Low & Negligible Risk Governance SSA Application Submission
Site-Specific Assessment (SSA) is a key element of research governance. Once an ethics submission has been made to the reviewing HREC, researchers MUST also submit a Research Governance/SSA Application to WH for Governance review and Site Authorisation before commencing the project even if ethics approval has been given.
Documents are downloadable on the right hand side.
Please note: A Western Health employee should be nominated as a contact person as a principal researcher in ALL projects undertaken at Western Health.
- The nominated Western Health employee should be listed as the Principal Investigator and must:
- Have expertise in a discipline relevant to the project.
- Provide a link between the researchers and Western Health
- Provide local knowledge that can facilitate the conduct of the research.
- Be updated on the progress and status of the project on a regular basis by the external researchers
Incomplete applications will not be accepted and will be returned to the principal investigator and study contact without being reviewed.
Why are we enforcing this instruction?
Receiving a complete application in one package allows that application to be reviewed once, as opposed to multiple times. This promotes efficiency and will allow the Office for Research team to provide a more timely and comprehensive service to all of our researchers and research partners.
Please ensure you are familiar with the WH Standard Operating Procedures - Good Clinical Practice (WH SOP-GCP) for research. The Office for Research may conduct an audit at any time.
LNR Governance Submission Requirements:
- Submit a Cover Letter, signed by the Principal Investigator
- Submit Site Specific Assessment Form
- Complete a LNR SSA/SSA form from Ethics Review Manager (ERM) that is to be generated from the LNR Vic/HREA form.
- Statement of Approval Forms
- Submit all research project documents as submitted and approved by the Reviewing HREC
- Investigator Qualifications - CV, GCP and Honorary Appointments
- Other documents, if applicable:
- Research Collaboration Agreement
- Honorary Researcher Application Form (external researchers only)
- Research Governance Fee
- Submit your Research Governance Application in hardcopy and electronic
Submission requirements in further detail
| | Document | Requirement/Details |
| 1. | Cover Letter | Signed by Principal Investigator |
| 2. | Site Specific Assessment Form | Low & Negligible Risk Projects Complete the LNR SSA/SSA form that is generated from the Ethics Review Manager (ERM). All investigators to sign declaration, Please note: SSAs are generated from the LNR Vic/HREA forms reviewed by the ethics committee. ERM Applicant User Guide - DHHS Note common errors - please ensure these are correct before submitting: Investigator details - Non WH address provided for WH personnel who may have multiple positions at other health services/organisations. Researchers should provide the address the personnel can be found at WH sites.
- Email address – personal email addresses not linked to Western Health or an organisation e.g. Gmail, Hotmail, Yahoo addresses. It is preferred that the WH email address for the WH personnel to be used or an email address that is linked with another organisation.
- Role in Project, researchers have often just stated the position of the research personnel e.g. "Principal Investigator" or "Associate Investigator" which is incorrect. This section requires further clarification regarding their duties within the project for example; Consent, data collection, ethics & governance submissions, interviews, blood collection etc. you may also wish to state the position as well for further clarification.
- CVs and GCP certificates not uploaded onto ERM form
Site Departments - 4.2 All departments listed in this section must also provide a Head of Department/Supporting Department signature.
Supporting documents: - Uploading of all documents relevant to the study
Signatures - Not signed by all research personnel involved at WH site – including Study Coordinators and students
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| 3. | Statement of Approval Forms | Provide Statement of Approval Form for each Western Health department whose services will be required to undertake your research. |
| 4. | Approved documents | Submit all research project documents as submitted to the reviewing Human Research Ethics Committee (HREC) e.g.: - Final approval letter from reviewing HREC
- Final approval letter and acknowledgements from the reviewing HREC. Please ensure that the HREC lists "Western Health" as an approved participating site or any of the following only:
- Please note that if the site involves Joan Kirner Women's & children's Hospital (JKWCH), the approval must state 'Sunshine Hospital' and not JKWCH
- Footscray Hospital
- Williamstown Hospital
- Sunbury Day Hospital
- Drug Health Services
- Hazeldean Transition Care
- Sunshine Radiation Therapy Care
- Bacchus Marsh and Melton Regional Hospital
- Melton Health & Community Services
- Bacchus Marsh Community Health Centre
- Grant Lodge Residential Aged Care
- As applicable: LNR Vic/HREA - non original signed copy
- Victorian Specific Module(VSM) (only required if HREA form completed) - generated on ERM
As applicable: - Master approved Participant Information and Consent Forms (PICF)
- Site specific Participant Information and Consent Forms based on Master approved PICFs
- Site Specific PICFs must include: WH Logo, local governance/site specific version number and date, PI/researchers contact details & WH local governance contacts details for complaints
- Questionnaires/surveys
- Data Collection Forms
- Letters of invitation
- Advertisements
- Etc
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| 5. | Investigator Qualifications | Curriculum Vitae (CV) Researchers involved at WH site are required to provide a CV using the Western Health CV template and sign the declaration that they have read and understood the WH Research Code of Conduct (2018). If researchers do not use the WH CV template, please sign and date their preferred full CV and sign and date the declaration located on the last page of the WH Research Code of Conduct (2018). International Conference on Harmonisation – Good Clinical Practice (GCP) It is mandatory for the Investigators and study coordinators to have completed GCP training. Please provide a certificate of completion; this must be completed within the last 3 years. Honorary Researcher Appointment This is required for any external researchers who may be coming on site and who may have contact with patients, access identifiable data, or using our resources/facilities. Please see Honorary Researcher Appointment process here. |
| 6. | Research Agreements | Research Agreement (Commercial, Investigator-Initiated or Collaborative studies) – see requirements and process here for legal review of endorsement of agreements. Once endorsed, please provide 3 x copies with original wet ink signatures in hardcopy for signing. Please contact Bill Karanatsios for any queries. [email protected]; 03 8395 8073 |
| 7. | Research Governance Fee | Include the applicable fee for research governance/site-specific assessment. Fees are payable upfront at the time of submission of your research governance/site-specific assessment application. Projects will not be reviewed until payment has been made. |
| 8. | Submission | Both Electronic and Hardcopy submissions must be made. See instructions for both below. Electronic Copy:Applicants must submit both the ethics application via Ethics Review Manager (ERM) and email ([email protected]) Mandatory electronic file name convention: To ensure the electronic copies submitted are easily identifiable, the format outlined below must be used for all electronic files. As shown in example below, include version numbers and dates in the file name. Projects submitted with documents that do not follow the below naming convention/format will not be considered and will be returned via email to sender. Convention: [ERM Project ID] [Document Name] [version number] [Date DDMMMYY] E.g. 41234 Protocol v1 01Jan19 CVs, GCP & Codes (where applicable) to be named as: - [First Name][Last Name] WH CV DDMMMYY
- [First Name][Last Name] GCP DDMMMYY
- [First Name][Last Name] WH Code DDMMMYY
See electronic naming convention document (download on right hand side links) for more details. One Hardcopy:By post/drop-off:
Manager
Office for Research
Level 3 Western Health Centre for Health Research & Education – Sunshine Hospital,
Furlong Road, St Albans VIC 3021 Drop-off/after hours:
A drop off box is located in the Ground Level Staircase (right of the elevators) of the Western Health Centre for Health Research & Education Building, Sunshine Hospital, Furlong Road, St Albans VIC 3021.
Please note that this box will be checked once a day. |
