Starting Salary Rationale Form

This form should be used to provide rationale for a starting salary being above the minimum pay point as allowed in the Agenda for Change terms and conditions of service. It should only be used for the following candidates:

Individuals not employed by the NHS prior to commencing their employment with the Trust
Individuals employed by the NHS prior to commencing their employment with the Trust but have had a break in service of 3 months or more.
Individuals employed by the NHS prior to commencing their employment with the Trust but not on Agenda for Change terms and conditions.
Individuals employed by the NHS and has relevant experience working at a higher level.

Starting Salary Rationale Form

Section A - Position Details

Vacancy Reference Number*

ESR Position Number*

Job Title*

Band/Grade*

Division*

Cost Centre*

Start Date*

Section B - Candidate Details

Surname*

First and middle names*

National Insurance Number*

Section C - Comparable Service (Part 1)

Detail in this section all the service which has been assessed as comparable with/higher than the position offered. Service/experience in less responsible/less senior roles should NOT be included.

Employer*

Job Title*

Salary and/or Band/Grade*

Date From*

Date To*

Completed Months' Service*

Section C - Comparable Service (Extra 1)

Employer

Job Title

Salary and/or Band/Grade

Date From

Date To

Completed Months' Service

Section C - Comparable Service (Extra 2)

Employer

Job Title

Salary and/or Band/Grade

Date From

Date To

Completed Months' Service

Section C - Comparable Service (Extra 3)

Employer

Job Title

Salary and/or Band/Grade

Date From

Date To

Completed Months' Service

Section C - Comparable Service (Extra 4)

Employer

Job Title

Salary and/or Band/Grade

Date From

Date To

Completed Months' Service

Section C - Comparable Service (Extra 5)

Employer

Job Title

Salary and/or Band/Grade

Date From

Date To

Completed Months' Service

Section C - Comparable Service (Extra 6)

Employer

Job Title

Salary and/or Band/Grade

Date From

Date To

Completed Months' Service

Section C - Comparable Service (Part 2)

Total Completed Months'*

Total Whole Years' Service*

Section D - General Comments

Please make any general comments in support of this application below*

Section E - Requested by

Name*

Position*

Date*

Don't fill this field

Form last updated: 26/09/2024

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Starting Salary Rationale Form

Starting Salary Rationale Form