CRIS project application form

Anyone can apply to use CRIS provided they meet the governance requirements set out in the CRIS Security Model.

The CRIS Oversight Committee review all applications to use CRIS. The Committee is patient-led. It oversees and monitors the use of CRIS. Applications to use CRIS are judged according to:

Underlying value and potential benefits of the project e.g., to inform patient care.
Appropriate supervision/ governance.
Inadvertent risk of de-anonymisation, for example, the likelihood of a particularly small cohort. In these cases, measures may be put in place to safeguard confidentiality.

The CRIS Security Model provides more information, including the CRIS Oversight Committee’s Terms of Reference. For support in completing the application, please see the guidance notes or contact a member of the CRIS team.

Are you applying to use CRIS for research, audit, service development/ evaluation or quality improvement?(Required)

Guidance notes

Research

Recruitment (Consent For Contact – C4C)

Audit

Service Evaluation / Development

Quality Improvement

About you

First name(Required)

Last name(Required)

Email(Required)

If possible, please provide an NHS or university email address

Job title(Required)

Department(Required)

Organisation(Required)

Applicant’s ORCID(Required)

Guidance notes. Register here: https://orcid.org/register

Do you have a substantive or honorary contract with SLaM?(Required)

Guidance notes

Substantive SLaM Contract

Honorary SLaM Contract

KHP Passport

Research Passport / Letter of Access

Contract Pending

Other

About your project

Project title(Required)

Guidance notes

Project lay summary(Required)

Please provide just one sentence summarising the reasoning behind the project, and just one sentence describing what the project will do. Guidance notes

Objectives of the analysis(Required)

Guidance notes

Rationale for the analysis(Required)

i.e. anticipated benefits / useful knowledge that will arise from the results. Guidance notes

Types of variables you envisage using to define groups(Required)

Guidance notes

Types of variables you envisage needing as outputs(Required)

Guidance notes

What steps will be taken to avoid de-anonymisation when using CRIS?(Required)

e.g. from any combinations of variables which might identify individuals in your output. Guidance notes

Research Ethics Committee (REC) approval number(Required)

IRAS ID(Required)

Date of REC approval(Required)

DD slash MM slash YYYY

REC Expiry Date(Required)

DD slash MM slash YYYY

SLaM Research and Development (R&D) reference number(Required)

Date of SLaM R&D approval(Required)

DD slash MM slash YYYY

Quote statement which explicitly states that your project is covered to approach clients who have given consent to be approached for recruitment purposes(Required)

Will your project require linking CRIS data to one of the external datasets held by the SLaM secure Clinical Data Linkage Service (CDLS)(Required)

e.g. HES (acute hospital admissions, outpatient, and A&E attendance), cause of death data, etc. Guidance notes

Yes

Please state which dataset your project will require linkage to(Required)

i.e. HES, Mortality, etc.

Names of anyone else who will be involved in CRIS use for this project

Anybody accessing CRIS data must have a contract with SLaM. Guidance notes

First name

Last name

Email address

Job title

Organisation

ORCID

Type of SLaM Contract

Other SLAM affiliation

Supervisor details

Please provide details of your supervisor.

Please note, we would like the details of the supervisor for the project you’ve detailed in this application - this may not necessarily be your line manager

Guidance notes

I am applying as the supervisor

Please indicate your level of clinical and/or academic seniority

First name(Required)

Last name(Required)

Email(Required)

Job title(Required)

Organisation(Required)

Supervisor ORCID(Required)

Type of contract with SLaM(Required)

Substantive SLaM Contract

Honorary SLaM Contract

KHP Passport

Research Passport / Letter of Access

Contract Pending

Other

King’s Health Partners (KHP) employment

All CRIS projects must have a least one collaborator who is an employee of King’s Health Partners (KHP), i.e. King’s College London University, South London and Maudsley NHS Foundation Trust, King’s College Hospital NHS Foundation Trust, Guy’s and St Thomas’ NHS Foundation Trust. Guidance notes

I (the lead applicant) am substantively employed by a KHP organisation

I am not substantively employed by a KHP organisation

Please provide the name and organisation of the person named on this application who will act as the KHP collaborator for the project.(Required)

How long do you envisage requiring use of CRIS for this project?(Required)

Guidance notes

Please confirm the project has received appropriate SLaM Clinical Governance approval and email the approval to the CRIS administrator

Guidance notes

State the Directorate responsible for this approval

Give the title of the approved project if different from above

What is the output envisaged to directly arise from this analysis (peer reviewed publication/ pilot study)?

If you intend to publish the output, please give an indication of where you are intending to publish. Guidance notes

Is it likely that text from CRIS will be quoted in publications or other outputs?

Guidance notes

Does this application relate to a study forming all or part of an MSc dissertation?(Required)

Guidance notes

Yes

Who is the main funder for this application?(Required)

Guidance notes

Externally funded

Industry

Self-funded / personal time

Fellowship

Studentship

MSc

SLaM / Employer

Maudsley BRC

Other

Please provide details of the funder including name, the approximate cost and grant reference number(Required)

Do you envisage any commercially relevant intellectual property as an output from this project?(Required)

Guidance notes

Yes

CRIS security requirements(Required)

Use of CRIS requires adherence to the CRIS Security Model, available to view here. Please tick here to confirm that you have read and understood these requirements. Guidance notes

I have read and understood the requirements of the CRIS Security Model

By submitting this project application, you agree to treat CRIS data confidentially and in adherence to the guidelines stated above. You confirm to have the necessary honorary or substantive contract with SLaM to be authorised to access CRIS. All use of CRIS will be audited to ensure that it is within the remit of the project you specify in this application form. Any use of CRIS outside the remit of the application form will be queried with the user and where found in breach of CRIS terms and conditions, CRIS access may be withdrawn subject to discussions with the CRIS Oversight Committee. You agree and confirm that this project has the relevant audit approvals or if a research project has an official research supervisor.

Comments

This field is for validation purposes and should be left unchanged.