Other forms in this section

New Starter Form - Medical and Dental

1. About the New Employee
2. Contact Details
3. Emergency Contact
4. Flexible Workforce Contract
You have the option to be set up with a zero hours Flexible Workforce assignment in addition to your primary assignment. You are not obligated to work additional shifts for the Trust above your contracted hours, however, if you do chose to opt out of this please be aware that if you are on the Terms and Conditions of service for NHS Doctors and Dentists in Training (England 2016), you are contractually required to offer such additional hours of work exclusively to the service of the NHS, via an NHS internal staff bank. #

Bank assignments are contracted through separate terms and conditions which would be issued to you on confirmation of opting in. Due to this being a separate contract you will also receive a separate payslip for any work completed until this assignment.

Bank work is paid weekly however you also have the option to change this if you prefer to be monthly.
5. Working Time Hours Regulation Opt-Out
I agree to opt-out of the 48 hour average weekly limit specified in the Working Time Regulation 1998. I understand that it remains my responsibility to ensure I do not work excessively long hours (for the Trust and/or another employer). Should I wish to end this agreement I will provide my employee with 4 weeks written notice.
6. Salary Deductions
Under the terms of paragraph 14 of your Contract of Employment, you are required to give specific consent for deductions from your salary in respect of monies owed by you to the Trust, however arising. Recovery of the monies attributable to over payment on the part of the Trust will be subject to negotiation. This may be in respect of accommodation charges, payments in lieu of notice, accrued holiday or telephone calls via the Switchboard. Calls are charged at 7p per unit and you may check with Switchboard directly after making your call for details of the number of units and total cost.v
7. DBS
I understand and accept that £41.90 will be deducted from my salary to cover the
costs of an Enhanced Disclosure and Barring Service (DBS) application.
If you answered 'I am already registered with the DBS' please answer the following questions:
In accordance with the terms and conditions of the on line DBS update service; I hereby give my consent for Calderdale and Huddersfield NHS Foundation Trust to check and receive up-to-date information in relation to my criminal record DBS Certificate and authorise the Trust to make regular checks using the update service as necessary.

I understand that if I let my Update Service registration lapse, a further DBS check will be required and I will be expected to meet the cost of this. I also understand that if I change my name whilst employed by Calderdale and Huddersfield NHS Foundation Trust, a further DBS check will be required.
8. Doctors Mess
The Junior Doctors Mess Fund organises regular social events for members along with paying for the facilities provided in the Mess such as newspapers, magazines, coffee etc. The membership fee is £5.00 per month.
9. Previous Employment
10a. Previous NHS Employment
10b. Previous NHS Employment (Additional)
10c. Previous NHS Employment (Additional)
10d. Previous NHS Employment (Additional)
If you have any more additional NHS Employment history not stated on this form, please email medicalhr@cht.nhs.uk with those details. Thank you.
11. Student Loans
12. P45 & P46 Forms
13. Bank Details
14. Pension Questionnaire
The pension Act 2008 requires employers to automatically enrol new employees into a pension scheme on commencement of their employment. In order to ensure that you are correctly enrolled your employer needs to establish your current NHS Pension Status. As part of the recruitment process, all new employees, staff transferring in from another NHS employer and existing NHS employees must complete this questionnaire as fully as possible.

Please note that information provided will only be used for local and central pensions/payroll administration purpose to determine eligibility criteria. Please use the completion notes while completing the form.
If you currently receive a pension, please provide the details below:
Important: If you change your hours or leave your other employment(s) it is your responsibility to advise the Payroll team as this may affect your eligibility to a pension scheme.
Please contact your AVC provider if you wish to continue to pay AVC contributions. You will need to advise them of your new employer so they can provide details for payroll deductions to continue.
If you did not have previous MHO status then your new post will not qualify for this status.
If your answer is "Yes" your employer will provide the Transfer of Benefits Booklet. However it is important to note that this can only be done in the first 12 months of joining the scheme, for member of the 1995 Section or within the first 12 months of becoming eligible to join the 2008 Section.
Part 2 Declaration