Modern Apprenticeship Programme 2017 Apprentice Painter & Decorator Job Ref: PTB204

Modern Apprenticeship Programme 2017 Apprentice Painter & Decorator Job Ref: PTB204 Please apply using the application form link embedded below BY EMAIL to the Resourcing Team. Please include the names and addresses of two referees, including your present or most recent employer. Your application can be e-mailed to recruitment@borders.scot.nhs.uk. Please phone the Resourcing Team on 01896 826165 for assistance and to confirm safe receipt. Alternatively send by First Class Post to the address detailed below:- Resourcing Team 1 st Floor Primary Services Block Borders General Hospital Melrose, TD6 9BS Link to application form Closing date: 5pm on Tuesday 12 December 2017 Visit our website: www.nhsborders.scot.nhs.uk Find us on Facebook at www. facebook.com/nhsborders Follow us on Twitter @NHSBorders

Contents Advert 3 Person Specification 4 About the Modern Apprenticeship Programme 5 The Selection Process 8 Job Description 9 Terms and Conditions of Employment 14 Guidance for completing the NHS Borders Application Form 16 Application Form 20 2

NHS Borders Modern Apprenticeship Painter & Decorator Permanent, 37½ hrs per week Agenda for Change Band 4 (Section 21) 16,523 per annum Ref: PTB204 An opportunity has arisen for a Painter & Decorator Modern Apprentice which will allow the successful applicant to gain skills and experience to provide a painting and decorating service and also to work towards a recognised vocational qualification at the same time. Applicants should have some practical aptitude or experience of painting and decorating and have the ability to understand and follow procedures and policies. Team working and flexibility in approach to work are important components of this post. Modern Apprenticeship posts are open only to those applicants aged between 16 and 24 years therefore we are unable to accept applications which do not meet this age criteria. Informal enquiries to Ross Hope, Estates Officer on 01896826363 To apply for this post please complete the application form which is included at page 20 of this job pack or by downloading the application form from the following link: application form Closing date: 5pm on Tuesday 12 December 2017 3

PERSON SPECIFICATION For the post of Apprentice Painter Below are the essential knowledge, training (including qualifications) and experience required to do this job. ESSENTIAL 1 Some practical aptitude or experience (Trade Based) 2 A willingness to attend college as required over the term of the apprenticeship. 3 The ability to study and gain qualifications up to SVQ level 3 in Painting and Decorating. 4 Possess some technical knowledge /experience to avoid any danger that maybe presented by the work undertaken. 5 Be familiar with the type of systems and equipment within patient care areas, which must be protected and /or removed during decoration works. 6 Possess a current UK driving licence or be willing to obtain one. 7 Be willing to learn and carry out work in conjunction with the policies, practices and procedures associated with the post. 4

The Modern Apprenticeship programme The current vacancy for a Painter and Decorator Modern Apprentice within NHS Borders is open only to those applicants aged 16-24 years therefore we are unable to accept applications which do not meet this age criteria. On completion of the MA programme you will achieve an SVQ3 in Painting and Decorating Applications are considered on a competitive basis which means not all candidates who submit an application will be guaranteed an interview. Shortlisting will include meeting the minimum educational qualifications for application along with evaluation of part C of the application form. Only complete applications will be considered. It is therefore important that you complete every section of the application form. You should ideally complete your application electronically and submit via email to recruitment@borders.scot.nhs.uk. (In the event you are unable to complete an electronic application then please refer to page 19 of this Information Pack for guidance on postal applications.) 5

What is a Modern Apprenticeship? Modern Apprenticeships (MAs) offer the opportunity of gaining skills and qualifications that will help to start your career. An MA has the chance to be in paid employment and work towards a recognised vocational qualification at the same time. How long will it last? If successful in your application to NHS Borders, you will be employed on a permanent contract. During your apprenticeship you will attend regular reviews to discuss your progress and development needs and you are expected to complete the agreed training plan. This includes attending internal and external training and taking responsibility, with support, to collect the evidence required that proves your competence in the job role. Will I be working to a Job Description? Yes. You will work towards a job description (see page 9) with the expectation that you will be supported and trained to carry out all the duties and responsibilities outlined. You would not be expected to perform at the full level of the job on appointment. You will also receive an outline of the Apprenticeship Programme which highlights the key areas which you are expected to complete before your apprenticeship will end. Where will I be working? Whilst your base will be within the Estates Department at Borders General Hospital, you will be required to work within all areas of NHS Borders. How long will the programme run for? This apprenticeship post will last for 4 years. During this apprenticeship you will: Complete NHS Borders Induction and Mandatory Training Complete role specific induction Complete the Core Skills Level 3 qualification and any enhancements outlined in the Level 3 Modern Apprenticeship Framework Adhere to NHS Borders Policies & Procedures. A MA in NHS Borders is about working and learning together. During this period you are expected to work as a member of our staff but also work towards an SVQ Level 3 qualification in Painting and Decorating As well as working you will work to a training / development plan and attend meetings with trainers, assessors and verifiers as required. Engagement with this workplace SVQ process and satisfactory course progression is a mandatory requirement of the Apprenticeship programme. You will be an employee of NHS Borders and therefore also expected to observe the same Terms and Conditions of employment and be subject to the same policies and procedures as all other staff. 6

Will I be paid? Yes. This Modern Apprenticeship will pay you a minimum of 60% of the maximum annual salary for the role and in line with the Scottish Living Wage. This calculation is based on an NHS Payscale called Section 21 designed specifically for Trainee Programmes Based on 2017/18 Payscale, your salary over the first year will be. Agenda for Change Band 4 Section 21 16,523 per annum What is a Modern Apprenticeship Framework and where does an SVQ fit in? An MA Framework is a document that describes the minimum standards of competence defined by employers and partner education provider for a given role. Frameworks identify relevant SVQs (or alternative competency based qualifications), core skills e.g. communication, numeracy and any industry specific training that might be required. More than 70 different Modern Apprenticeship Frameworks have been developed in Scotland. A Scottish Vocational qualification (SVQ) is a qualification that shows that you are able to perform a job to nationally recognised standards. SVQs are made up of Units, each one of which describes an aspect of the job. You are expected to work your way through all of the relevant Units identified for your job role. There are no exams involved in an SVQ, staff are assessed at their workplace using observation, professional discussion and work related evidence. You will be assessed on the skills you use every day in your job. Your Training centre will be Borders College. What qualifications will I hold when I complete the Modern Apprenticeship? An SVQ3 in painting and decorating What happens at the end of the Modern Apprenticeship? On successful completion of your MA (and SVQ qualification) NHS Borders will support your transition into permanent employment within the organisation. 7

The Modern Apprenticeship Selection Process What is the closing date for applications? The closing date for applications is 5pm on Tuesday 12 December 2017. We will not accept late applications. How do you decide who to interview? We base our decision of who to interview by assessing the information you have provided and your responses to the questions asked in the application form. If there are a large number of candidates who demonstrate on their application form that they meet the essential criteria as detailed in the Person Specification, then the shortlisting panel will also use the desirable criteria when selecting candidates to interview for the post. Who will assess my application form? Your application will firstly be assessed by a shortlisting panel. They will be judging how well your application matches the selection criteria for the post. They will review the information you provide in relation to the educational qualifications, knowledge, skills and experience required for the post. The shortlisting panel will be looking for well presented, clear, concise information and any additional information that is interesting and highlights any additional skills and qualities you have over and above your educational qualifications. 8

1. JOB DETAILS 5575B Job Title: Responsible to: Apprentice Maintenance Painter & Decorator Estates manager (DLO) Department & Base: Estates & Facilities Directorate Borders General Hospital Date this JD written/updated: Job Reference Number: 27/6/2017 PTB204 2. JOB PURPOSE To provide Painting and Decorating services to the organisation. Carry out routine and emergency maintenance tasks throughout the estate maintaining the fabric of all Healthcare premises to a satisfactory condition for the benefit of patients, relatives and staff. 3. ORGANISATIONAL POSITION ( Head Of Estates ) I (Estates Manager) I ( Estates Officer ) I (Painter ) I ( Apprentice Painter) The Apprentice Painter will be accountable to all senior positions as above. 9

4. SCOPE AND RANGE The post holder will work within a small professional team of maintenance Painters and Decorators, covering all related routine and emergency maintenance tasks throughout the Estate. This includes the provision of planned internal and external redecoration of all surfaces treated with either oil, acrylic, water based paints, emulsions and preservatives. The repair to such surfaces required to maintain the integrity of the item following damage/unprotected failure of surface coating. The provision of routine planned surface washes and emergency infection washes as required. A considerable number of tasks will be undertaken in conjunction with other maintenance Painters and Decorators, in such circumstances the post holder will act as equal partner and/or Health and Safety second man as required. The post holder will be expected to hold or be in the process of getting a full UK Driving licence to enable independent travel to NHS Borders sites. OUR VALUES IN ACTION Care and Compassion Quality and Teamwork Dignity and Respect Openness, honesty and responsibility 5. MAIN DUTIES/RESPONSIBILITIES Achieve acceptable maintenance standards on all internal and external painting and decoration work undertaken within planned maintenance, general repairs, renovations and new building works, including specialist coatings. The supply, fitting and finishing of dry lining (plasterboard), plastering repairs and ceramic tiling (new and repair) around appliances as required. Undertake routine maintenance on road markings, lining and symbols, within all NHS Borders properties. Actively participate in the operation of the labour management system by working within the scheme including the completion of all paperwork required, (including completion of all work order dockets and time sheets). Participate in training for application of specialist paint coatings to operating theatres/laboratories etc. and achieve high level of workmanship on same. Work overtime and/or shift working as required to carry out painting, redecoration, wash down work within patient care areas where there is limited access/urgency to reinstate services. Carry out infection wash down to internal surfaces to predetermined specification. Use of all relevant tools and equipment within safety guidelines as necessary for the completion of works. 10

6. SYSTEMS AND EQUIPMENT The post holder will be very much involved with the maintenance and minor works service covering painting and redecoration services within a wide and varied range of property use from domestic scale premises for example, dayrooms, long stay bedrooms etc., through to specialist areas such as high dependency/operating theatres to industrial areas such as boiler houses and laundries. An understanding is required on the equipment utilised within each category as invariably fixed items of equipment will be retained within areas subject to redecoration and adequate protection is essential. Training will be given to this end. The post holder must understand the paint system application including preparation and time intervals between surface application of propriety paint systems. Equipment utilised frequently and routinely includes step-ladders, ladders, scaffolding and personal protection equipment: masks, gloves and eye protection. 7. DECISIONS AND JUDGEMENTS The post holder, for the most part, will work within a small professional team of painters under the direct supervision of Painter/Decorator Charge Hand. Although there will be at times a degree of autonomy where the post holder will work under his own initiative in completing tasks as detailed within work order dockets issued by the Estates Officer (DLO). In circumstances where the post holder is working on his own, supervision will, given the geography of NHS Borders, be limited. Tasks allocated will be done so on the understanding that the individual is competent to undertake these and to plan and execute all aspects through to completion. This includes the estimating of quantities, ordering materials and special mixing of paints (colour and finish) to match work within repairs. By the nature of the work undertaken it is at times within hazardous areas or utilising potentially hazardous materials. The post holder will take all safety measures to prevent danger, avoid injury and prevent damage to himself, to others and to equipment. 8. COMMUNICATIONS AND RELATIONSHIPS Communications are necessary with other trades groups within the department and other departments within the organisation who utilise the services of the Estates Department. This will include dialogue with ward and/or department managers and a limited direct involvement with patients/visitors. The post holder will work and communicate with private sector contractors/service contractors/ technicians/design consultants commissioned to undertake work for NHS Borders as required. The post holder will work closely and take instruction from the Estates Officer/Manager, having regular meetings to discuss his/her progress. 11

9. PHYSICAL DEMANDS OF THE JOB By the nature of maintenance the post holder will be required to work within all areas of NHS Borders. This will include work within domestic areas, highly serviced patient care areas, operating theatres and industrial areas such as kitchens/laundries/boiler houses. On work both internal and external there will be a high degree of work from step-ladders, scaffolds or work within awkward confined spaces. A degree of physical fitness is essential for the post holder to undertake the full range of duties required. A limited involvement with computer keyboards is essential as accurate recording or work undertaken within the departmental job docket system. (Developing aspect). Driving is essential to access all sites. Post holder will be trained on manual handling to ensure correct procedures are followed at all times. 10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB To undertake painting and redecoration works in an efficient and safe manner, minimising service interruption to Healthcare premises. Updating personal skills to meet the challenging requirements of developing technology. Within the Health and Safety framework the post holder will be required to carry out risk assessments and act as key worker under manual handling policies. This job description is not definitive and may be subject to future amendments following negotiation and consultation. 12

PERSON SPECIFICATION For the post of Apprentice Painter Below are the essential knowledge, training (including qualifications) and experience required to do this job. ESSENTIAL 1 Some practical aptitude or experience (Trade Biased) 2 A willingness to attend college as required over the term of the apprenticeship. 3 The ability to study and gain qualifications up to SVQ level 3 in Painting and Decorating. 4 Possess some technical knowledge /experience to avoid any danger that maybe presented by the work undertaken. 5 Be familiar with the type of systems and equipment within patient care areas, which must be protected and /or removed during decoration works. 6 Possess a current uk driving licence or be willing to obtain one. 7 Be willing to learn and carry out work in conjunction with the policies, practices and procedures associated with the post. 13

TERMS AND CONDITIONS Grade and salary: Hours of work: Annual leave: Public Holidays: Superannuation: Band 4 (Section 21) 16,523 per annum 37.5 hours per week, Permanent 27 days per annum Details of other types of leave entitlement (such as sick leave) are set out in the Agenda for Change handbooks. 8 days per annum on dates designated by NHS Borders Details of other types of leave entitlement (such as sick leave) are set out in the Agenda for Change handbook. The post-holder is entitled to join the NHS superannuation pension scheme. If Unsuccessful: If you have NOT heard from us within 4 WEEKS of the closing date, then we regret that your application has not been successful on this occasion. However, we appreciate your interest in working with NHS Borders and your time and effort in completing the application form. We would welcome your application for future posts. Equal Opportunities: In NHS Borders, we believe that all staff should be treated equally in employment. We will not discriminate against any member of staff, or job applicant, on grounds of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex and sexual orientation. Trade Union membership. Disclosure checks: We carry out criminal record checks on new staff who fall within certain staff groups within NHS Borders, through Disclosure Scotland. We send out Disclosure Forms to all shortlisted candidates for these staff groups, and ask for these to be completed and returned at interview. If a successful-at-interview candidate forgets to bring their completed form to interview, then they will be required to return the form (and proofs of identity) within 7 days, otherwise the provisional job offer will be withdrawn. Unsuccessful candidates forms will be shredded. The Rehabilitation of Offenders Act does not apply to this post. Mandatory Induction Standards for Healthcare Support Workers in Scotland: Your performance must comply with the Mandatory Induction Standards for Healthcare Support Workers in Scotland and with the Code of Conduct for Healthcare Support Workers (in line with CEL 23 (2010)), both subject to amendment from time to time, which are attached. 14

If, despite ongoing support, you fail to adhere to the Standards or to comply with the code, your performance will be managed in line with the NHS Borders Management of Employee Capability Policy and could result in the termination of your employment with NHS Borders. Tobacco policy: We have a Tobacco policy in place. When selecting staff, we do not discriminate against applicants who smoke, but staff must observe our policy on smoking. Hepatitis B: We offer Hepatitis B immunisation through our Occupational Health Service (OHS). If you think you may be at risk of contracting Hepatitis B through your job, you should ask for this immunisation at OHS. If your work involves exposure-prone procedures, you must keep to the document Protecting Health Care Workers and Patients from Hepatitis B, and the NHSiS Management Executive Directive on this issue. You must be immune to Hepatitis B, and if you cannot prove that you are immune, OHS will investigate to find out whether you are Hepatitis B positive or not. Health and Safety at Work: You must look after the health and safety of yourself and anyone else who may be affected by what you do at work. You must also co-operate with us to make sure that we keep to legal and organisational safety regulations. You can get more information from the NHS Borders Health & Safety Adviser. The closing date for completed application forms is: 5pm on Tuesday 12 December 2017 15

Guidance for completing the NHS Borders application form General guidance Before starting your application form please ensure that you read the advert and person specification and this guidance for completing the application form. To give you the best possible chance of selection please ensure you complete all sections of the application form with care and attention as incomplete applications will not be shortlisted. Please do not send any other inclusions, e.g. copies of qualification certificates, other award letters or CVs etc, as these will not be considered during shortlisting. If you are selected for interview we will let you know what evidence we need you to provide regarding your educational qualifications. if you have any questions or need some help with completing the form, please call the Resourcing Team on 01896 826165. Please have the job reference number handy if possible if you are using the hard copy version of our application form, please use black ink and write clearly in BLOCK CAPITALS. This makes the form much easier to read and clearer when we photocopy it the job reference number can be copied from the job advertisement the job location will be on the job advertisement the candidate number will be written in by us once you have returned the form to our office the people who look through your completed form (short listing or short listing team) to see if you have the skills and abilities needed for the job, will only see Part C of the form. They will only see your candidate number and all personal details will be anonymous. please fill in all sections of the application form. If some parts are not relevant, write not applicable or N/A in that space if you need more space to complete any section, please use extra sheets of paper. Do not put your name or any identifying information on it as it needs to remain anonymous. Secure it to the relevant section, and we will add a candidate number to it when we receive it Personal details section this gives us your contact details such as name and address. Under title you would put either Mr, Mrs, Ms, Dr or just leave blank if you prefer we may need to contact you at some time throughout the recruitment process. Please let us know the most suitable method of contacting you, e.g text message, email or phone call. Contact will usually be made during office hours. 16

Declarations only if this is asked for in the details/information pack about the job, you must tell us about all convictions and cautions regardless of how long ago the offence may have occurred. Convictions from other countries must also be notified. If in doubt please call our office at the help line number on page one of this guidance. please note that having a conviction will not automatically disqualify you from getting a job with us. Careful consideration will be given to the relevance of the offence to the particular post in question. However, if you are appointed, and it is found that you did not reveal a previous conviction your employment may be terminated remember to read, consider and sign the declaration at the bottom of page 2 NHS Borders complies fully with the Code of Practice issued by Scottish Ministers regarding the correct handling, holding and destroying of Disclosure information. Please contact the Employee Relations Department if you would like to requrest copies of our policies on Recruitment of Ex-offenders or Handling, Holding and Destroying disclosure information. Qualifications section please tell us of any qualifications you have. This can include school standard grades, GCSEs highers, or work based qualifications such as SVQs or NVQs remember to write down any non formal qualifications or certificates that you think are relevant to the job you are applying for Present (or most recent) post section if you are currently out of work, please write this in the job title space please write your start date in month/year format MM/YYYY please tell us briefly about your duties (what you do or did in your job). You could tell us your role, the main tasks, and any responsibility for supervising others. There is not a lot of space here so continue on a separate sheet if you need to Employment history section this is where you write down all the jobs you have done previously remember that if a job you have done in the past supports or is similar to the job you are applying for, please tell us more about it in your support of application statement on page 6 of the application form use a separate sheet if you need more space 17

References section referees are people who know you at work. We know if might be hard for applicants to provide us with 2 referees if they have not worked before so that is why we will accept an educational reference from a teacher from your school. However, if you do have a current part-time job or have volunteered or worked before please also give us details of someone who can provide a reference for this. Please give the full names and addresses of your 2 referees. you should check that the people you have put on your form are happy to be referees your referees will not be contacted unless you are a preferred candidate after interview. A preferred candidate is someone who is the preferred choice for the job, subject to satisfactory checks where appropriate Disability section The Disability Discrimination Act 1995 (DDA) defines Disability as follows any physical or mental impairment which has a substantial adverse effect on a person s ability to carry out normal day to day activities. NHS Scotland is Positive about Disabled People as part of our continued commitment to extend job opportunities for people who are disabled. NHS Scotland operates a Job Interview Guarantee (JIG). All candidates who indicate they have a disability and meet the minimum criteria outlined within the person specification will be guaranteed an interview. Driving Licence section you only need to complete this if the job requires you to drive. Please check the job description or person specification. if you have any penalty points / endorsements on your driving licence and are applying for a post that requires you to drive you should insert the details of the number of points / endorsements here. Statement in support of your application this is one of the most important parts of the form. In here you say why it is you want this job, and can list all your skills and abilities that you think help to match up you against the person specification. In here you could describe how something you have done in a non work setting (for example, planning and leading a group outing) shows planning skill and some leadership qualities Where did you see the advertisement section please try to remember where you heard about this job, and tick the relevant box. The information you give will help us find out how good our advertising is. 18

Equal opportunities monitoring please note that all details on this section (Part D) will remain totally anonymous. It will be detached from the rest of the form as soon as we get it and remain anonymous we want to ensure that there are no barriers to joining our workforce. As an employer, NHSScotland is as fully inclusive as possible. One way we can ensure this is to analyse all the data provided in this section and ensure that job opportunities are being accessed by as wide a community as possible. Final Check Make sure you have included details of all your qualifications (including dates awarded) Make sure you include contact details for your Educational Reference(s) and Work/Character Reference, including email address for them. Don t forget to ask their permission to use their details on your application form Make sure you ensure that your responses are checked for spelling and grammar and provide details. It might be useful to get someone else to look over your application form for a second opinion in case you have made any mistakes. It is always useful to make a few drafts before you submit one you are happy with. Keep a copy of your final draft you submit. Remember if you are selected for interview it will be important to review the application you submitted as part of your interview preparation. And finally before you submit it check it one last time. How to submit your Application Form: Applications should be completed electronically, saved and submitted by e-mail to: recruitment@borders.scot.nhs.uk. For confirmation of receipt or if you have any problems submitting your application form please email recruitment@borders.scot.nhs.uk, Alternatively please phone the Resourcing Team on 01896 826165 for assistance and to confirm safe receipt. Applications should be returned by the closing date of 5pm on Tuesday 12 December 2017 Applications received after the closing date will not be considered for shortlisting. If you are unable to submit your application by email then please post your application with the correct postage well in advance of the closing date to:- Resourcing Team 1 st Floor Primary Services Block Borders General Hospital Melrose, TD6 9BS Please not that if you post your application form you must ensure that the correct amount of postage is paid as this may result in a delay in your application reaching us and we will be unable to progress your application if it is received after the closing date. Postage costs can be obtained from the Post Office or visiting http://www.royalmail.com/price-finder 19

NHS Scotland Application Form First save this form under another name. To complete this form, point your mouse arrow on to the highlighted portions OR use your tab key to move between the highlighted fields and start typing. You must complete the application form in full as we do not accept CVs. PART A Application for (Job Title): Job Reference No: PTB204 Location: Candidate ID No: No applicant will be unfairly discriminated against. We are particularly alert to eliminating discrimination on account of age, cultural/religious/political belief, disability, ethnicity, gender, race, relationship status, sexual orientation, and/or Trade Union membership or stewardship. Only 'Part C' of this form will be made available to short-listing panels. Parts A, B and C would then be used by the interviewing panel if you are selected for interview. Personal Details Surname: Forename: Name known: Title: Address: Post Code: Contact Telephone Numbers: Evening: Day: Mobile: E mail: If we need to, the best way for us to contact you is by: Work Permit Do you need a work permit to take up this post? Yes No Working in the UK Are you eligible to work in the UK? Yes No 20

Job Reference No: Candidate ID No: Declarations PART B Convictions NHS Scotland is exempt from the 1974 Rehabilitation of Offenders Act (Exclusions & Exceptions) (Scotland) Order 2003. This means that unless stated in the job description, person specification or application pack, you must tell us about any previous convictions either classed as spent or unspent. If you are offered employment, any failure to disclose such convictions could result in dismissal or disciplinary action. Any information you give will be considered only in relation to the post for which this application form refers. Information will be verified by Disclosure Scotland for relevant posts. I declare that I have: (a) No previous convictions (b) Previous convictions details of which are: Please read the following statements. You will be asked to sign a declaration if you are appointed: I have completed Parts A to D of this application form and the details I have supplied are, to the best of my knowledge, true and complete; I understand that if appointed to this post the information on this form will be kept as part of my personal file record; I authorise you to obtain references to support this application if I am identified as a preferred candidate; I understand that details of educational qualifications, membership of professional bodies and referee reports may be verified through the establishments and individuals I have indicated; I consent to my details being kept confidentially and used for specific and lawful purposes as specified in the Data Protection Act 1998; I declare that I have no previous convictions, or have identified any I have above. Read, agreed and understood (check box) Date: 21

Application for (Job Title): Location: PART C Job Reference No: Candidate ID No: Qualifications Achieved Subjects Type of Qualification eg. Standard Grade, GCSE, Higher, BSc Grade Achieved Qualifications Currently Studying or Working Towards Type of Qualification Subjects eg. Standard Grade, GCSE, Higher, BSc Grade Anticipated Date Anticipated Membership of Professional or Regulatory Bodies Full name of organisation(s) Registration Number Renewal Date 22

Job Reference No: Candidate ID No: Present (or most recent) Post Job Title: PART C Grade: Date of Starting Grade: Employer: Dates of Employment: From: To: Reason for Leaving (if applicable): Notice Period: Current Salary: Role Purpose / Summary of Responsibilities Employment History Start with your most recent employment first and work down the page. If a job supports the position applied for, please say more about it in your Application Support Statement. Job Title Employer Date From Date To 23

Job Reference No: Candidate ID No: Referees PART C Your referees will include your present (or most recent) employer. Please identify below the person in your organisation (for current NHS staff this is your direct line manager) who is authorised to confirm your employment and the details given in your application. Please identify a second referee who may have closer knowledge of your skills, knowledge and abilities and who may offer opinion on your suitability for this post. You should not use family members or friends. Our pre-employment screening also includes, where appropriate, health and fitness for work, criminal records, qualifications and professional registration. Note that references will only be taken up for Preferred Candidates following interview. Name 1: Designation: Address: Post Code: Telephone: Name 2: Email: Designation: Address: Post Code: Telephone: Email: Disability The Disability Discrimination Act 1995 and Amended Regulations 2005 defines disability as follows: any physical or mental impairment which has a substantial adverse effect on a person s ability to carry out normal day to day activities. NHS Scotland is Positive About Disabled People, and as such we provide job opportunities for disabled people. NHS Scotland operates a Job Interview Guarantee (JIG), which means that if you have a disability, and meet the minimum criteria outlined within the person specification, you will be guaranteed an interview. However, some disabled people prefer not to take this option, so please tick your preference if you are a disabled candidate. Do you want to participate in the guarantee scheme? Yes No Please specify any special requirements you require if attending for interview, eg. Induction Loop, Wheelchair Access, Signer Driving Licence (see Job Description - only complete if a driving licence is essential) Do you have a driving licence? Yes No If yes, which categories are you entitled to drive, eg. B, BE, C 24

Job Reference No: PART C Candidate ID No: Statement in Support of Application please tell us your personal qualities, skills and attributes, experience and any major achievements and show how they match those needed for this job. Where did you see the Advertisement for this Post? Newspaper (which one?) Professional Journal (which one?) Vacancy Bulletin SHOW (NHS Scotland Website) Job Centre Plus Other (please specify) 25

Job Reference No: Candidate ID No: Equal Opportunities Monitoring PART D We want to ensure that our job opportunities are open to all. The only way we can ensure there is equal opportunity is to monitor applications we receive and compare the profile of people who apply with those appointed. Therefore this form asks you for your ethnic origin, gender, disability, religion, sexuality and age. The information you provide in this part of the form (Part D) is confidential and is not used in the selection process. It will be separated from the rest of the form when we receive it. 1) If you are currently an employee of this NHS Board, will getting this job be a promotion? Yes 2) You are: Female No Male 3) Have you undergone, are you undergoing or do you intend to undergo gender reassignment? For example, this includes having changed your sex (gender)? Yes No Prefer not to say 4) What is your age? I am years old, and my date of birth is: 5) Do you have a physical or mental health condition or disability that: has a substantial effect on your ability to carry out day to day activities? has lasted or is expected to last 12 months or more? Yes No Prefer not to say If you answered yes please tick if it is either of the following: Learning Disability Long standing illness Mental health condition Other (please describe): Physical impairment Sensory impairment Again, if yes, please describe any particular arrangements you would need for your work location: (Continued on next page) 26

Job Reference No: PART D Candidate ID No: 6) What is your ethnic group? Choose one section from A to F, then tick the appropriate box to indicate your cultural background A: White Scottish Irish Other British Any other White background B: Mixed Any mixed background C: Asian; Asian Scottish; Asian British Pakistani Indian Chinese Bangladeshi D: Black; Black Scottish; Black British Caribbean African Any other Black background E: Other ethnic background Any other background F: Prefer not to answer Any other Asian background 7) To which religion, religious denomination or body do you actively belong? (Christianity) - Church of Scotland (Christianity) - Roman Catholic Christianity (other) Other faith / belief Buddhism Prefer not to answer Hinduism Sikhism Judaism Islam 8) Which of the following best describes your sexual orientation? Bisexual Heterosexual Other No religion (none) Gay Man Lesbian/Gay Woman Prefer not to answer 27