Innovation and Improvement in Health and Care Second Stage Application Form

2025 Innovation and Improvement in Health and Care Fund - Second-Stage Application

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INFORMATION AND GUIDELINES FOR APPLICANTS

1. Before completing the second-stage application, applicants should fully read the Trust's guidance to ensure both the project and organisation meet the criteria.

2. This form will be available until the deadline on Friday, 28 February 2025 at 17:00. We will not be able to accept late submissions due to technical errors.

3. This form is designed for use as the second-stage application where applicants will be shortlisted to the third and final stage. Shortlisted applications will be asked to provide a fully detailed final application, which will be presented to the Board of Trustees for a decision at its meeting in the autumn.

4. Please note, this form can be saved by clicking the "Save & Return" box above.

5. Applicants should contact the Trust, should they have any further questions:

Tel: 0207 487 5851

Email: [email protected]

Please tick here to confirm you have read and agree to the linked guidelines in order to access the Second-Stage Application Form:

I agree

Section 1 - Organisation Details

It is recommended that you save your application before starting so that you can return to it if necessary. Please check the box above to register an email address and password, and remember to save your form if you do not yet wish to submit it.

Application Reference

The Application Reference was provided in the email inviting you to apply for the second stage of the Fund. Please enter it exactly as received. Any other information entered in this field will delay the processing of your application and could result it in being rejected.

Organisation Name (as per your registration with your governing body)

Registered Charity Number (if applicable)

Company Number (if applicable)

Website

Link to your organisation's most recent Annual Report & Accounts

Section 2 - Application Contact

Please provide details of the person who should be contacted about this application.

Title

First Name

Surname

Job Title

Email Address

Section 3 - Organisation Objectives & Public Benefit

A. Describe briefly the work of the applicant charity/organisation and the public benefit you provide. (500 words maximum)

Section 4 - Your Appeal

A. Please provide the title of the project for which you are requesting support. (25 words maximum)

B. Please provide a summary of the project. (50 words maximum)

C. Please provide a concise overview of the project for which you are seeking financial support. This overview should explain how any funding from the Trust will be used to develop a new model of health and care or support the integration of health and care services. Your overview should explain how the project addresses an area of unmet need, comment on the track record of the applicant organisation and any partners, and how the proposal relates to the organisation's wider strategy. (750 words maximum)

D. Please provide a summary of the evidence underpinning your application. This could include evidence of the unmet need your project aims to address, the size of any pilot study completed to show that the model is effective; the outcomes of any pilot study, or, evidence that a similar model has been implemented successfully in other locations or by comparable organisations. (250 words maximum)

E. What are the anticipated outcomes of the project and how will these be disseminated? (250 words maximum)

F. Explain how your project is an innovation for your organisation and sector, and how it differs from your organisation's existing provision or similar models currently in use elsewhere. (250 words maximum)

G. The cost of your project:

i. What is the total cost of the project?

Please enter numbers only - do not include commas or £ signs.

ii. How much are you requesting from Sir Jules Thorn Trust?

Please enter numbers only - do not include commas or £ signs.

iii. How much are you contributing from your funds?

Please enter numbers only - do not include commas or £ signs.

iv. How much have you raised so far from external sources, not including your own contribution?

Please enter numbers only - do not include commas or £ signs.

v. How do you plan to bridge any shortfall, and what are the key risks in your fundraising plan? (150 words maximum)

vi. Source of funds already secured, excluding your own contribution (100 words maximum):

vii. Applications pending (100 words maximum):

vii. Please comment on your organisation's current level of free reserves and its relationship to your Trustee's policy. The Trust defines free reserves as unrestricted reserves less fixed assets. Unrestricted reserves include all designated funds, regardless of purpose. (100 words maximum)

Please note:

A project budget should be attached as an Excel and using the Trust's template.
Awards are made at the discretion of the Trust and may be for less than the amount applied for.

Budget in support of the project. This should be the Trust's budget template, which is available on our website. Budgets in any other format will result in the application being rejected. (PDF file format)

I can confirm that the attached budget is in the Sir Jules Thorn Trust Budget Template.

Yes

Section 5 - Timescales

Please explain the anticipated start date for the project and how long it will take to complete (250 words maximum):

Section 6- Address Details

Organisation Address

Postcode

Section 7 - Consent Statements

To deal with your application/award Sir Jules Thorn Charitable Trust needs to collect, use and store some of your Personal Data; so before we can help you we need you to tick this box to say that you/and or the Principal Applicant have read, understood and consent to the terms of our Privacy Policy.

I agree

As we assess your application and manage your award we may need to ask some questions, so we need you to tick these boxes to say that you consent to us contacting you as set out in our Privacy Policy by:

Post

I agree

Telephone

I agree

We collect your personal information through our website, so we need you to tick this box to say that you have read, understood and consent to our Website Terms of Use.

I agree

Because you are asking for, or using a grant from the Trust we need you to tick this box to say that you have read, understood and consent to our General Grant Terms and Conditions.

I agree

To prevent spam responses, what is 4+2?

Please note that you may withdraw your consent at any time by contacting the Trust.

Sir Jules Thorn Charitable Trust is a Charity registered in England and Wales, number 233838

Our registered address is 24 Manchester Square, London, W1U 3TH

We can be contacted by:

Telephone on 0207 487 5851,

E-mail at [email protected],

Or through our website at www.julesthorntrust.org.uk

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