Market-Led Proposal - Online form

Section A - Organisation information

Entity name

Business name

Business address

Business phone number

A1 - Key contact person 1

This is the person that will manage and coordinate the project.

Name

Position in business

Phone

A2 - Key contact person 2

This is the person that will manage and coordinate the project.

Name

Position in business

Phone

A3 - Key contact person 3

This person is authorized to sign the contract.

Name

Position in business

Phone

Section B - Market-Led Proposal overview

Title of proposal

Summary of proposal (500 words Max)

Funding requested (Ex-GST)

Proposed start date

Proposed end date

Section C - Assessment criteria

1. Strategic alignment - 20 %

Word Limit (1000 words)

Provider to address the following questions with evidence (provide links):

Does the proposal align with PHN objectives and the Commonwealth Funding Agreement?
Does it address identified gaps in the PHN Needs Assessment?
Does it support priority populations (e.g., Aboriginal and Torres Strait Islander health)?
Does it promote service integration and continuity of care?

Providers may access the Health Needs Assessment and COORDINARE’s Strategic Directions to address the above criteria.

2. Uniqueness and innovation – 30%

Word limit 1000 words

Provider to address the following questions with evidence:

Is the proposal genuinely unique or innovative compared to existing services or market offerings?
Does it introduce new models, technology, or approaches that improve health outcomes?
Does the provider have unique ability to deliver the activity and achieve outcomes to justify COORDINARE departing from the Competitive process?

3. Proposed approach for activity – 15 %

Word limit 1000 words

Refer to the following prompts when writing your response:

Provider to provide a Gannt chart as part of evidence.
Describe your proposed delivery model and methodology.
Explain how your approach aligns with COORDINARE’S strategic priorities.
Outline key steps, timelines, and milestones.
Provide evidence or rationale supporting the effectiveness of your approach.

4. Outcomes, monitoring and evaluation – 15%

Word limit 1000 words

Refer to the following prompts when writing your response:

List expected short-term and long-term outcomes. Please refer to COORDINARE health needs assessment.
Explain how outcomes align with COORDIANRE’s strategic objectives.
Detail monitoring indicators, frequency, and responsible parties.
Describe your evaluation framework and continuous improvement plan.

5. Risk and compliance – 15%

Word limit 1000 words

Providers must provision a risk management plan clearly identifying potential risks associated with their proposal and outline strategies to mitigate them. This includes:

Financial, operational, reputational, and clinical risks.
Probity and conflict-of-interest considerations.
Contingency plans to ensure service continuity if risks materialize.
Providers should demonstrate a proactive approach to risk management by including a risk register and mitigation plan as part of their submission.

6. Value for money – 5 %

Word limit 500 words

Refer to the following prompts when writing your response:

Provide a detailed cost breakdown.
Explain how the proposal represents value for money.
Identify measurable benefits (health outcomes, efficiencies, cost savings).
Outline opportunities for co-investment or alternative funding sources.
Demonstrate sustainability and avoidance of duplication.

Section D - Compliance

D1 - Referee 1

Name

Position

Organisation

Phone number

D2 - Referee 2

Name

Position

Organisation

Phone number

Section E - Declaration

The following section must be completed by an authorised representative of the organisation submitting the application:

I declare that the organisation is able to implement the project within the proposed time frame.

I can confirm that the contents of this application are to the best of my knowledge accurate, complete and do not contain any false, misleading or deceptive misrepresentation, claims or statements.

I declare that the organisation is financially viable and able to manage the funding within the proposed timeframe and within proposed budget.

I understand and accept that information provided in this proposal may be stored by COORDINARE – South Eastern NSW PHN in various hardcopy and/or electronic formats.

I understand that this proposal does not create a legal or binding commitment and that if successful I will be bound by a contract with COORDINARE - South Eastern NSW PHN.

I understand that I am required to have current and adequate insurances in place.

If this proposal is successful, I agree to provide reports in the specified format to COORDINARE – South Eastern NSW PHN on activity processes and outcomes.

I understand that if the conditions of the funding are not complied with, COORDINARE – South Eastern NSW PHN may seek to recover any funds allocated.

Applicant signature

Authorised Representative's full name

Position of Authorised Representative

Date