Discretionary Points Application Form
NHS Greater Glasgow and Clyde
Declaration:
By submitting this form, I declare that the information provided is accurate. I understand that this form may be subject to review as part of the application audit process.
Section 1 - Applicant Information
Payroll Number
*
* Denotes required field(s).
Job Title
*
Current Specialty
*
Clinical Director
*
Principal Employer
*
NHSGGC
University of Glasgow
Directorate/Sector/Partnership
*
North Sector
South Sector
Women and Children's
Regional
Diagnostics
Clyde
Corporate/Partnerships
Base/Hospital
*
Date of Submission
*
-
Day
-
Month
Year
Date
Date of Last Award (if applicable)
-
Day
-
Month
Year
Note: this application should only cover activities since last award up to 31 March 2021.
Section 2 - Applicant Awarded Points Last year (Exceptional Applications)
Applicants may usually only apply for discretionary points every 2 years. If you wish to be considered this year, for exceptional reasons only, please indicate the reasons here.
Please detail
0/150
Section 3 - Limited of Discretionary Points
If you wish to limit points awarded indicate maximum points here.
1
2
Section 4 - Most Recent Job Plan
Detail number from current job plans.
*
Current Number
Number of Direct Clinical Care PAs
Number of SPAs
Number of External Duties PAs
Number of Additional Responsibilities PAs
Number of EPAs
Number of Medical School PAs
Total number of current PAs
*
Total Number
Current PAs
Brief description of Main Professional Activities in Job Plan
0/100
Brief description of SPAs in Job Plan
0/100
Brief description of EPAs in Job Plan
0/100
Other Remuneration Activity (Please provide a summary of all activities attracting remuneration e.g. Clinical Tutor, Management Lead, Training Programme Director etc.)
0/150
Section 5 - Application Details
Only activity undertaken since any previous discretionary points have been awarded, up to 31st March 2021 will be considered. The allocation of discretionary points will be based entirely on the information provided on Section 5 of your application form. If information is not included, it cannot be used in the assessment. Please ensure that specific time periods and dates are used for work/tasks undertaken in the written submissions. For further guidance on how to complete your application please refer to the document: Discretionary Points - Guidance and Completion 2020-21 which can be downloaded on HR Connect.
(a) Professional activities e.g. quality of clinical care, service development (16 points).
0/500
(b) Professional leadership (4 points).
0/125
(c) Contribution to improving health of the population (4 points.)
0/125
(d) Contribution to professional and multi-disciplinary team working (4 points).
(e) Research, innovation and service improvement (4 points).
0/125
(f) Clinical audit (4 points)
0/125
(g) Medical teaching and training (4 points).
0/125
(h) Contribution of training to other groups (4 points).
0/125
(i) Wider national contribution to the work of the NHS (4 points).
0/125
Any other factors that should be taken into account? Not scored.
0/200
Research and Publications. If applicable please provide a list of references for audit and research publications. Applicants who fail to anonymise bibliography will have application disqualified.
0/1000
Equality Monitoring Form:
Please ensure you also complete the separate Equality Monitoring Form which can be downloaded from the Discretionary Points page on HR Connect. Once completed the Equality Monitoring Form should be emailed to DiscretionaryPoints@ggc.scot.nhs.uk
Declaration Reminder:
By submitting this form, I declare that the information provided is accurate. I understand that this form may be subject to review as part of the application audit process.
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