Project number: [to be completed by ResearchOne]

ResearchOne Data Access

The purpose of this form is to define the proposed project, the governance arrangements that apply, the scope, format and intended use of data and any analytical input required. Data is only released for specified research purposes and cannot be passed to a third party without the express permission of the ResearchOne Project Committee.

Upon completion please return to:

  1. Indicate the purpose of this form

Expression of Interest
Fill out the bold sections to submit an expression of interest. ResearchOne will use the information to assess the feasibility of assisting the project. / Yes
Data Request
Following a successful expression of interest you can complete all sections of this form and return it to make a data request to the ResearchOne Project Committee. / Yes
  1. Complete the following

Date
Name, affiliation and addressof the lead investigator
Project title
Organisation that will hold the data
Name, affiliation and address of the data controller
Name, affiliation and contact details for your Data Protection Officer (if requesting identifiable or linkable data)
Stage of project: / Early stage development of proposal
Later stage development of proposal
Funded project
  1. Have you used the NHS Health Research Authority Decision Tool ( and does this determine that your project is research? The NHS REC has approved that data from ResearchOne can be used in research. Read more about this at
  1. Attach your research protocol.
  1. Has this project been, or will it be, submitted to any ethics/review committees? Detail any outcomes. Attach copies of any documents submitted and their responses.
  1. Please provide a summary of your proposal in fewer than 300 words. If your project has a website address then include this. Cover the purpose and any expected advances, for example in understanding, care delivery and patient outcomes.
  1. Indicate the data items requested, as specifically as possible, giving examples where appropriate. Should you request coded data, please describe the indicators in this box (e.g. ‘COPD codes’) and attach a list of the codes in comma separated format. Where codes have a hierarchical structure (e.g. BNF chapters), indicate in the attachment whether the codes listed are specific or all lower codes are to be included.
  2. If requesting drugs, please attach a list of the 14 digit BNF chapter headings, e.g.03.00.00.00.00,05.01.02.01.00
  3. If requesting clinical data, please attach a list of CTV3 concept IDs- these are accessible via anNHS TRUD browsere.g. H32.., XaYai
  1. From which organisation types will data be requestedvia ResearchOne? Consider that you may need to specify in Point 6 whether you request data entered by, or visible to, a clinician. For example, to request GP data would only be to request data they have entered.

Child Health / Out of Hours
Community / Palliative
General Practice / Prison
Hospital / Social Care
Mental Health / Urgent Care (e.g. Minor Injuries, A&E)
Other [please specify]
  1. Indicate whether identifiable, pseudonymous linkable or de-identified data is required.

De-identified
Identifiable
Pseudonymous linkable
  1. Define the inclusion and exclusion criteria for your cohort. Include the proposed sample size (this may be a maximum and minimum).
  1. What period of time would the dataset cover?
  1. What plans are there to make project outcomes available and shared with ResearchOne? Outcomes developed using ResearchOne data must be openly available and listed on the ResearchOne website.
  1. Would you request any support, for example in case definition, analysis, imputation? If so, please define here.
  1. Would you need to contact SystmOne users or patients during the project? If so, how do you plan to make the first contact and collect consent?
  1. If requesting identifiable or pseudonymous data, indicate whether a copy the following are attached.

NRES guidance or approval
NIGB guidance
Section 251 approval
Consent form/s
Information leaflet/s
Other [please specify]
  1. If requesting identifiable or pseudonymous data, for what purpose will it be used?
  1. Give details of any datasets that you will be linking to and the linkage methodology
  1. Who will receive, manipulate or otherwise handle the data (append as necessary)?

Name / Affiliation / Title / Role in the project
  1. Define the location/s in which data will be stored
  1. Until when will the data be held? Note that data is usually approved for up to five years, whereupon a further request may be submitted for extended use.
  1. What are the protection, retention and destruction plans for the data?
  1. What are the funding details for your project?
  1. Contact details for the person to receive the invoice:

Name
Role title
Organisation name
Address
Telephone number
Email address
  1. Indicate whether the following apply and provide details if not.

No attempt will be made to identify any de-identified data
I agree to acknowledge the source of ResearchOne data in all outputs, including papers, presentations and reports
My team has sufficient capability to manipulate and analyse the data received to the level required for the project (indicate whether a statistician has been involved)
No data or metadata will be released to a third party
The data will be used expressly for the project defined in our protocol and this form
Verification of the data destruction will be provided to ResearchOne
If this research is part of a clinical trial, will it be listed on a trials register?
  1. Please answer these questions and provide details as necessary

Will outcomes and definitions be made available under open access?
Will any new algorithms be made available under open source?
Do you have any existing IP rights regarding this work that could not be published under open access?
  1. Indicate acceptance of the following on behalf of your research team:

Data access depends upon signing a confidentiality agreement /

ResearchOne may reference and share any information provided unless otherwise specified (for example in newsletters) /

All results and publications, including the final project report, will be supplied in their entirety to ResearchOne within one week of their publication. /

Date......

Signature......

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