Trainee UI - Field Validation | Form R (Part B)

This table specifically specifies the fields relevant to Form R, Part B only

As Is Form

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

Order	Field name	DR field	Reference Table	Type (free text, drop down, check box) & Interaction (autopopulate etc)	Mandatory (Y/N)	Notes
Form R - Part B
Section 1 - DOCTORS DETAILS (assistance information required)
1	Forename	Forenames	vwPerson	Pre-populate Editable	Y
2	GMC-Registered Surname	LegalSurname	vwPerson	Pre-populate	Y
3	GMC Number	GMCNumber	vwPerson	Pre-populate	Y
	Primary Contact Email Address	EmailAddress	vwPerson	Pre-populate Editable	Y	Strongly advised to give 'NHS.net' address
4	Deanery / HEE Local Team	LocalOfficeName	vwPerson	Pre-populate	Y
	Previous Designated Body for Revalidation	DesignatedBody	vwRevalidationEpisode		Y - if applicable
5	Current Revalidation Date	ExpectedRevalidationDate	vwRevalidationEpisode		Y
6	Date of Previous Revalidation	PreviosusRevalidationDate	vwRevalidationEpisode		Y - if applicable
7	Programme / Training Specialty	vwProgrammemembership	ProgrammeNumber	pre-populate
8	Dual Specialty	vwcurrciculummembership	SpecialtyName
Section 2 - WHOLE SCOPE OF PRACTICE (assistance information required)
10	Type of Work	N/A	N/A	Free Text Add multiple
11	Start Date	N/A	N/A	Calendar Picker Add multiple
12	End Date	N/A	N/A	Calendar Picker Add multiple
13	Training Post?	N/A	N/A	Options: Y or N Add multiple
14	Site Name	N/A	N/A	Free Text Add multiple
15	Site Location	N/A		Free Text Add multiple		Guidance text needed
Time Out of Training (assistance information required)
16	Short- and Long-term sickness absence	N/A	N/A	Number counter / entry
17	Parental leave (incl Maternity / Paternity leave)	N/A	N/A	Number counter / entry
18	Career breaks within a Programme (OOPC) and non-training placements for experience (OOPE)	N/A	N/A	Number counter / entry
19	Paid / unpaid leave	N/A	N/A	Number counter / entry
20	Other	N/A	N/A	Number counter / entry		Assistance information required here - see actual form Page 1
21	Total	N/A	N/A	Autopopulated count of above fields 16-20
Section 3 - DECLARATIONS RELATING TO GOOD MEDICAL PRACTICE (assistance information required)
22	1) I declare that I accept the professional obligations paced on me in Good Medical Practice in relation to honesty and integrity.	N/A	N/A	Selection box Y / N		Guidance information required here
23	2) I declare that I accept the professional obligations placed on me in Good Medical Practice about my personal health	N/A	N/A	Selection box Y / N
24	3a) Do you have any GMC conditions, warnings or undertakings placed on you by the GMC, employing Trust or other organisation?	N/A	N/A	Selection box Yes - go to Q3b No - go to Q4
25	3b) If yes, are you complying with these conditions / undertakings?	N/A	N/A	Yes - go to Q4 No - TBC
26	4) Health Statement	N/A	N/A	Free text 500 words	N	Guidance text needed here
SECTION 4 - UPDATE TO PREVIOUS FPRM R PART B (guidance/warning info needed)
27	1) If you did not declare significant events, complaints, or other investigations on your previous Form R Part B, check this box	N/A	N/A	Check box Go to Section 5
28	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	N/A	Selection: Y/N Add multiple
29	2a) Declaration Type	N/A	N/A	Smart-search / drop down significant event Complaint Other investigation	Y - If (2) is yes
30	2b) Date of entry into Portfolio	N/A	N/A	Calendar picker	Y - If (2) is yes
31	2c) Title / Topic of Reflection/Event	N/A	N/A	Free text	Y - If (2) is yes
32	2d) Location of entry in Portfolio	N/A	N/A	Free text	Y - If (2) is yes
33	3) Unresolved detail	N/A	N/A	Free text	N	Guidance text required
Section 5: NEW DECLARATION SINCE YOUR PREVIOUS FORM R PART B (guidance/warning info needed)
34A	I do not have anything new to declare since my last ARCP/RITA/Appraisal	N/A	N/A	selection box	Y - must select either 34A or 34B
34B	I have been involved in significant events/complaints/other investigations since my last ARCP/RITA/Appraisal	N/A	N/A	selection box	Y - must select either 34A or 34B
35A	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	N/A		Read only text field
35B	Issue Type	N/A	N/A	Drop down: significant event complaint other investigation Add multiple	Y - if 34B is selected
35C	Date of Entry in Portfolio	N/A	N/A	Calendar picker add multiple	Y - if 34B is selected
35D	Title / Topic of Entry	N/A	N/A	Free text Add multiple	Y - if 34B is selected
35E	Location of Entry in Portfolio	N/A	N/A	Free text Add multiple	Y - if 34B is selected
36	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	N/A	FREE TEXT 500 characters	Y - if 34 selected
SECTION 6: COMPLIMENTS (advisory text required)
37	Free text	N/A	N/A	Free text 1000 characters	N
SECTION 7: DECLARATION (advisory text required)
38	Declaration statement (see form)	N/A	N/A	Read only	Read only text field
39	Trainee Signature	N/A	N/A	Name autopopulated based on user logged in validation of email address required to confirm	Y
40	Date	N/A	N/A	Autopopulated on submission date	Y