Nhsggc Mental/Sexual Health Partnership Call

Nhsggc Mental/Sexual Health Partnership Call

R & D Office Ref:

NHSGGC MENTAL/SEXUAL HEALTH PARTNERSHIP CALL

Application Form for Research Fellowship Award

The conditions of funding and notes for applicants must be read before completing this form

ALL ENTRIES MUST BE TYPED

Send one electronic copy to: Erica Packard -

  1. Applicant details:

Title and full name
(Principal applicant - NHS)
Full address
Telephone no/ext. / Fax no / e-mail
Organisation / Position held
Title and full name
(Mentor where applicable)
Full address
Telephone no/ext. / Fax no / e-mail
Organisation / Position held
Title of Research Programme
  1. Research history

Please list any research projects you have been involved in(please expand table if necessary):

Project title / Start/ end dates / Funder (if applicable) / Grant Value (if applicable) / Role
  1. Clinical Support:

3a.Please detail your current and proposed job plans (include details of any sessions currently ring-fencedfor research) and how the requested research sessions would be incorporated:

3b.Please describe how your Clinical Department would ensure that your time is ring-fenced for protocol development. This should include details of how your clinical sessions will be backfilled. (max 250 words)

  1. Declaration and authorisation:

Applicants:I have read the conditions of funding as specified by the NHS Greater Glasgow & Clyde Mental/Sexual Health Research Funding Partnership Call Guidance and agree to abide by them.

Signature of applicants (NHS and academic) / Name (Capitals) / Date
  1. Research Programme:

Please describe the Programme of Research you would seek to develop if successful in this Fellowship application. On no more than four pages of 12 point font and one side only, please include:
  • Introduction to your research area of interest,including results of any pilot studies
  • Aims/research questions
  • Plan, methods, expertise available, statistical power, key references
  • Existing facilities and justification of requirements
  • How is it relevant to current NHS policy in your clinical area, how this will influence patient care and/or impact on the health and wellbeing of patients
  • Number of weekly/monthly sessions required
  • Schedule of activities for first and second year
  • Outcomes by end of first and second year

  1. Financial details

Research Co-ordinator will submit application for NHS finance review

Please specify costs as indicated

Post Title / Band/
Grade / W.T.E. requested / Proposed Start Date / Proposed End Date / Total funding requested
  1. Authorisation

Clinical Director:
Signature / Date
Title and full name (block capitals) / Position held
Research Co-ordinator:
Signature / Date
Title and full name (block capitals) / Position held

Note: Funding will be awarded strictly in accordance with Conditions of Funding as detailed in NHSGGC Guidance and Conditions of Funding.

  1. Short Curriculum vitae of applicant

Surname / Initials / Title
Degrees, etc.
Posts held (with dates)
Relevant recent publications (with title and reference)

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