS England priority areas to tackle health inequalities for adults and children.


Does your innovation have a direct or indirect impact on NHS Net Zero / environmental sustainability? Direct – refers to when an innovation is created solely to reduce carbon emissions / provide environmental benefits – e.g. reusable product / better use of materials and natural resources in creation of product / reduce fossil fuel usage. Indirect refers to when an innovation is created for healthcare use but net zero / environmental benefits are a secondary benefit – e.g. Digital platform to manage patient care – that can help reduce travel / make care more efficient and effective.












- Initial idea
- Intellectual property protected
- User testing
- Proof of concept tested
- Early prototype
- Working prototype / pathway developed
- Clinical evidence (or equivalent)
- Pilot / real-world evaluation
- Regulatory status
- Adoption & spread
- Other (NICE guidance, case studies, inclusion on any accelerator programmes etc.)




Only complete this field if you selected 'Other' in the field above








Only complete this field if you selected 'Other' in the field above


















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