NIHR NON-COMMERCIAL PARTNER SELF-DECLARATION FORM

  1. I confirm that my non-commercial organisation meets the Department of Health criteria for an NIHR non-commercial Partner organisation (as stated in Eligibility for NIHR Clinical Research Network Support (February 2013)), for the funding streams listed below.

Funding streams which meet the Partner Criteria / Funding Streams which do NOT meet the Partner criteria
[funder to complete] / [funder to complete]
[insert additional rows as required]

PLEASE NOTE: In order to self-declare with respect to funding streams that support Research Training Awards, the funding assessment process must include protocol peer review in addition to review of the applicant (see section 3.6 of the Eligibility for NIHR Clinical Research Network Support (February 2013) policy document).

In order to self-declare with respect to funding streams that support Programme or Centre Grants, the funding assessment process must include protocol peer review of individual studies at the point of awarding the grant and/or as part of the on-going review of the grant (see section 3.6 of the Eligibility for NIHR Clinical Research Network Support (February 2013) policy document).

Where protocol peer review is not part of the review process this should be noted in your declaration alongside the appropriate funding stream. Protocol peer review will be required before a study can be considered for Clinical Research Network support.

PLEASE NOTE: If you contribute funding to a joint funding stream[1], only the funder who manages the funding process including the peer review process should self-declare with respect to this funding stream.

  1. I understand that my organisation may be audited to ensure that it meets the NIHR Partner criteria.
  1. I confirm that my organisation agrees to be contacted at any time by the NIHR Clinical Research Network, acting on behalf of the Department of Health, should any questions arise regarding the organisations suitability as an NIHR non-commercial Partner.
  1. I understand that my organisation will be removed from the NIHR non-commercial Partner List if, following an audit by the Clinical Research Network,it is found to notmeet the criteria for being an NIHR non-commercial Partner organisation for one or more of its funding streams.
  1. I agree to inform the NIHR Clinical Research Network of any new funding streams established by my organisation and to provide an updated self-declaration form incorporating these new streams.

Signature
Name
Position in organisation
Organisation
Address:
Telephone number:
E-mail address:

Version 4– January 2017

[1] Joint funding streams are those where multiple funders are contributing to one funding stream, for example the Stroke Association and British Heart Foundation joint programme grant funding stream.