Request For Charitable Expenditure | Bucks Hospitals Charity

"(Required)" indicates required fields

Lead contact

Name(Required)

First Last

Job title(Required)

Where you are based(Required)

Area(Required)

Enter your ward / team / department / service / division / care group

Contact number(Required)

Including extension if relevant

Email(Required)

Your work email address

Bid details

Bid title(Required)

Summarise your request with a title, what are you looking to buy and where will it be used?

Business Case Number

If you’re asking for more than £5,000 you must include a business case number.
Available from QI Transformation: bht.qiandtransformation@nhs.net.
If you already have a completed business case, please provide summary information, then attach it at the end of this form.

Funding request details

A full list of funds can be found on CAKE.
For fund manager(s) approval, please supply a signature, or electronic approval by attaching a copy of an e-mail at the end of this form.
If you have specific funding, please detail below
Procurement advice should be sought for any purchase over £20,000.

Fund number(Required)

Fund name(Required)

Fund Manager(s) approval or source of funding(Required)

Amount requested (including VAT)(Required)

Further bid details

If this request is for medical equipment, has it been presented to the Medical Equipment Panel? (Optional)

All medical equipment purchases over £5,000 must be approved by the Medical Equipment Panel. Please note that a VAT zero-rating certificate may be required.

Yes

Is this a request for colleague training? (Optional)

If you’ve already been in contact with the Education, Learning and Development Department (ELD), please attach copies of this correspondence at the end of this form.

Yes

What item(s) are you asking us to fund and for what purpose?(Required)

Please give as much information as possible so that we can determine whether your request is eligible for support. Please provide details of the supplier, and attach a quote at the end of the form if you have one. Include make and model if applicable.

Why is this expenditure required?(Required)

Please provide details of how the need has been identified and who this has been discussed with. If approval has been given by your division, IT, Procurement or Estates, please attach details at the end of this form.

If this is a pilot project, please define how you will measure the success of the project.

Why is this a charitable request?(Required)

Our charitable funds support expenditure which is usually additional to what the NHS can provide. Please explain how this might apply to your request. All requests for support must offer value for money.

Ongoing costs(Required)

Please let us know if there will be ongoing costs, such as maintenance costs, and what they are. The charity is not able to provide ongoing support, please indicate which budget will cover any ongoing costs.