Health Enterprise East
Innovation Awards
2017
Entry Form
Entry Form
Deadline: All entries must reach the inbox below by 5:00pm, Friday 14th July 2017
** No late entries will be accepted into the competition **
Please complete all sections of the form and return via e-mail, along with any accompanying material in electronic
format to [email protected]
Please refer to the Innovation Awards categories and additional guidance detail on the Health Enterprise East website
(www.hee.co.uk)and read the essential information for entrants below.
Note: If your innovation entry relates to a new medical technology, software/ICT or diabetes application please do not disclose it
to other external parties as it may be possible to seek formal protection for the idea. If you would like advice in this area you can
direct your enquiry to Health Enterprise East via the same e-mail above who will deal with your enquiry in confidence.
Essential information for all entrants
By submitting your entry you agree that you have read and accepted the following Innovation Awards terms and
conditions:
1.
Closing date for all entries is 5:00pm, Friday 14th July 2017. Entry forms received in the [email protected]
inbox after this time will not be accepted for judging.
2.
Only supporting materials contained in the three identified pages at the end of this entry form will be taken into
consideration by the judging panel.
3.
Shortlisted entrants will be informed by early August. Please ensure a valid telephone number that we can
contact you on is provided on your application form.
4.
All shortlisted entrants will be invited to the Innovation Awards Dinner which will be held on the evening of the
20th September at Sturmer Hall for an evening of celebration and where the winners will be announced.
5.
You agree to Health Enterprise East (HEE) publishing non-confidential details about your innovation in
publications and website pages associated with the HEE Innovation Awards 2017.
6.
Health Enterprise East reserve the right to review all entries with a view to identifying any suitable ideas for
further review and potential development. Where an appropriate entry is identified the principal contact/lead
innovator will be contacted by a member of the HEE team to discuss further. Further support and development
is not implied by your entry being accepted into the Innovation Awards.
7.
Winner(s) of the Diabetes category, sponsored by Roche Diabetes Care Limited will receive a educational grant
for the further development of their innovative idea.
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OFFICE USE ONLY:
Official Use only
Date received:
Entry number:
Title:
Category (circle):
/
/
/
/
Team Details:
Principal Contact /
Lead Innovator
Name:
Job Title:
Department:
Address:
Telephone:
Mobile:
E-mail:
Employing NHS
Organisation/or SME
Team Members (if any)
Name(s) & Job Title(s) & NHS Trust(s) (if different to Lead Innovator’s):
The following information will be used by the judging panel to assess your idea. All information will be treated in
confidence and the judging panel will be bound by a confidentiality agreement.
1. Which category does
your idea fit into (choose
only one):
Tick box
1. Medical Technology
2. Service Improvement
Please refer to category
descriptions
3. Innovation in Primary Care
4. Small and Medium‐sized Enterprises (SME's) Innovation
5. Diabetes – Positive Impacts on People’s Lives
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2. Short Title of your
Innovation (max 20
words):
3. Please summarise
your innovation (50 –
100 words):
4. What was the
inspiration for your
idea?
Please describe the
unmet need it fills.
(150 - 200 words)
In your answer please
demonstrate:
What are the
consequences of not
meeting this need? How
high a priority is it?
5. Please explain your
innovation in more
detail
Additional supporting
information such as
drawings, tables, charts
etc can be included in the
pages at the end of this
entry form.
Please note:
ONLY detail in the three
pages indicated will be
forwarded to the judging
panel.
6. What is the status of
your innovation? i.e
concept stage, working
prototype, pilot, product
or service in use?
(max 100 - 200 words)
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7. What features of your
innovation are believed
to be new?
What is the unique
element of your
innovation?
8. What impact has this
innovation had / is likely
to have?
What are the potential
benefits?
(200 - 300 words)
For example how might it
benefit patients? Are
there potential cost
savings?
Do you have any
evidence of the impact?
Any plans for evaluation?
9. Are there any
particular factors or
conditions required for
your innovation to be
implemented / used?
(150 – 200 words)
10. Have clinicians /
patients/ users / carers
been involved in
developing /
implementing this
innovation? If so, how
and why?
(100 words)
11. Has anyone from
outside your
Trust/Company been
involved in developing/
implementing this
innovation?
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12. Would this
innovation be attractive
to other organisations /
healthcare professionals
to adopt and use? If so,
why?
(150 - 250 words)
Have any other
organisations expressed
an interest in using your
innovation already?
Does it align with any
CQUIN schemes for
example?
13. If your innovation
were to win first prize,
how would the prize
money be used to
further this innovation?
What do you see as the
next steps in
development, promotion
for adoption and
diffusion etc that the
prize money could be
used for?
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Q5. Supporting Information – maximum 3 pages of A4 (anything over this limit will not be forwarded to the judges)
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