The application pre-populates certain fields later in the form using the information in this section.

If you require any of the prefilled data to be modifiled please change it in the Personal Details section here.

Bank Partners will require you to be appraised at least annually by a senior practitioner of the same discipline who is entered on the NMC/HCPC/GMC/GPHC/GDC etc.

The appraiser must be appropriately trained to complete an appraisal.

The appraisal should be completed inline with the Approved NHS Appraisal System, which includes 360 Feedback (NHS Work).

You should maintain a written portfolio of your professional experience and attendance at professional development courses, which should also include a written and agreed Personal Development Plan as agreed at your appraisals.

Data Protection

Bank Partners are processing your data on behalf of Barking, Havering and Redbridge University Trust. You confirm that by submitting your personal data that you have read and understood Barking, Havering and Redbridge University Trust privacy notice.

We’ll occasionally send you information about our exclusive promotions. We’d hate for you to miss out, but if you’d rather not receive this information, you can opt-out by emailing: click here.

You can find more information about managing your marketing preferences here:

Please note that job opportunities, legal and service updates relating to you working with us are not direct marketing and cannot not be opted out of.

Criminal Records.

Please note that under new filtering rules - certain offenses may be removed from your criminal record after 11 years (5.5 years if you were under the age of 18) Cautions will be removed after 6 years (2 years if you were under the age of 18); providing that this was your only offence and did not result in a custodial sentence. Serious offences will never be filtered. If you are unsure of whether your conviction/caution/reprimand is filtered, please see the DBS website for more information before signing the declaration. If you do not declare a conviction/caution/reprimand that later appears on your DBS this could result in dismissal or non-employment. Please tick:

1. I understand that if I am charged or cautioned after signing this declaration, I must inform Bank Partners.

3. I acknowledge that I will be given a copy of the Terms and Conditions of Service issued by Bank Partners on behalf of Barking, Havering and Redbridge University Hospitals NHS Trust, at the end of the registration process, which is mine to keep and to abide by.

4. I am not aware of any condition, medical or otherwise, which would affect or limit my employment or performance, other than those declared in my Occupational Health Questionnaire.

5. I declare that the information given herein is true and complete and is not presented in a way intended to mislead. I agree that if I have given false or misleading information or omit to give relevant information now or in the future, that Bank Partners may cease to offer me further agency placements without notice, as well as a claim for recovery of any payments I have received, together with a claim for a loss of profit to Bank Partners.

6. I acknowledge and confirm that Bank Partners is authorised to apply for and obtain a Disclosure and Barring Service Check (including the online status update service check if app) and references from any previous employers and educational establishments.

7. I acknowledge that my personal details will be stored and handled correctly by Bank Partners in accordance with the Data Protection Act 2018 however, I agree that they may be made available for audit/review by relevant parties. (This is relevant for all information including all documents – DBS, Occupational Health, References).

8. I understand that if I am on a student visa, I can only work for 20 hours per week during term time. I understand that I have a responsibility to monitor this. In addition, if my position as a student changes, I must inform Bank Partners

9. I understand that if I am on a Tier 2 Sponsorship Visa, I can only work for a maximum of 20 hours per week at the same professional level as my sponsorship. I understand that I have a responsibility to monitor this. In addition, if my position with my sponsored company changes, I must inform Bank Partners.

10. I acknowledge that if any of my details stated on this Application Form change, or my circumstances change, which may affect my ability to work for, I must inform Bank Partners immediately.

11. I confirm that I am not currently under investigation, or currently suspended, by my professional regulatory body (e.g. NMC/HCPC) or being investigated by my current or previous employer. I will inform Bank Partners if I am under investigation or suspended by my professional regulatory body or employer at any point whilst working for Bank Partners.

12. I give my permission for Bank Partners to run a Right to Work check with the Home Office if I provide them a Biometric Residence Card for my Right to work in the UK.

If you require any of the prefilled data to be modifiled please change it on the Personal Details section on the first page.

Important information regarding the NHS Pension scheme.  

You will automatically be entered into the NHS Pension Scheme upon commencement of employment. Should you wish to opt out, you must confirm that you are fully aware of the implications of opting out and have reviewed these using the online calculator available on the NHS Pensions website via the following link  https://www.nhsbsa.nhs.uk/member-hub.  The website will also provide you with information regarding future potential pension contributions. If you still wish to opt out you will need to complete and return the SD502 opt out form.

 

Please note under pension auto enrolment rules, anyone who opts out or stops making payments will be automatically enrolled back into a pension scheme at a later date (usually every three years). This is because your circumstances may have changed and it may be the right time for you to start saving. We will contact you when this happens, and you can opt out if it’s still not right for you.

 

Please note that you may not be eligible to join the NHS Pension Scheme and you may be automatically be enrolled in to NEST instead.  NEST is our alternative workplace pension scheme.  An example of someone that would not be eligible for enrolment into NHS Pensions is where they are already in receipt of their NHS Pension. Further information on auto enrolment can be found via the following link  http://www.nestpensions.org.uk/ 

I declare that I have completed and checked the information above and it is to the best of my belief correct. I hereby authorise you to deduct from my salary/wage or Training Allowance, any amounts which shall be due from me.

IMPORTANT
The Data Protection Act 1998 requires us to advise you that we will be processing your personal data. Processing includes: holding, obtaining, recording, using, sharing and deleting information. The Data Protection Act 1998 defines ‘sensitive personal data’ as racial or ethnic origin, political opinions, religious or other beliefs, trade union membership, physical or mental health, sexual life, criminal offences, criminal convictions, criminal proceedings, disposal or sentence.

Where you are applying for a position which involves regulated activity, this will also include any barring decisions made by the Disclosure and Barring Service (DBS) against the Children’s or Adults barred lists under the terms of the Safeguarding Vulnerable Groups Act 2006 (as amended by the Protection of Freedom's Act 2012).

The information that you provide in this declaration form will be processed in accordance with the Data Protection Act 1998. It will be used for the purpose of determining your application for this position. It will also be used for purposes of enquiries in relation to the prevention and detection of fraud.

Once a decision has been made concerning your appointment, Bank Partners will not retain this declaration form any longer than necessary [see further details in ‘Guidance Notes for Applicants’ which was provided with your application form. This declaration will be kept securely and in confidence.  Access to this information will be restricted to designated persons within the organisation who are authorised to view it as a necessary part of their work.

In signing the declaration on this form, you are explicitly consenting for the data you provide to be processed in the manner described above.

 

I have read the ‘Guidance Notes for Applicants’ that accompanied my application form, and I consent to the information provided in this declaration form being used by Bank Partners for the purpose of assessing my application, and for enquiries in relation to the prevention and detection of fraud.

I confirm that the information that I have provided in this declaration form is correct and complete. I understand and accept that if I knowingly withhold information, or provide false or misleading information, this may result in my application being rejected, or if I am appointed, in my dismissal, and I may be liable to prosecution.

Please sign and date this form.

I confirm I will inform my payroll team if my employment position with other NHS organisations changes.