Icnarc Letter Template

Request for analyses / data

Simple analyses and / or data requests for local quality improvement are produced free of charge for sites participating in ICNARC Case Mix Programme. All other requests may incur a charge based on the nature and complexity of the request.

All requests from non-participating sites and those that are not specifically for local quality improvement are passed to the independent Data Access Advisory Group for approval and prioritisation.

All requests are:

• reviewed internally at ICNARC

• clarified with the applicant where necessary

• produced on a timeline based on workload demand

Please note that deadlines of less than six weeks for local quality improvement purposes are unlikely to be met. Deadlines for other purposes which fall before the date of the next DAAG meeting, at which the request is to be discussed, will not be met. We urge all requests to be made well in advance of personal deadlines to avoid disappointment.

Completing this form:

• All information must be added to this form and not in an accompanying document or email(s)
• Be as specific as possible; the form expands to allow more information to be entered
• Once completed, email form to

Terms and conditions:

All outputs must include the following:

“These data derive from the Intensive Care National Audit & Research Centre (ICNARC) Case Mix Programme Database. The Case Mix Programme is the national, comparative audit of patient outcomes from adult critical care coordinated by ICNARC. We thank all the staff in the critical care units participating in the Case Mix Programme.”

“For more information on the representativeness and quality of these data, please contact ICNARC.”

“Disclaimer: The views and opinions expressed therein are those of the authors and do not necessarily reflect those of ICNARC”

By submitting this form, you agree that the data requested is for use, as described above.

Once complete, please email this form to

ICNARC INFORMATION SHARING AGREEMENT

This Agreement is between the Intensive Care National Audit & Research Centre (ICNARC) of Napier House, 24 High Holborn, London WC1V 6AZ and

(the applicant)

of

ICNARC is a registered charity (No. 1039417) and a Company limited by Guarantee, without shareholders. It is a non-profit organisation established to provide a national audit of patient outcome from critical care. ICNARC will grant controlled access to data and information to an applicant on the following terms.

IT IS AGREED between ICNARC and the applicant

1.The applicant will not give any other person, or organisation, confidential information to which they have access in the course of their work with ICNARC. This also applies after they have discontinued working with ICNARC, without time limit.

2.The applicant acknowledges that all data contained in the ICNARC Databases shall vest in and be the absolute and exclusive property of ICNARC. The applicant shall not reproduce any data derived from the ICNARC Databases in any form whatsoever without prior consent.

3.The applicant agrees to use the data contained in the ICNARC Databases solely for the objectives agreed in their ‘request’.

4.The identity of the source of data, whether Participant, hospital, unit, staff or patient shall remain confidential. Notwithstanding the termination of this agreement the parties agree to keep the source of data confidential.

5.The applicant will inform ICNARC, in advance, of any presentation(s) and/or publication(s) based on analysis of the ICNARC Databases, including joint ICNARC analysis and sole analysis.

6.The applicant will ensure proper safeguards are applied in keeping the data secure and destroying it on completion of the work/project to prevent any breach of confidentiality. Any misuse or loss of these data should be notified immediately to ICNARC.

7.Statistics or results of research based on data received from ICNARC should not be made available in a form which:

a) directly identifies individual data subjects or creates a risk of indirect identification;

b) is not covered by the intended use of the data specified on the request form.

8.The applicant will ensure that if they will be using Personal Data that it will be in accordance with current Information Governance requirements.

9.Where ICNARC agrees to share Personal Data with the applicant that they will be processing for their own purposes, the applicant will become a data controller in relation to the shared data and ICNARC will require the applicant to have a valid entry in the Register of Data Controllers, where applicable.

10.All intellectual property rights in the ICNARC Data shall remain the property of ICNARC at all times. Nothing in this agreement shall be construed as granting any license to ICNARC Data or ICNARC’s other intellectual property rights unless otherwise expressly set out under this agreement.

11.ICNARC is disclosing data to the applicant on the express understanding that neither party will be obligated to enter into any further agreements relating to the subject matter hereof, and unless and until any final definitive agreement with respect to the above subject matter is agreed between the parties, the parties will not have any obligation to the other party except under this agreement or any other definitive written agreement already entered into with respect to the subject matter.

Name(s): Applicant(s)

Date:

Name: for ICNARC

Date:

Version 1 / Oct 2013