Substantive Registration Welcome to the Substantive Registration process - we are delighted that you are looking to join NHSP s Staff Bank as a Substantive Worker. In order to make the process as simple as possible, you will need to do the following: Complete page 3 of this registration form please use capital letters when completing this form. Take the form to your line manager and ask him/her to complete page 5 (line manager details/authorisation) and the assignment codes on page 6. Make an appointment with your local Trust Liaison Co-ordinator do NOT send your paperwork until your documents have been verified by your TLC. Attend appointment with your TLC and bring with you this completed registration form and the following documents: Proof of ID/Right to Work Category What this covers Acceptable documents Notes 1 Proof of Right to Work in the UK Valid or Expired UK/EEA passport Valid or Expired EEA identity card Valid Passport (non EEA) and valid visa OR Valid UK Biometric Residence Permit Your visa must be in a Valid Passport (Unless leave was granted as a family member of an EEA National or EEA derivative) This includes holders of Indefinite Leave to Remain If you have a student visa, you need to provide two documents from your school, college or university: A letter confirming that you are a student and details of the course you are attending; and A copy of your term dates, so that we can confirm your study periods. 2 Change of name, if applicable; bring all that are relevant A full birth/adoption certificate issued in the UK or Channel Islands along with a document from a government agency or previous employer which includes your name and NI number (this could be your Trust payslip). Marriage/Civil Partnership certificate Proof of divorce/civil Partnership dissolution Adoption certificate Deed poll Additional Documents 3 Trust Payslip Dated within the last 3 months with a photocopy showing all 4 corners of the payslip 4 NMC PIN (if applicable) If you have a Tier 2 visa you will need to provide a copy of your statement of Certificate Of Sponsorship. You can get this from your sponsor. A full birth certificate contains details of at least one your parents These documents need to be produced if your name is not the same on all of the other documents 0761_A_03.16 Failure to provide your TLC with the above documents will prevent your application from being processed. 1 0761_A_02.16 SUB REG FORM N&M.indd 1 04/05/2016 14:22:21
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Substantive Registration / Appointment Form Personal Details - to be completed by the applicant (using CAPITAL LETTERS) Title: First Name: Surname: Contracted Trust: Location: Ward: Present Post: Start Date: Fixed Term Contracts only: what is your contract end date? Date of Birth: Male r Female r E-mail: Home Telephone Number: Mobile Number: Address: Post Code: NI Number: Nationality: Are you an authorised Trust User for NHSP? (do you have access to NHSP:Online to request shifts and/or authorise timesheets?) Yes r No r If yes, what is your user name? Bank Details Bank/Building Society: Branch: Account Holder s Name: Roll Number: Account Number: Sort Code: Emergency Contact Details Name: Relationship: Telephone Home: Telephone Mobile: Declaration I declare that the information provided on this form is correct and that I will advise NHS Professionals of any changes in writing. I consent to the disclosure of the information from this form between NHS Professionals and NHS Shared Business Services for HR and Payroll purposes. I understand that the details on this form will not become valid until I have successfully completed the registration process. Signed: Date: If your status changes for any of the following reasons you MUST advise us immediately in writing: Leave contracted post Change in contracted hours Change of name, address, telephone numbers If you should need to contact us by telephone, please call our Service Centre on 03332 407552. FOR COMPLETION BY RECRUITMENT Job Title Flexible Worker Enclosed: Staff Role Assignment Code(s) Recruitment Process Completed by Date Form P45 Form P46 Form P38S SD502 FOR COMPLETION BY SBS PAYROLL Input onto ESR by Date 3 0761_A_02.16 SUB REG FORM N&M.indd 3 04/05/2016 14:22:21
Substantive Registration / NHSP Verification Check List to be completed by NHSP Representative Name of Substantive Employee: Trust: NI Number: r Proof of ID/Right to Work + Colour Photocopy r Trust Payslip dated within the last 3 months + photocopy showing all 4 corners of the payslip r Assignment Code Form signed by Line Manager. Review codes with applicant and refer to Line Manager if necessary r Registration/Appointment Form fully completed, bank details confirmed and signed by applicant r Signed copy of the Flexible Worker Registration document name, address, signature and date completed on front page r P46 r NMC PIN if applicable PIN: Expiry Date: r Given to FW full copy of FW Registration Document; Code of Behaviour; Orientation Schedule NHSP Verification Name: Position: Signature: Date: If you have any questions relating to any of the above, please call the Substantive Registration Team on 01923-699929 4 0761_A_02.16 SUB REG FORM N&M.indd 4 04/05/2016 14:22:21
Substantive Registration /Manager s Authorisation Manager Details to be completed by Ward/Line Manager Manager s Name: Job Title: Ward: Trust: Contact Telephone Number: E-Mail Address: Name of Substantive Employee: Employee s contracted hours: I can confirm that the person named above has an NHS contract with the Trust and that all pre-employment checks were completed in line with NHS Employment Check Standards at the point of employment. I can confirm that the assignment codes selected over are correct. Signature: Date: Please see over the page to select the assignment codes 5 0761_A_02.16 SUB REG FORM N&M.indd 5 04/05/2016 14:22:21
Substantive Registration / Coding Form to be completed by Line Manager Please select the assignment type/s from Box 1 and then all appropriate codes in Box 2, including General Acute (00) if the Substantive Worker has the relevant experience/qualifications. Substantive Employee Name: Line Manager Name: Line Manager Position: Line Manager Signature: Box 1: Assignment Type Assignment Type Code Assignment Type Code Assignment Type Code Care Support Worker CSW Health Visitor HV RN Preceptorship RNP Care Support Worker Higher CSWH Midwife Team Manager MTM Nurse Consultant NC Community Psychiatric Nurse CPN Nurse Associate Practitioner ASP Nurse Modern Matron NMM Dental Nurse Entry Level DNE Nurse Practitioner NP Nurse Team Leader NTL Dental Nurse DN Registered Midwife RM Nurse Team Manager NTM Dental Nurse Team Leader DNTL Registered Nurse RN Nursery Nurse NN District Nurse DIN RM Preceptorship RMP Box 2: Area of work ACUTE Area of work Code Area of work Code Area of work Code Accident & Emergency 04 Intensive Care 08 Paediatric Respiratory 69 Cardiology 13 Maternity 66 Paediatrics 60 Coronary Care 05 Neonates 62 Palliative Care Medicine 15 Day Surgery 43 Neurology 23 Rehabilitation 98 Endoscopy 16 Neurosurgery 48 Renal Medicine & Dialysis 29 ENT 44 Oncology 24 Resuscitation 21 Family Planning 68 Ophthalmology 49 Sexual Health 95 General Acute 00 Outpatients 94 Theatre Anaesthetics 40 General Anaesthetics 40 Paediatric A&E 63 Theatre Circulator 57 General Obstetrics and Gynaecology 45 Paediatric ICU 61 Theatre Recovery 52 Genito-Urinary Medicine 19 Paediatric ITU Transport 64 Theatre Scrub 55 Geriatric Medicine & Elderly Care 17 Paediatric Oncology 65 Theatres General 59 High Dependency Unit 07 Paediatric Oncology 65 Trauma & Orthopaedic Surgery 54 Infection Control 36 Paediatric Orthopaedics 67 Urology 56 COMMUNITY General 102 Child Health (Community) 100 Prisons 131 Schools 111 MENTAL HEALTH General 03 Adult Mother & Baby 71 Adult Acute 70 Child & Adolescent 73 Forensic 76 Forensic Secure Unit 78 Forensic Child & Adolescent 75 Learning Disabilities 77 Old Age 79 Substance Misuse 74 Community Mental Health 120 If you are unable to identify the required assignment code, please contact your local Trust Liaison Co-ordinator 6 0761_A_02.16 SUB REG FORM N&M.indd 6 04/05/2016 14:22:21
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