2015 opportunities for innovations process
Innovation proposal review form
Completion notes
Proposals will initially be reviewed by the relevant Theme Director/Clinical Lead and Head of Programmes
against the criteria listed in section 2. If the proposal sufficiently meets the criteria, it will be forwarded for
review by relevant WMAHSN Advisory and Reference Groups and Spoke Councils. Subject to their
agreement, it will then by reviewed by the WMAHSN’s Calls Panel and a recommendation made to the AHSN
Board.
Please complete section 1 only, ensuring you cover the approval criteria listed in section 2 as far as possible.
You should aim to provide concise descriptions, but may attach additional documentation to support the
proposal.
Section 1 - Programme details
Theme/priority
Programme title
Programme lead name
Contact email
Contact telephone
Address
Programme duration
Proposed start date
Programme description
Please describe the programme briefly (max 30 words)
Programme summary
Please provide a brief description of your proposed innovation and how it addresses customer need, market
and patient problems. Include how you plan to engage key stakeholders at this stage. Please consider
defining the market/patient problem you plan to address, the implications, size, cost of the problem and market
(max 450 words)
What are the planned outcomes?
Please include measurement criteria and intended achievements within the programme’s timescale (max 450
words)
Costs
Please give a breakdown of costs e.g. pay, non-pay, events, including how the expenditure will be profiled
along the contract duration e.g. quarterly breakdown (max 450 words)
Delivery methodology
Please describe the leadership, operational management and delivery of the programme, including quality
assurance, risk management and governance (max 450 words)
Project activities
Please give a short assessment of the project activities and the key risks and issues, and how these will be
overcome. List the key technical deliverables and how they will be met (max 450 words)
How will this benefit the wider West Midlands region?
Please describe how you intend to promote adoption in other organisations or areas (max 450 words)
AHSN funding sought
£
Other funding sought/found
£
Submissions
To take part in the 2015 opportunities for innovations process, please complete this form and return it
info@wmahsn.org. Submissions will be reviewed on receipt and subject to Theme Director and Calls Panel
support, presented to the next available AHSN Board for approval. Proposals can be received or agreed
throughout the year.
Page 2 of 3
Section 2 - Approval criteria
[For completion by WMAHSN personnel]
Confidence
score
Weighted
score
Commentary
Excellent
confidence
4
The proposer has provided a thoroughly comprehensive and very detailed response
to all elements of the questions. They have evidenced a good understanding of the
requirements and demonstrated the capability to deliver against these.
Confidence
3
The proposer has provided a detailed response to all elements of the questions,
evidenced an understanding of the requirements and demonstrated the capability to
deliver against many of these.
Minor
concerns
2
The proposer's response contains minor shortcomings and/or is lacking in detail in a
number of identifiable areas. Capability is not demonstrated in a number of areas.
Concerns
1
The proposer's response either significantly fails to address the question in its
entirety or contains significant shortcomings.
Comment
Funding sought for 2015
Are clear outcomes defined?
Programme defined?
Regional perspective clearly addressed?
Objectives aligned with WMAHSN?
Are the key deliverables clear?
Are outcome measures detailed?
Theme Director/Clinical Lead involved in
agreeing measures?
Spoke, Reference Group and Advisory Group
support?
Patient/carer involvement?
Does it match the original WMAHSN
submission?
AHSN-wide focus, tested with TDs/CLs and
Spoke Chairs?
Submission links to NHSE Outcome
Framework?
Have additional funding/resources been found
/sought?
Scalable and transferable?
Clear return on investment?
Recommend approval?
£
Page 3 of 3
Score/value