Applicant type (check one)
☐	Internal (employee of St Andrew’s)

☐	External (e.g. university researcher)

Project type (complete and attach outcome: Is my study research?)
☐	Research
☐	Service Development / Innovation

☐	Service Evaluation

APPLICANT
Name	Job title
Organisation	Contact (email/mobile)
Internal applicants only
IPU	Line manager
PGR student support	Choose an item.	Line manager support?	Choose an item.
Students only
Level of study	Choose an item.	Supervisor name & email
Course start date	Click to add date	Proposal agreed by	Click to add date
Projects with external involvement only
Sponsor	Data controller
Principle investigator (if different to applicant)	Data processor
PROJECT
Title
Short title/acronym
Research question/s
Aims (1-4 bullet points)
Follow-on STAH project?	Choose an item. If yes, please give title:
Background (max. 250 words) How did you decide on the project?
Research method (check one)	☐ Qualitative ☐ Mixed methods ☐ Quantitative ☐ Other
Brief details (max. 250 words)
Project dates	From Click to add date to Click to add date
Preliminary results due	Click to add date	Final results due	Click to add date
DATA
Data to be used (check all that apply)	☐ New data, collected specifically for this project ☐ Data extracted from electronic patient records (please attach a Request Use of Data form)
Collection of new data
Details	Method (Select all that apply)	Collector/processor
☐ Participant generated: interview/focus group	Choose an item.
☐ Participant generated: questionnaire	Choose an item.
☐ Participant generated: other (please give details):	Choose an item.
☐ Other (please specify):	Choose an item.
Consent	Choose an item.
Data collection dates	From Click to add date to Click to add date
Data retention period
RECRUITMENT
Participants (Select all that apply)	Participant category	No.	Recruitment strategy
☐ Patient (change in care required)
☐ Patient (no change in care required)
☐ Family member
☐ Care giver
☐ Former care giver
☐ Staff
☐ Other (please specify):
Minimum sample size (Include details of power analysis)	Sites (Select one)	☐ St Andrew’s only ☐ Multi-site
Inclusion criteria (List separately by population type)	Ward/s (if known):
Exclusion criteria (List separately by population type)
Patient & Public Involvement (PPI)
Patient & Public involvement	☐ I need more information about PPI ☐ I am planning PPI in the project development ☐ I am not planning on doing any PPI activity (please provide justification):
Planned PPI activity How do you plan to engage people?
ETHICS
Research only	Complete: Do I need NHS REC approval? (complete and attach outcome) Choose an item. Click to add date
Detail ethical considerations (non-research)
RISK ASSESSMENT
Risk assessment (Include contingency & mitigation)
OUTPUTS & TRANSLATION INTO PRACTICE
Outputs (E.g. final report, guidance toolkit, publication etc.)
Dissemination plan How will you disseminate findings?
Impact
Outcomes What are you hoping will change?
FUNDING
Grant funded?	Choose an item.	Funder
Funding Brief details of funding plans

Date of original application	Click to add date	Date of revised application	Click to add date

Attached with this application:

☐	Request Use of Data Form

☐	Risk Assessment

☐	Other

Applicant By signing and/or submitting this form including an embedded “Request use of anonymised patient data” form (Appendix 1), you are agreeing to all the T&Cs. x Academic Supervisor (student applications only) By signing this application2, including an embedded “Request use of anonymised patient data” form (Appendix 1), you are indicating your support for the project and are agreeing to all the T&Cs, on behalf of your Research Organisation. x	Clinical/Operational Lead (internal applications) By signing this form, you are indicating support for this project (including area of study) within your IPU; this does not guarantee final approval. x Research Supervisor/Chief Investigator (non-student applications only) By signing this application3, including an embedded “Request use of anonymised patient data” form (Appendix 1), you are agreeing to provide the necessary research supervision required to ensure the delivery of a high quality project and are agreeing to all the T&Cs, on behalf of your Research Organisation. x

Appendix 1: Guidance and T&Cs

Thank you for coming to the Research Centre to register your interest in conducting a research project at St Andrew’s Healthcare. This form is intended to elicit the information required for the pre-check – recommended before project development and ethical approval.

MSc students, in particular (due to the timeframes involved), are strongly encouraged to submit an EoI prior to project development, ideally by mid-November (of the calendar year before the course starts). This timeframe enables us to give an early indication of whether the project is suitable, give timely feedback and allow enough time to make alternative arrangements, should the project be rejected. Students submitting after the deadline may be successful in getting approval, but are advised to have a contingency plan, in case they are not.

Eligibility criteria for students

Applicant must be studying a postgraduate course at a university

Applicant must have achieved either:

An upper second class degree in a health-related subject, with a dissertation by research, or

A lower second class degree and a minimum of a merit classification in a health-related postgraduate degree, with a dissertation by research

University supervisor must support application to conduct research at St Andrew’s Healthcare

Application process

Please complete one form per project; save using the filename format: stah_EoI_shortprojecttitle

Students: Ensure your university supervisor has read and signed this application (signature at the bottom or attach an email from them confirming they have read the T&Cs and support the application)

Email the completed form (scan/photo accepted), plus any other relevant study documentation, to: research@standrew.co.uk

Terms & conditions

These T&Cs have been lifted from the full procedures that apply when conducting research St Andrew’s, for notification at EoI application stage; they are in addition to standard research best practice such as securing appropriate ethical approval, aiming to publish findings, following good authorship practice etc.

Applicant

The applicant agrees to familiarise themselves with and follow the procedures for conducting research at St Andrew’s (available on request from the Research Centre)

Where the Project involves conducting research at a St Andrew’s premises, a signed St Andrew’s Honorary Contract will be required for each non-staff Researcher

Research Organisation (for the attention of the Academic Supervisor or Chief Investigator)

Where the Project involves conducting research at a St Andrew’s premises, a signed St Andrew’s Honorary Contract will be required for the non-staff Researcher

Evidence of a suitable Disclosure and Barring Service registration check will be provided by the Research Organisation for each of their researchers, prior to them attending Charity premises

The Research Organisation warrants that their researcher/s has (and will maintain) adequate training to carry out the research, and will provide evidence of such training to the Charity on request

Where the Project involves contact with patients, the Research Organisation warrants that they have made the Researcher aware of, and deemed them capable to deal with, the nature and risks of working within a secure mental health hospital

Where the Project involves conducting research at a St Andrew’s premises, the researcher/s must complete a St Andrew’s Induction and adhere to the St Andrew’s Research Policy and Procedures (available upon request)

Application assessment

Research projects must align with the strategy of the Research Centre at St Andrew’s Healthcare; therefore, if this project is intended to be submitted to an external funder (such as NIHR or RCUK), applicants are encouraged to engage with the Research Centre as early as possible

Your completed form will be reviewed (usually within 2 weeks of submission); you may be required to provide further information and/or attend a meeting to present your idea and answer questions

You will be advised of the outcome as soon as possible, and usually within 2 weeks; a full Project Registration Form may be required for detailed assessment and approval

Full St Andrew’s Healthcare approval is required before any research can be undertaken at our sites; for large, high risk, complex or high resource projects, this process can take up to 3 months (this does not include IRAS)

Requirements for time and/or support from St Andrew’s Healthcare staff for project delivery, will need separate agreement

,2,3 Support can also be indicated via covering email

For projects that have already been fully developed, please include the full protocol and complete study documentation

Contact research@standrew.co.uk for a full version of the procedures governing research activity at St Andrew’s