NSW Regional Health Partners. Targeted Project EOI Application Guide for MRFF 2018

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1 NSW Regional Health Partners Targeted Project EOI Application Guide for MRFF 2018 This form is to be used as a guide to complete the MRFF Expression of Interest for the NSW Regional Health Partners. This form is not to be completed and will not be accepted as an application. All applications need to be submitted through the NSW Regional Health Partners Website. Lead Details Enter the details for the project lead, note that you can only be the lead on one project. These details will be used to contact you regarding this expression of interest Telephone Number Additional contact details Participating Organisations Please note that evidence of stakeholder engagement or policy alignment will be required if invited to prepare full submissions for MRFF. NSW Regional Health Partners Lead Organisation (select 1) Hunter New England Local Health District Central Coast Local Health District Calvary Mater Newcastle Mid North Coast Local Health District Hunter New England Central Coast Primary Health Network I have consulted with my organisation s Translation Committee Member or Proxy and they support this application. The project must be sponsored by the Translation Committee representative for their organisation, who must commit to supporting the project. Your Translation Committee Member and Proxy can be viewed by clicking the link above. NSW Regional Health Partners organisations Must include three or more partner organisations, select all that apply. Select at least 3 and no more than 8. Hunter New England Local Health District Central Coast Local Health District Calvary Mater Newcastle University of Newcastle Mid North Coast Local Health District Hunter New England Central Coast Primary Health Network Hunter Medical Research Institute University of New England Other Partners List any partners from other AHRTCs/ CIRHs if involved. Note that partners from outside of these organisations is not permitted. Melbourne Academic Centre for Health South Australian Academic Health Science and Translation Centre Brisbane Diamantina Health Partners Western Australian Health Translation Network Monash Partners Academic Health Science Centre Sydney Health Partners Sydney Partnership for Health, Education, Research and Enterprise Central Australia Academic Health Science Centre

2 If other partners are involved Please Specify which Organisations within the AHRTCs/ CIRHs would be involved. Priority Areas Medical Research Future Fund Priorities The project must align with at least one MRFF priority area. Select all that apply. Patient and Public Engagement Health Services Improvement Evidence Practice Gap or Clinical Variation Care Across the Care Continuum (including end of life care) Health Care Improvement Primary Care or Community Health Related Government Policy or Engagement Aged Care/ Elderly Populations Vulnerable groups (including ethnic and indigenous groups) NSW Regional Health Partners Priorities Economic Assessment of Models of Care Population Health Messaging Consumer/ Community Engagement Knowledge Transfer Models Integration of New Knowledge into Professional Training Programs AHRA Priorities Indigenous Health Better use of Health Data or Linkage Project Information Title of project (maximum 400 characters, including spaces) Impact Metrics Describe your proposal including significance, aims, methodology and feasibility Ideally use dot points. (Maximum 2500 characters, including spaces.) Stage of Activities Ethics Approved An existing ethics is required for the parent project that this research has been developed from. However an ethics variation for this specific element of the project is NOT required until after the project has been found to be successful. Stages of activities Describe the stages of the project, timelines and if a component of an existing project, how will MRFF funds add value and deliver pace and scale. Funding MUST be spent and the project delivered in 12 months. (Maximum 1000 characters, including spaces)

3 Competitive Funding Has competitive funding been received for this project? If yes list all funding bodies Impact: Describe the Patient and/or Policy impact or measurable process change to be recorded in 1 year. Maximum 800 characters including spaces Indicative budget Enter the indicative budget for the project. A detailed budget breakdown may be requested during the assessment stage. <$50K $50-100K $ K $200 - $500K $500K - $1M Projects with a budget over $1M may not be funded in the first round Project Team Chief Investigator Details Team Member 1 Team Member 2

4 Team Member 3 Team Member 4 Team Member 5 Team Member 6

5 Team Member 7 Team Member 8 Team Member 9 Please submit all EOI s via the NSW Regional Health Partners website for collation and review.

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