Office use only - csp.org.uk · Web viewPRF Scheme B. 2. CSP Charitable Trust Awards, 14 Bedford Row, London WC1R 4ED ... registered charity 279882) RESEARCH PROJECT GRANT. APPLICATION

Office use only PRF(18)B

Lead Researcher: ..............................

PHYSIOTHERAPY RESEARCH FOUNDATION(Part of the CSP Charitable Trust registered charity 279882)

RESEARCH PROJECT GRANT APPLICATION FORM 2018 Scheme B

IMPORTANTBefore completing this form, please read the accompanying guidance notes. Forms must be word-processed.

1. Details of lead researcher (to whom all correspondence will be addressed).

Lead ResearcherCSP number: HCPC number:First name: Last name: Title: Present position/job title Institution: Contact Address:

Contact email address:

2a. Details of Supervisor

SupervisorFirst name: Last name: Title: Present position/job title Institution: Contact Address:

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2b. Details of Co-researchers(Reproduce this box if required for additional applicants)

Co-researchersFirst name: Last name: Title: Present position/job title Institution: Contact Address:






CSP Charitable Trust Awards, 14 Bedford Row, London WC1R 4ED Tel: 020 7306 6666

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3. Project detailsa) Project title (20 word max.)

b) Project category. Please mark the relevant box.Clinical researchEducational researchService delivery research

c) Does your project address a topic related to paediatric non-acquired brain injury and paediatric cerebral palsy? Yes / No

d) Total Sum requested:

£

e) Estimated duration of project (in months)

f) Expected start date:

g) Please provide a plain English summaryPlease refer to the INOLVE guidelines on how to write a plain English summary

(Max 300 words).

h) Please provide a project summary.This should include objectives for your project. (Max 250 words)

4. Involving patients, carers and the public (and other stakeholders as appropriate)


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You must indicate clearly how you have involved patients, carers and the public in your study (Max 500 words)

5. Dissemination PlansOutline how you plan to disseminate and implement your research findings (Max 300 words)

6. Background and Justification Please indicate how this piece of work will potentially enhance the understanding

of physiotherapy practice and/or improve patient care. Describe the potential

impact of your study; this can include social, economic, cultural, environmental,

health and quality of life benefits. Impact purely within academia should not be

included. (Max 200 words)

7. Research Ethics and Governance approvals7a. Will approval for the project be sought from the Research Ethics

Committee(s) concerned? Yes / No

If no, please attach a covering letter indicating, with reference to relevant guidelines, why the project does not require REC approval.

Confirmation of funding for a successful application will be subject to ethical approval as required.

7b. Will approval for the project be sought from the appropriate research governance bodies? Yes / No

If no, please attach a covering letter indicating, with reference to relevant guidelines, why the project does not require Research Governance approval.


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Confirmation of funding for a successful application will be subject to research governance approval as required.

8. Registration

PRF funded projects which are trials must have International Standard Randomised Controlled Trial Number) ISRCTN registration before any funding can be released.

I agree to register the project with Current Controlled Trials Ltd Yes / No

If no, please give a brief explanation:

PRF funded projects which are systematic reviews must be registered on PROSPERO https://www.crd.york.ac.uk/prospero/

I agree to register the project with PROSPERO Yes / No

If no, please give a brief explanation:

9. Please provide details of all persons working on the project including those named in section 2

Name & main duties Average no. of hours per week spent on project

10. Costings (with an estimate of the breakdown of costsGive an outline of the costs incurred in the conduct of your study. It will not be possible to request additional funds after funding is agreed (Max 50 words)


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https://www.crd.york.ac.uk/prospero/


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11. Additional research fundingState whether financial support is provided or being sought from another source or this project or related research proposals.

a) Is your research supported by any outside body? Yes / No

If yes, please state: the supporting organisation:...................................................................................

amount: £ ......................... duration (months): .................................................

b) Is this or a related application currently being submitted elsewhere Yes / No

If yes, please state to which organisation: ..............................................................

and what date is a decision expected:………………………………

This will not necessarily affect the Panel's decision but if you do obtain funding

from elsewhere you should withdraw this application.

12. Co-operation confirmation

(1) Does the project require the co-operation of specific individuals (e.g. NHS consultants and/or managers) or bodies (e.g. Health Authority, NHS Trust, University, etc.)? Yes / NoIf yes, please attach copies of letters confirming co-operation.

(2) Will your project be carried out within an NHS provider? Yes / NoIf yes, please attach copies of letters confirming that the necessary infrastructure is in place at no additional cost to the PRF.

13. Postgraduate study (PhD, MPhil, DPhil, Prof Doc)

Is this research part of a postgraduate degree or higher education course?Yes / No

If yes, please give details:


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14. Declarations

Lead Researcher I have read the conditions set out by the Physiotherapy Research Foundation, and agree to abide by them if my application is successful. I shall be actively engaged in, and take full control of the project. I agree to comply with standards set out in the Department of Health Research Governance Framework.

Signature of lead researcher: .................................................................................

Name: .....................................................................................................................

Position: ..................................................................................................................

Organisation: ..........................................................................................................

Date: ...../....../......./

Research Supervisor I confirm that I have read this application and that, if funded, I will be responsible for the conduct of the research and the monitoring of its progress. I agree to comply with the standards of good research set out in the Department of Health Research Governance Framework.

Signature of Research Supervisor: .........................................................................

Name: .....................................................................................................................

Date: ...../......./......./

Position: ..................................................................................................................

Organisation: ..........................................................................................................

Address: .................................................................................................................

................................................................................................................................

................................................................................................................................


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14. Declarations continuedHead of Department I confirm that I have read this application and that the work will be accommodated and administered in the Department/Organisation. I will ensure procedures are in place to manage and monitor the research in accordance with Research Governance.

Signature of Head of Department: ..........................................................................

Name: .....................................................................................................................

Date: ...../......./......./

Position: ..................................................................................................................

Organisation: ..........................................................................................................

Address: .................................................................................................................

................................................................................................................................

................................................................................................................................

Finance Officer I confirm that I have read this application and that, if funded, the work will be administered in the Department/Organisation. The staff grades and salaries quoted are correct and in accordance with the normal practice of this organisation.

Signature of Finance Officer: ..............................................................................

Name: .....................................................................................................................

Date: ...../......./......./

Position: ..................................................................................................................

Organisation: ..........................................................................................................

Address: .................................................................................................................

................................................................................................................................

................................................................................................................................

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APPENDIX I: DETAILS OF PROPOSED RESEARCH

Please give details of the work for which you are requesting support using the following headings (using ‘full application’ guidance notes to assist you).

Do not exceed TEN sides of A4 (including references), of which a maximum of TWO of sides should be used for the background to the project.

Use Arial font with a minimum size 12 point, with 1.5 line spacing.

1. Title

2. CSP research Priorities

3. Aims & Objectives

4. Background to the project (max 2 sides of A4)

5. Study participants (inclusion and exclusion criteria; recruitment)

6. Plan of investigation, including research methodology proposed

7. Data analysis

8. Dissemination

9. References

10.Appendices

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APPENDIX II: PROJECT TIMESCALE AND MILESTONES

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APPENDIX III

A) Financial details of support requested, including on costs

Category Year 1 costs Year 2 costs(if applicable)

Year 3 costs(if applicable)

TOTAL

Staff salaries

Travel and subsistence

Equipment

Consumables

Other(Please include PCPI costs here if applicable)

TOTAL

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B) Justification for support requested.

This should include the basis for any calculation or estimate of costs e.g. staff salaries should indicate the grade and salary of staff expected to be funded by the project.

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APPENDIX IV: CURRICULUM VITAE OF ALL APPLICANT(S)(Please use one sheet for each person and reproduce)

LEAD RESEARCHER AND ALL OTHER CO-RESEARCHERS

Surname:....................................................... Forename(s):

......................................................................

Qualifications, degrees etc:

Relevant Post-Registration courses attended:

Recent publications, provide up to 6 references (if applicable):


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Please tick the box below before signing and returning your form:

☐ I consent to the CSPCT using the information supplied for the above detailed funding application, in order to process and manage this award, including processing payments, as well as contacting the project team regarding the application, reporting requirements and any impact and evaluation work, and any other contact as part of our contractual obligations and legitimate interests.

If you choose not to share your personal data with us, or refuse certain contact permissions, we will not be able to process your award payment.

Please refer to the CSPCT’s Privacy Notice for further information: http://www.csp.org.uk/documents/cspct-privacy-notice.

PLEASE SIGN AND DATE BELOW

Please insert an electronic image of your signature and submit an MS Word version of your form via email. The form cannot be accepted if your name is typed in, in place of a signature.

FULL NAME:

SIGNATURE: Date:

Please email an MS Word version of your application to [email protected] by 12 midday on 3rd September 2018. Your form will not be accepted if it is submitted as a PDF. Late submissions will not be accepted either.


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Office use only - csp.org.uk · Web viewPRF Scheme B. 2. CSP Charitable Trust Awards, 14 Bedford Row, London WC1R 4ED ... registered charity 279882) RESEARCH PROJECT GRANT. APPLICATION