As part of your application we also
require:
-
a statement of support written and signed by the chief executive,
clinical director or equivalent addressing the four bullet points in section six.
The application form is divided into numbered sections:
-
contact and organisational details
-
project details
-
dissemination plan
-
project costs
-
timetable and comments
-
organisational support
Provide contact details for the hospice and
the person responsible for undertaking the proposed work.
2.1 Project
name
(25 words maximum)
2.2 Project
summary
(100 words maximum)
Provide a short summary of your pilot project,
giving brief details of what you are going to do and why. This may be used to
publicise your project if successful, so please be concise and use plain
English to describe your project.
2.3 Project
need
(150 words maximum)
Tell us why there is a need for your pilot project.
For example:
-
How did you identify the issue(s) you wish
to tackle in your area?
-
Who has been involved in the development of
thinking about this proposal?
- Have service users and other stakeholders had
a say in this process?
- Will the pilot project be innovative? Does
it offer a solution to a previously identified local unmet need, rather than
replicate work done elsewhere?
We are looking for specific references and evidence
of need for your proposed work in your area. This could include consultations,
mapping exercises, national strategies or any other research.
2.4 Project
description and purpose
(500 words maximum)
Describe your pilot project. We are
particularly interested in:
-
your main aim and objectives
-
the activities you will undertake to
achieve them
-
how this work will allow people to be cared
for at home for longer, particularly when this is their choice
-
how the proposed work will have a direct
impact on care offered to the targeted beneficiaries.
Please refer to the programme information
and criteria for further details of what applications will be assessed against.
2.5 How
does this work strengthen the provision of hospice care in people’s own homes
and how does it support patient choice?
(150 words maximum)
For example, the proposed work could
involve:
-
making it easier for anyone, whatever their
background or situation, to be cared for at home for longer
-
identifying and reducing barriers to patient
choice.
2.6 Outline
how users or knowledge of their experiences and preferences will be
incorporated in your proposed work and how you propose to ensure such
representation?
(150
words maximum)
Demonstrate clearly how the targeted
beneficiaries are meaningfully involved in the development and implementation
of the proposed work.
2.7 How
will other stakeholders be involved in your proposed work?
(150 words maximum)
We would be interested to know of
partnership working, within your hospice as well as externally, especially
that encourages seamless provision of care for patients, their families and
carers.
Identify the main people involved in the
project, their role and their contribution, as well as the rationale for their
involvement.
If you have them, please send letters of
support from any organisation that you propose a significant partnership with. This
will help strengthen your application.
2.8 Project
outputs
(100 words maximum)
Outputs are the activities that will take
place as a direct result of the proposal that will help achieve the potential
outcomes. They might include:
-
development of a new service or way of
working
-
production of information for patients
and/or health professionals
-
a contribution to a workshop or conference
around learning.
2.9 Project
outcomes
(100 words maximum)
Briefly describe what will be the result of
the project once it has been completed. Identify three outcomes you hope to
achieve from your project and when you plan to achieve them.
Outcomes are the changes or difference that
your project can make in the longer term once it has been completed. They
should be measurable and achievable. For example:
-
the difference your project will make for
the beneficiaries
-
the amount of time it will take to see
those differences
-
the findings of this project will be
reported back to, and inform the development of, the hospice business plan/strategy.
If successful, you will be asked to report
back on how you have progressed on meeting these outcomes so it is best to be
realistic.
2.10 How
will you monitor and evaluate the difference your project has made?
(150 words maximum)
Describe how you will monitor and measure
the effectiveness of your project in achieving your identified outcomes. This
could include activities such as:
-
data gathering to record numbers of users
-
feedback forms
-
observations from staff and volunteers.
2.11 How
will the work be sustained beyond the life of this grant? If it is a time
limited project, explain why.
(150 words maximum)
We are interested to know your initial
thoughts on how the work might continue in the longer term, once the grant
ends.
2.12 Have
you identified any potential risks in the implementation of the proposed work?
If so, what are they and how will they be minimised?
(150 words maximum)
We are keen to ensure the success of your
proposed work, so encourage you to think about any potential risks and how you
would address them. These could include:
-
difficulties reaching and recruiting your
targeted beneficiaries
-
delays in releasing the applicant from
their duties to enable them to undertake the work.
We believe that it is important to share the
outcomes of any funded work with relevant audiences.
The following questions are designed to
find out:
-
how you propose to share any learning
locally as well as nationally
-
who you see as the key audiences.
3.1 Identify
the key audiences who will be interested in the potential outcomes of this work
(100 words maximum)
This could be anyone with an interest in allowing
people to be cared for at home for longer, so could be:
-
patients
-
healthcare managers
-
policy makers
-
anyone working in the field.
We encourage you to think widely about who
might be interested in the work you are undertaking.
3.2 Are
there any local or national strategies that your proposed work relates to?
(100 words maximum)
Tell us how your proposed work is relevant
to current policy and practice and the timeliness of the proposal in relation
to this.
Provide a detailed breakdown of the costs
of the pilot project showing how you determine the total cost. It should be
clearly explained how any items budgeted for, particularly training and
administration costs, are directly related to achieving the project outcomes.
Your application will not be assessed
without a detailed breakdown. You can apply for a pilot project grant of up to
£15,000.
It is expected that the majority of the
grant would go towards implementation costs for the new service. However a
range of different items should be budgeted for and all must be relevant to the
project.
You can apply for a maximum of:
-
£1,000 for course/conference attendance
-
£500 towards conferences to disseminate
work
-
£500 for IT equipment.
If any other funding has been secured to
contribute to the proposed work, please state how much it is and from where.
Hospices’ free reserve levels will be taken
into account when considering applications to the programme if there proves to
be a high level of competition for funding.
For the purpose of this grant programme:
-
free reserves are defined as all reserves
with the exception of endowed or restricted funds and any reserves represented
by property
-
running costs are defined as total
expenditure as per the most recent audited accounts.
-
where the hospice operates one or more
trading subsidiaries, the figures are to be based on the consolidated levels of
reserves and expenditure for the group.
Hospices with a high level of free reserves
should explain why they are applying for a pilot project grant rather than
using their own reserves to fund the work.
Value for money will be taken into account
when assessing applications.
Provide a simple schedule of significant
milestones in your proposed work, indicating what you hope to achieve and by
when. You should also state:
-
proposed start and end dates – projects
should start within three months and finish within 12 months of the date the
grant was awarded
-
whether you will be undertaking the work
full or part time and how much time per week you anticipate spending on your
proposed work.
Please be realistic as this timetable will
enable us to monitor your progress and so better support you in your work.
We reserve the right to withdraw funding 12
months from the award date, so it is important that you keep us up to date with
progress.
Any other comments
There is space for any additional
information not already mentioned in the application form, which will enable us
to fully consider your request for funding.
The lead applicant could need dedicated time
undertake the proposed work and full support from the organisation to execute
necessary change to practice. Therefore, we ask you to state the name
and contact details of the organisational support: the chief
executive, clinical director or equivalent of the hospice.
They also need to write and sign a
statement of support on hospice headed paper, stating:
-
what support will be provided to the
applicant, such as resources, project management support and any arrangements
for mentorship/supervision
-
the name and role of the person who, on
behalf of the organisation, is directly responsible for supporting the
applicant to ensure the success of his/her proposed work
-
the sponsor’s assurance that this work will
make a difference in practice and that the organisation will take
responsibility to review the progress of the project to ensure that change is
effected
-
how the proposed work fits with the
strategic direction and business plan of the organisation.
Submitting your application
The application form can be submitted
online. By submitting the form online, you confirm that you accept all of the
terms and conditions of the grant as indicated in the grant application form.
In addition, send by post or email (scanned copies):
-
a signed statement of support from your
organisation on headed paper
-
signed letters of support from significant partner
organisations (if appropriate)
-
any other supporting information.
Deadline for submitting an application and
supporting documentation is 22 February 2012.
