SECTION 1: APPLICATION DETAILS
Project title
Project type	Choose an item.	Attach outcome of HRA decision tool: Is my study research?)
Strategic fit (Explain how project fits with our research priorities)
Anticipated start date	Click to add date
Duration of project (months)
Single site or multi-centre	Choose an item.
Date of application	Click to add date

SECTION 2: PERSONAL DETAILS
Applicant name
Applicant type	Choose an item.
Organisation (external applicants) OR Division (internal applicants)
Job title
Contact email
Contact number
Line manager support (internal applicants)	Choose an item.

SECTION 3: STUDENT DETAILS
Level of study	Choose an item.
University
Course
Supervisor name
Supervisor email

SECTION 4: ROLES & RESPONSIBILITIES (definitions)
Project Sponsor (organisation)
Project Lead (named individual & role, e.g. PI)
Data Controller (if different to Sponsor)

SECTION 5: PROJECT DETAILS
Short title/acronym
Research question/s
Aims (1-4 bullet points)
Background (max. 500 words) How did you decide on the project? (Include refs)
Is this a follow-on project? (Give details)
Research method	Choose an item.
Briefly describe your approach (max. 500 words)

SECTION 6: DATA COLLECTION SCREENING
(Tick all that apply) ☐ Secondary analysis of existing data (Use of routinely collected data extracted from electronic records – please provide details in Section 7) ☐ Informed participant consent will be sought prior to use of data ☐ Collection of new data (New, non-routinely collected data from eligible participants for the duration of the study only; includes the collection of data generated by a study-specified change in patient care – please provide details in Section 8) ☐ Informed participant consent will be sought prior to data collection ☐ Service evaluation (Please apply via Clinical Audit’s online form; if you would like Research Centre input, please email a copy of your online application form to research@standrew.co.uk) ☐ Other (please give details):
Data Protection Processing (i.e. collection and use) of personal data will be:	(Tick all that apply) ☐ Lawful, fair & transparent ☐ Adequate, relevant & not excessive ☐ Explicit & legitimate ☐ Not kept longer than necessary ☐ Accurate & kept up to date ☐ Conducted in a secure manner
Data management plan
Data retention period (m)	after date of: Choose an item.

SECTION 7: USE OF EXISTING DATA
Data extracted by Business Intelligence?	Choose an item.
Minimum sample size
Date required by	Click to add date
Is dataset anonymous?	Choose an item.
If ‘no’, what is the legal basis for processing personal data?	Choose an item.	Special condition?	Choose an item.
Variables (Select all that apply and give details)	Type	Details (see variables guidance in Appendix 2)
☐ Demographic
☐ Clinical
☐ Criminal
☐ Medication
☐ Scale
☐ Other

SECTION 8: RECRUITMENT OF PARTICIPANTS
Patient engagement (PPI) Please give details of public & patient involvement activities
Anticipated recruitment start date	Click to add date
End date	Click to add date
Please list each participant group that you will be recruiting from (use a new line for each different group/ward)
Participant group (e.g. patient, staff)	Division & ward (if known)	Minimum no. (STAH)	Inclusion and exclusion criteria	Method of collection (e.g. interviews, questionnaire)

SECTION 10: DOCUMENTATION, RISK ASSESSMENT & ETHICS
Study documentation (e.g. patient information sheet)	(Tick and attach all that apply) ☐ Protocol ☐ Patient information sheet ☐ Informed consent form ☐ Interview schedule ☐ Other (please list):
If you have not attached your study documentation, please explain:
Risk assessment (e.g. subject matter, resource or time constraints; include contingency & mitigation plans)
Ethics review required (research only)	Choose an item.	Attach outcome of HRA decision tool: Do I need NHS REC approval?
Date of submission to REC	Click to add date

SECTION 11: OUTPUTS & TRANSLATION INTO PRACTICE
Outputs (e.g. final report, guidance, toolkit, publication)
Dissemination plan How will you disseminate findings?
Translation into practice (what are you hoping will change or be done differently as a result of your project?)

SECTION 12: FUNDING
Details of funding plans (include details of any grant funding received or funding application plans)

Applicant By signing and/or submitting this form, you are agreeing to all the T&Cs (Appendix 1). x Clinical/Operational Lead (internal applications) By signing this form, you are indicating support for this project (including area of study and any participant recruitment) within your Division; this does not guarantee final approval. Name (printed): x	Academic Supervisor (student applications only) By signing this application2, you are indicating your support for the project and are agreeing to all the T&Cs (Appendix 1) and roles & responsibilities (Section 3), on behalf of your Research Organisation. Name (printed): x Research Supervisor/Chief Investigator (non-student applications) By signing this application3, you are agreeing to provide the necessary research supervision required to ensure the delivery of a high quality project. You are also agreeing to all the T&Cs (Appendix 1) and roles & responsibilities (Section 3), on behalf of your Research Organisation. Name (printed): x

Appendix 1: Application 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; the project protocol 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 the ethical review)

Once data has been provided to you, it is assumed this project will not require further time or support from St Andrew’s Healthcare staff for successful project delivery; any addition support will need separate discussion and agreement

ST ANDREW’S HEALTHCARE RESEARCH DATA USE TERMS (de-identified DATA)
These terms describe the limited basis on which St Andrew’s Healthcare (Charity) shall make its data (Charity Data) available to you.

Access to the Charity Data is given to you for your non-commercial use and only for the research purposes agreed with the Charity in the data request form. The Charity Data must not be used for any commercial purpose.

You will receive de-identified Charity Data and will not attempt to deconstruct or establish identity of any persons nor attempt to link the Charity Data to any other data.

You shall not distribute, grant access to, sub-licence or transfer the Charity Data to any other person or organisation, nor publish it on the internet or any other public forum. You will keep the Charity Data in a secure location.

You will ensure appropriate ethics approval has been obtained before conducting any research using the supplied Charity Data and will provide evidence of such to the Charity, upon request.

You will respond promptly to any requests from the Charity regarding your use of the Charity Data.

You acknowledge that no intellectual property or ownership rights are being transferred to you by the access granted and agree not to claim (directly or indirectly) any intellectual property or ownership rights in the Charity Data.

No warranties are given and no responsibility or liability is or will be accepted by the Charity in relation to or as to the accuracy, availability or completeness of the Charity Data. All Charity Data is provided “as is” and “as available”. The Charity Data may be updated or amended by the Charity from time to time (without notice).

You shall not remove or alter any copyright or other notice contained on or within any Charity Data.

You must acknowledge the Charity in any papers or publications which use Charity Data.

The Charity shall automatically be considered an official collaborator on any studies and the appropriate staff should be represented in the contributors’ line of any research papers. This should be done using the CRediT taxonomy (https://casrai.org/credit).

Copies of all publications, either as peer-reviewed papers, abstracts or posters, should be submitted to the Charity within one month of publication or presentation.

Save as provided in paragraphs 8 and 9, you must not use the Charity’s name or logo without the Charity’s prior written consent. You must not use the Charity Data in any way which is (or may be) detrimental to the Charity or which may bring the Charity into disrepute.

The Charity may immediately terminate your access to the Charity Data if you fail to comply with any of these terms.

On termination of this arrangement, or completion of the research (if sooner), you will return all Charity Data to the Charity and confirm (in writing) that you have done so.

Any manipulations of the data or secondary data generated should also be returned to the Charity and the Charity may subsequently distribute this to third parties in a similar form to primary data. It shall remain the property of the Charity.

These terms supersede any previous agreements in relation to the Charity Data.

The Charity may amend these terms at any time, such amendments to be effective 30 days after publication. If you do not agree to such amendments, you must stop using the Charity Data immediately.

If any of these terms is or becomes invalid, illegal or unenforceable, it shall be deemed modified to the minimum extent necessary to make it valid, legal and enforceable.

A waiver of any right or remedy under these terms or law is only effective if given in writing. No failure or delay to exercise any right or remedy shall constitute a waiver of that or any other right or remedy.

These terms (and your access to and use of the Charity Data) are subject to English law and the exclusive jurisdiction of the English Courts.

Appendix 2: Existing patient data variables

Please provide further details for each variable, including type of variable (see examples below), timeframe (e.g. violent incidents between Mar – May), follow up (e.g. every 3 months, 6 months). Note: this is not an exhaustive list of variables within the electronic systems at St Andrew’s Healthcare.

Privacy by design

Remember to request only what data is necessary for your enquiry – always plan minimisation and de-identification during project development.

Please liaise with the Research Centre if you need advice.

Data category	Example variables
Demographic	Age (e.g. at admission, at time of data extraction), gender, education, ethnicity, language
Clinical	Section of the Mental Health Act (1983), date of admission/discharge, discharge location, primary diagnosis (ICD-10 codes), comorbidities, IPUs, re-admissions, length of stay, enhanced support/restrictive practice
Criminal	Index offence, date of index offence
Medication	Type of medication (any medication, antidepressant, antipsychotic, rapid tranquillisation), date of prescription/administration, dosage, frequency of administration, time reference, follow ups
Scale	HCR20, HoNOS, ReQoL, START, SASBA, APOM, OAS, Other; complete questionnaire/single item, , date of assessment, follow ups
Other	Violence, type/severity of violence, date of incidents, time reference, follow ups

Electronic data extraction using automatic scripts

,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