HS&DR COMMUNITY OF REFEREESREGISTRATION
The HS&DR programme relies on independent review of important reports and documents produced by their funded researchers and other individuals. These include short briefing papers, proposals and draft reports of research findings. The people involved in these reviews form our ‘community of referees’.
NETSCC HS&DR is keen to give the best possible support to the community of referees. We have information in a databaseof people prepared to review research either for applications or researchers final reports. This database allows us to make the best use of our community of referees, matching their preferred areas of interest closely with the work of the programme.
To join the HS&DRcommunity of referees we ask that you provide us with enough information to allow us to match your preferred areas of interest with the work of the programme. You are not obliged to accept any subsequent invitations to act as a referee (up to four invitations per year on average); although we would hope that you would be willing to do so.
If you would be happy for us to ask for your help in reviewing briefing papers, research proposals or reports submitted to the programme, please complete the attached application form in order that we may capture your expertise and areas of interest.
Referees’ comments are passed to members of NETSCCHS&DR Boards, to applicants and fellow referees in confidence, and in anonymised format, as part of our assessments process.
In addition, we listthe names of referees annually on the HS&DR website and add them to ourmailing lists to receive the HS&DRbulletin newsletter and regularinformation relating to call for proposals.
Your personal information will be held on a shared NETSCC database and you may be approached by other NETSCC managed programmes; these approaches are recorded centrally and this helps us ensure that we do not overburden any of our referees with requests. For information on all NETSCC programmes please go to
Your personal information is held and used in compliance with the Data Protection Act 1998. The Department of Health, National Institute for Health Research (DH NIHR) is the Data Controller under the Data Protection Act 1998 (‘the Act’). Under the Data Protection Act, we have a legal duty to protect any information we collect from you. You should be aware that information given to us might be shared with other DH NIHR bodies for the purposes of statistical analysis and other DH NIHR management purposes. Applicants may be assured that DH NIHR is committed to protecting privacy and to processing all personal information in a manner that meets the requirements of the Act.
CONTACT DETAILSPlease complete all relevant fields
Title / Prof Dr Mr Mrs Ms Other (please state)
First Name
Last Name
Job title
Department
Organisation
Address
Postcode
Country
Tel No
Fax No
Mobile No
QUALIFICATIONS
Please tick ONE of the following boxes indicating your highest level of qualification
PhD / MSc / MA
MD / BSc / BA
M Phil / Other (please state)
BACKGROUND
NETSCCHS&DR seeks to make only appropriate requests to referees. We are keen to know as much detail as possible concerning your particular areas of interest and specialist activity. Please complete the following sections with as much detail as possible as this information will assist us in this task.
Brief job description:
Current research interests and/or expertise:
(a) High expertise (areas on which you can confidently comment with a high level of expertise, in which you work personally and/or are an expert)
(b) Medium expertise (areas in which you are sufficiently knowledgeable to provide an informed opinion, e.g. those that your research group work in or those related to your own field, in which you would be aware of recent developments)
(c) General expertise (areas more broadly related to your own field in which you are able to provide a generalist opinion only)
Past research interests and/or expertisethroughout your career
Areas of methodological / technical expertise:
Include a brief summary of any other relevant experience, e.g. as a grant applicant and/or holder, referee or journal editor:
KEY WORDS
Please use the space below to provide key words which summarise your research and/or methodological experience
PUBLICATIONS
Please list up to 5 of your own recent published papers, journal articles, book chapters, conference presentations (if applicable)
1)
2)
3)
4)
5)
SUCCESSFUL GRANT APPLICATIONS
Please list up to 3 of your own recent successful grant applications (if applicable)
1)
2)
3)
REFERRALS
We are constantly seeking further individuals who may be willing to act as a referee for the HS&DRprogramme. We would be grateful for any recommendations you might have.
REFERRAL 1
Name
Job Title
Organisation and Address
Email / Phone
REFERRAL 2
Name
Job Title
Organisation and Address
Email / Phone
REFERRAL 3
Name
Job Title
Organisation and Address
Email / Phone
REFERRAL 4
Name
Job Title
Organisation and Address
Email / Phone
Please return your completed form to us via email or in the post to:
NIHR Evaluation, Trials and Studies Coordinating Centre
Health Services & Delivery Research Programme
University of Southampton
Alpha House, Enterprise Road
ChilworthSciencePark
Southampton, SO16 7NS
Tel: +44(0)23 8059 5586
Fax: +44(0)23 8059 5639
Email:
Web:
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