"National Performers Lists Application Form" - United Kingdom

The United Kingdom National Health Service has released this version of the "National Performers Lists Application Form" on January 1, 2013.

This form may be used by all United Kingdom residents: download the printable PDF by clicking the link below and use it according to the applicable legal guidelines.

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NPL 1: National Performers Lists Application Form
From 1 April 2013, the NHS Commissioning Board adopted the name NHS England, a
name that gives people a greater sense of our role, scope and ambitions – as the
organisation responsible for allocating the NHS budget, working to improve outcomes
for people in England and ensuring high quality care for all, now and for future
generations.
NHS England’s legal name remains the NHS Commissioning Board as set out in our
establishment orders. While the NHS Commissioning Board will be known as NHS
England in everything that we do, there are times when the statutory name is required
for legal and contractual transactions. The following list provides some key examples of
legal documentation which requires us to use our full legal name:
• Human resources contracts of employment;
• Any documentation involving a court of law, e.g. litigation claims
• Contracts for directly commissioned services.
For ease of reference NHS England is the generic term used throughout this form.
Application Form
The application process and associated documentation has been produced in
accordance with the National Health Service (Performers Lists) (England) Regulations
2013.
Applications submitted will be considered under the provision of these Regulations.
Performers who appear on a performers list should be aware of the requirements placed
upon them by these Regulations.
Please note: Applications received from performers who have been nationally
disqualified from the performers list on the grounds of suitability or fraud cannot be
considered until a minimum period of two years has past following the applicant’s
removal from the list and the applicant can evidence that the national disqualification
has been lifted by the First Tier Tribunal.
Applications should be made to the NHS England team in the local footprint in which
performers will be undertaking the majority of their work within the NHS.
Please use the ‘look up’ function on NHS England national performers lists website for
clarity of which team to apply to. This is available at:
NPL1 Application Form v2 final
Page 1 of 32
NPL 1: National Performers Lists Application Form
From 1 April 2013, the NHS Commissioning Board adopted the name NHS England, a
name that gives people a greater sense of our role, scope and ambitions – as the
organisation responsible for allocating the NHS budget, working to improve outcomes
for people in England and ensuring high quality care for all, now and for future
generations.
NHS England’s legal name remains the NHS Commissioning Board as set out in our
establishment orders. While the NHS Commissioning Board will be known as NHS
England in everything that we do, there are times when the statutory name is required
for legal and contractual transactions. The following list provides some key examples of
legal documentation which requires us to use our full legal name:
• Human resources contracts of employment;
• Any documentation involving a court of law, e.g. litigation claims
• Contracts for directly commissioned services.
For ease of reference NHS England is the generic term used throughout this form.
Application Form
The application process and associated documentation has been produced in
accordance with the National Health Service (Performers Lists) (England) Regulations
2013.
Applications submitted will be considered under the provision of these Regulations.
Performers who appear on a performers list should be aware of the requirements placed
upon them by these Regulations.
Please note: Applications received from performers who have been nationally
disqualified from the performers list on the grounds of suitability or fraud cannot be
considered until a minimum period of two years has past following the applicant’s
removal from the list and the applicant can evidence that the national disqualification
has been lifted by the First Tier Tribunal.
Applications should be made to the NHS England team in the local footprint in which
performers will be undertaking the majority of their work within the NHS.
Please use the ‘look up’ function on NHS England national performers lists website for
clarity of which team to apply to. This is available at:
NPL1 Application Form v2 final
Page 1 of 32
https://www.performer.england.nhs.uk/AT/SearchByPostcode.
If you are unsure as to whether you are already on the performers list, please check the
Primary Care Performers Directory at
https://www.performer.england.nhs.uk/
or
alternatively contact the team as identified via the ‘look up’ function above.
Disclosure and Barring Service (DBS)
Applicants seeking to join the Performer List will be required to complete and submit
these forms themselves and can use any one of the umbrella bodies recommended by
the Home Office for supporting applicants with their DBS application. These umbrella
bodies can be found at https://dbs-ub-directory.homeoffice.gov.uk/
Details relating to the DBS can be found at:
https://www.gov.uk/disclosure-barring-service-check
Applicants are required to subscribe to the online update service. This may be done at
the time of the application using the application form reference number or within 19
days of receipt of the Enhanced Disclosure Certificate using the certificate number.
Details can be found at:
https://www.gov.uk/dbs-update-service
As outlined in the Disclosure and Barring Update Service Applicant Guide dated January
2014, subscription to the online update service is not a requirement of the DBS but
some organisations may make subscription a condition of employment. NHS England
has placed this requirement on all applications to the performers list.
Applicants who cannot provide UK residency details for the last five years must undergo
a Police Home Check. Applicants can arrange this by contacting their Home Office or
Embassy.
If the document provided is not in English, a translation that has been issued by a
bonafide organisation and signed by an official translator is required.
Foreign convictions
NHS England cannot request that the applicant discloses all foreign convictions or
cautions. NHS England can only request that the applicant discloses foreign convictions
or cautions that are equivalent to convictions and cautions in England and Wales and
which are not protected convictions and cautions. Further information can be found at
https://www.gov.uk.disclosure-barring-service-check/overview) to enable the applicant
to determine whether the offence for which they received a foreign conviction or
caution is equivalent to a listed offence in England and Wales, and therefore must be
disclosed.
NPL1 Application Form v2 final
Page 2 of 32
English Language Testing
NHS England requires the following to be evidenced:
All applicants who have studied or trained in the UK or Irish Republic must provide:
1. A certificate of graduation or postgraduate training from a UK or Irish Republic
medical or dental school or a university optometry department.
If applicants have not studied or trained in the UK or Irish Republic, they must provide:
Doctors
• A certificate indicating a pass obtained within the last two years of one of the
current accepted language tests (or equivalent), at the required level of IELTS or
equivalent as defined by the regulator. (Details of the standard are found in the
application form for inclusion in the national performers lists NPL1); or
• A certificate of graduation or postgraduate training within the past two years
from a recognised medical school taught and examined in English; (Please refer
to the general information section of this document for a list of countries where
the first and native language is English); or
• Evidence of successful completion of an Induction and Refresher assessment (I&R)
including a simulated surgery assessment; or
• Evidence of successful completion of Annual Review of Competence Progression
(ARCP)
AND
• Evidence of three months professional employment from the past two years in a
country where English is the first language, and current English language
capabilities necessary for the work which those included in the list could
reasonably be expected to perform are documented in the references submitted
as part of the application form;
Dentists
• A certificate indicating a pass obtained within the last two years of one of the
current accepted language tests (or equivalent), at the required level of IELTS 7.0
and no less than 6.5 in each module, or equivalent as defined by the regulator.
Ophthalmic practitioners
NPL1 Application Form v2 final
Page 3 of 32
• A certificate indicating a pass obtained within the last two years of one of the
current accepted language tests (or equivalent), at the required level of IELTS 7.5
(or equivalent) as defined by the regulator.
AND
• Evidence of three months professional employment from the past two years in a
country where English is the first language, and current English language
capabilities necessary for the work which those included in the list could
reasonably be expected to perform are documented in the references submitted
as part of the application form.
Where the applicant cannot demonstrate evidence of their English language
proficiency through the IELTs test or references, the team will need to consider on a
case by case basis whether the applicant has a sufficient command of the English
language to allow inclusion on the list. In the event that the team requires the
applicant to undertake an oral language test, the cost of this will need to be met by
the applicant.
Documents required to support the application
Applicants need to submit to the local NHS England team:
• An electronically completed application form. Handwritten forms will not be
accepted.
• An enhanced disclosure and barring (DBS) certificate. Please note that Criminal
Records Bureau (CRB) disclosures are no longer acceptable.
• Applicants must register for the online update service within 19 days of the
certificate being issued or in the interim, using the reference number issued by
the DBS at point of application. Annual subscription to the Disclosure and
Barring Service (DBS) online update service is at the cost of the applicant.
Applicants who have lived abroad during the last 5 years should provide a police
check regarding criminal activity in the country or countries in which they have
lived. It is the responsibility of the applicant to seek this information – guidance is
provided on the DBS website;
• If the applicant is from abroad they must provide a certificate of good standing
from their professional body. Applicants from Australia and New Zealand are
exempt from this requirement.
• An occupational health clearance certificate from an occupational health
provider, with accreditation for Safe Effective Quality Occupational Health Service
(SEQOHS) or one which is working towards this accreditation. This applies to
medical, ophthalmic medical and dental performers but not optometric
performers. Trainees who received OH screening at the start of their training and
NPL1 Application Form v2 final
Page 4 of 32
have been working under the supervision of a postgraduate dean without any
break in service may seek their OH clearance certificate from the OH service who
conducted their previous screening. There is a Memorandum of Understanding
for Occupational Health Clearance for UK Dental School graduates applying for
entry onto NHS England’s National Performers List available on the NHS England
website
• Current passport (original) or (where the applicant does not have a passport) an
acceptable photo ID (original) as defined on the DBS website. This must include a
work Permit – (non EEA applicants admitted to UK after April 1985 only)
• A detailed curriculum vitae, including complete work history, with any gaps in
service explained
• An acceptable certificate of communication skills or evidence to support
applicant’s declaration of communication skills as set out in Section 4
• A copy of your most recent appraisal/outcome statement
• Confirmation of your revalidation status (applicants on the GMC register only)
• Evidence of current indemnity at an appropriate level, through membership of a
defence organisation or through insurance.
• Evidence of child protection competence at the level agreed
Please note all official documents must be originals . Photocopies cannot be accepted.
It is the responsibility of the applicant to obtain all information required for the
application.
NPL1 Application Form v2 final
Page 5 of 32
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