Data Access Request Application
Please complete the following pages with as much information as possible to ensure a smooth approval process. You will be asked to provide information relating to:
- Is this is a research or clinical based request for accessing patient data?
- Are there any external or internal approvals you have obtained?
- Is it just your organisation that will have access to the data, or will other organisations need access?
- Are you seeking in principle approval (before grant funding and other approvals are in place) or full approval?
- Will you analyse our data in our Secure Data Environment, or request to analyse the data elsewhere?
Our charges to access patient data and to use the Secure Data Environment will be made in accordance with NHS England’s guidelines and our own policies. The final data access agreement will include agreed details as to how any value derived from our patient data will be distributed between all parties.
Information provided in your application (i.e., lead applicant's name and organisational details, type of study and lay summary), will be made publicly available on our website following a successful application so we can keep the local community informed as to how the health data collected within the hospital has been used. Other information in your application will be made confidentially available to the Data Access Committee to undertake their review.
By completing this form you are accepting these conditions. You may stop and continue completing the form, or return and review the form, at any point. If you are unable to access the application form online, please contact us to discuss alternative submission mechanisms.