Page content:
As Is Form
User Journey
Assumptions
- All fields are mandatory
- Specified fields should also be editable, should the Trainee need to make changes to what is held in the system - these are currently captured on the
- Appropriate field assistance should be displayed
- Trainee photograph from the original form is not needed
- All help text should be displayed as is contained within the form
- This is only displayed to medical trainees
Guidance Text
Guidance for applicants on how to complete:
https://heeoe.hee.nhs.uk/sites/default/files/form_r_guidance_-_april_2017_version_4.pdf
Field validation
This table specifically specifies the fields relevant to Form R, Part B only
| Order | Field name | Reference Table in TIS | Example value | Type (free text, drop down, check box) & Interaction (autopopulate etc) | Mandatory for submission (Y/N) | Validation / Error Messaging | Notes |
|---|---|---|---|---|---|---|---|
| Form R - Part B | |||||||
| Section 1 - DOCTORS DETAILS (assistance information required) | |||||||
| 1 | Forename | vwPerson | Pre-populate Editable | Y | |||
| 2 | GMC-Registered Surname | vwPerson | Pre-populate Editable | Y | |||
| 3 | GMC Number | vwPerson | Pre-populate Editable | Y | |||
| 4 | Primary Contact Email Address | vwPerson | Pre-populate Editable | Y | Strongly advised to give 'NHS.net' address | ||
| 5 | Deanery / HEE Local Team | vwPerson | Pre-populate Read-Only | Y | |||
| 6 | Previous Designated Body for Revalidation | vwRevalidationEpisode | Pre-populate Read-Only | Y - if applicable (i.e. only if they have gone through revalidation at the point of ARCP) | |||
| 7 | Current Revalidation Date | vwRevalidationEpisode | Pre-populate Read-Only | Y - if applicable | |||
| 8 | Date of Previous Revalidation | vwRevalidationEpisode | Pre-populate Read-Only | Y - if applicable | |||
| 9 | Programme / Training Specialty | ProgrammeNumber | Pre-populate Read-only | Y | |||
| 10 | Dual Specialty | SpecialtyName | Pre-populate Read-only | Y - if applicable | |||
| Section 2 - WHOLE SCOPE OF PRACTICE (assistance information required) | |||||||
| 11 | Type of Work | N/A | Pre-populate Editable Multiple lines | Y | This should consist of
Alistair Pringle (Unlicensed) - we need to finalise which leave types apply here | ||
| 12 | Start Date | N/A | Pre-populate Read-only & Editable Multiple lines | Y | |||
| 13 | End Date | N/A | Pre-populate Read-only & Editable Multiple lines | Y | |||
| 14 | Training Post? | N/A | Pre-populate Read-only & Editable Multiple lines | Y | |||
| 15 | Site Name | N/A | Pre-populate Read-only & Editable Multiple lines | Y | |||
| 16 | Site Location | Pre-populate Read-only & Editable Multiple lines | Y | Guidance text needed | |||
| Time Out of Training - guidance text see document | |||||||
17 | Short- and Long-term sickness absence | N/A | Pre-populate Number counter read only | Y | |||
| 18 | Parental leave (incl Maternity / Paternity leave) | N/A | Pre-populate Number counter read-only | Y | |||
| 19 | Career breaks within a Programme (OOPC) and non-training placements for experience (OOPE) | N/A | Pre-populate Number counter read only | Y | |||
| 20 | Paid / unpaid leave | N/A | Pre-populate Number counter Read only | Y | Alistair Pringle (Unlicensed) - can this come from absence data? | ||
| 21 | Unpaid / unauthorised leave | N/A | Editable Number counter / entry | Y | |||
| 22 | Other (see guidance) | N/A | Editable Number counter / entry | Y | |||
| 23 | Total | N/A | Autopopulated =Count of above fields 16-22 | Y | Confirm this should not include line 21 | ||
| Section 3 - DECLARATIONS RELATING TO GOOD MEDICAL PRACTICE (assistance information required) | |||||||
| 23 | 1) I declare that I accept the professional obligations paced on me in Good Medical Practice in relation to honesty and integrity. | N/A | Selection box Y / N | Y | Guidance information required here | ||
| 24 | 2) I declare that I accept the professional obligations placed on me in Good Medical Practice about my personal health | N/A | Selection box Y / N | Y | |||
| 25 | 3a) Do you have any GMC conditions, warnings or undertakings placed on you by the GMC, employing Trust or other organisation? | N/A | Selection box Yes - present Q3b No - present Q4 | Y | |||
| 26 | 3b) If yes, are you complying with these conditions / undertakings? | N/A | Yes - present Q4 No - TBC | Y - if 3a = yes | what happens if no? Alistair Pringle (Unlicensed) | ||
| 27 | 4) Health Statement | N/A | Free text 500 words max | N | Guidance text needed here | ||
| SECTION 4 - UPDATE TO PREVIOUS FPRM R PART B - see guidance text doc | |||||||
| 28 | 1) If you did not declare significant events, complaints, or other investigations on your previous Form R Part B, check this box | N/A | Check box Go to Section 5 | Y - IF 3A = no | |||
| 29 | 2) If any previously declared significant events, complaints, or other investigations have been resolved since your last ARCP/RITA/Appraisal, you are required to have written a reflection on these in your Portfolio | N/A | Selection: Y/N Add multiple | Y | |||
| 30 | 2a) Declaration Type | N/A | Smart-search / drop down
| Y - If (2) is yes | |||
| 31 | 2b) Date of entry into Portfolio | N/A | Calendar picker | Y - If (2) is yes | |||
| 32 | 2c) Title / Topic of Reflection/Event | N/A | Free text | Y - If (2) is yes | |||
| 33 | 2d) Location of entry in Portfolio | N/A | Free text | Y - If (2) is yes | |||
| 34 | 3) Unresolved detail | N/A | Free text | N | Guidance text required | ||
| Section 5: NEW DECLARATION SINCE YOUR PREVIOUS FORM R PART B - see guidance text doc | |||||||
| 35A | I do not have anything new to declare since my last ARCP/RITA/Appraisal | N/A | selection box | Y - must select either 35A or 35B | |||
| 35B | I have been involved in significant events/complaints/other investigations since my last ARCP/RITA/Appraisal | N/A | selection box | Y - must select either 35A or 35B | |||
| 36A | If you know of any resolved significant events/complaints/other investigations since your last ARCP/RITA/Appraisal, you are required to have written a reflection on these in your Portfolio. Please identify where in your Portfolio the reflection(s) can be found | N/A | Read only text field | ||||
| 36B | Issue Type | N/A | Drop down:
Add multiple | Y - if 35B is selected | |||
| 36C | Date of Entry in Portfolio | N/A | Calendar picker add multiple | Y - if 35B is selected | |||
| 36D | Title / Topic of Entry | N/A | Free text Add multiple | Y - if 35B is selected | |||
| 36E | Location of Entry in Portfolio | N/A | Free text Add multiple | Y - if 35B is selected | |||
| 37 | If you know of any unresolved significant events/complaints/other investigations since your last ARCP/RITA/Appraisal, please provide below a brief summary, including where you were working, the date of the event and your reflection where appropriate. If known, please identify what investigations are pending relating to the event and which organisation is undertaking the investigation. | N/A | FREE TEXT 500 characters | Y - if 35B selected | |||
| SECTION 6: COMPLIMENTS - see guidance text doc | |||||||
| 38 | Free text | N/A | Free text 1000 characters | N | |||
| SECTION 7: DECLARATION - see guidance text doc | |||||||
| 39 | Declaration statement (see form) | N/A | Read only | Read only text field | |||
| 40 | Trainee Signature | N/A | Name autopopulated based on user logged in
| Y | |||
| 41 | Date | N/A | Autopopulated on submission date | Y | |||
0 Comments