Foreword

1. The Agreement

1.1 Parties

1.2 Purpose

1.3 Nature

2. What the Member Can Expect

3. Confidentiality

3.1 What is confidential

3.2 What is not

3.3 Duration

4. Conduct

4.1 Public statements

4.2 Respect

4.3 Conflicts of interest

4.4 The WhatsApp group

5. Personal Data

6. Term and Ending

7. Law and Disputes

Annex A — Completed Example

Annex B — Signature Form

References

Index

Foreword

A council only works if people speak freely in it, and people only speak freely when they know what is said stays in the room. This agreement makes that promise mutual. It also protects the facility — which opens its problems to the council in confidence — and it protects each member from being drawn into public disputes they did not choose.

It is written to be read and signed in ten minutes. It is not a contract of employment and creates no financial obligation on either side. Sections 1–7 are the agreement; Annex A is a completed example; Annex B is the form to sign.

1. The Agreement

1.1 Parties

This agreement is between the member named in Annex B ("the member"), the facility named in Annex B ("the facility"), and the secretariat named in Annex B ("the secretariat"). Where the secretariat is Accréditation Sans Frontières, it is bound in addition by its Secretariat Impartiality Undertaking (ASF-PV-SECRETARIAT-001).

1.2 Purpose

The member joins the Patient Voice Council of the facility to review, monthly, the feedback patients and families have given, to propose improvements, and to take part in patient education, under the Terms of Reference (ASF-PV-TOR-001).

1.3 Nature

Membership is voluntary and unpaid. It is not employment, agency, or representation of the facility. The member may withdraw at any time by writing to the secretariat. The facility may not remove a member for what they raise in the council; removal is only for breach of Section 3 or 4, decided by the chair and the secretariat together.

2. What the Member Can Expect

To receive the verified monthly report 48 hours before each meeting

To speak freely in the meeting and to be recorded accurately

To see an action log with owners and dates, and to be told at the next meeting what happened

To have their own concerns about the facility handled through the same channels as any patient, with the same anonymity option

Never to be disadvantaged in their own care, or that of their family, for anything said in the council

To have their personal data handled under the Data Protection Policy and to see, correct or delete it on request

3. Confidentiality

3.1 What is confidential

Everything the member learns in the council about: other patients or families; individual members of staff; the facility's internal matters, incidents, investigations, data and plans; and the content of any case, report or discussion, whether or not it is later published in summary.

3.2 What is not

The existence of the council, the fact of the member's own membership, the published council record, the published annual summary, and the education materials. The member may say "I am on the patient council and this is what it does".

3.3 Duration

The confidentiality obligation continues after the member leaves the council, without limit of time for information about identifiable people, and for five years for the facility's internal matters.

4. Conduct

4.1 Public statements

The member does not post, publish, give interviews or contact media about council business, the facility, or its staff in their capacity as a member. Concerns are raised inside the council, not outside it. If the council decides something should be said publicly, the chair says it in words the council agreed. Nothing in this section restricts the member's rights as a private citizen on matters unrelated to the council, or the member's right to make a complaint to a regulator or to ASF under its Complaints Policy.

4.2 Respect

The member treats other members, staff and the secretariat with courtesy, does not make damaging or defamatory statements about the facility or any person, and accepts that the council discusses practices and systems, not the character of individuals.

4.3 Conflicts of interest

The member declares any personal, family or financial interest in a matter under discussion and does not take part in that item. A member who becomes an employee or supplier of the facility, or acquires a financial interest in it, tells the secretariat and steps down.

4.4 The WhatsApp group

The group is for logistics, reports and materials. The member does not post individual cases, names, photographs of patients or records, or debate about a specific staff member. Such matters go to the secretariat directly.

5. Personal Data

The secretariat holds the member's name, contact details, relationship to the facility and attendance record, for the purposes of running the council, under the ASF Data Protection Policy (ASF-DATAPROTECT-001) and applicable law. Data is not shared with the facility beyond name and attendance, is not used for any other purpose, and is deleted twelve months after the member leaves. The member may ask to see, correct or delete their data at any time by writing to the secretariat.

6. Term and Ending

No fixed term. The member may withdraw at any time. After three consecutive missed meetings the secretariat will ask whether the member wishes to continue. Membership ends on withdrawal, on loss of eligibility (Section 4.3), or on a decision under Section 1.3. On ending, Sections 3 and 5 continue to apply.

7. Law and Disputes

This agreement is governed by French law and, where a local-law annex is attached, by the law named in it for the clauses it covers. Any dispute about this agreement is raised first with the secretariat, then with ASF under its Public Complaints and Feedback Policy. No party will bring legal proceedings against another over council business without first following that process.

Annex A — Completed Example

An illustration only. Names are fictitious.

Annex B — Signature Form

Facility: __________________________________________________

Secretariat organization and named secretariat: __________________________________________________

Member — full name: __________________________________________________

Relationship to the facility (patient / family member / carer): __________________________________________________

Contact (phone, email): __________________________________________________

Why I want to join (one sentence): __________________________________________________

Declared interests (or "none"): __________________________________________________

I have read Sections 1 to 7 of this agreement, the Terms of Reference (ASF-PV-TOR-001) have been explained to me, and I agree to them.

☐ I agree to keep confidential everything described in Section 3

☐ I agree to the conduct rules in Section 4

☐ I consent to the handling of my personal data as described in Section 5

☐ I understand membership is voluntary and unpaid and that I may withdraw at any time

Signatures

Third signature — Secretariat

Name, signature, date: __________________________________________________

References

1. Accréditation Sans Frontières. Patient Voice Council — Terms of Reference and Method Guide, ASF-PV-TOR-001-v1. Paris: ASF; 2026.
2. Accréditation Sans Frontières. Data Protection Policy, ASF-DATAPROTECT-001-v1. Paris: ASF; 2026.
3. Accréditation Sans Frontières. Public Complaints and Feedback Policy, ASF-COMPLAINTS-001-v2. Paris: ASF; 2026.
4. Accréditation Sans Frontières. Confidentiality Agreement and NDA Template, ASF-NDA-001-v1. Paris: ASF; 2026.
5. Regulation (EU) 2016/679 (General Data Protection Regulation).

Index

Confidentiality, 3

Conflicts of interest, 4.3

Data, personal, 5

Example, completed, Annex A

Public statements, 4.1

Signature form, Annex B

WhatsApp, 4.4

Withdrawal, 1.3, 6