Workforce Solutions Affiliate Registration Form

Workforce Solutions – Affiliate Registration Form

Join our network of Workforce Solutions affiliates. Complete this registration form to express your interest in working with us. The details you provide will help us match you to consultancy assignments that best fit your expertise and our delivery requirements.
This form may take some time to complete. If you are unable to finish it in one sitting, a Save button is available at the bottom of the form, enabling you to save your progress and return to it at a later point. If you require support while completing the form, please contact workforcesolutions@nhsemployers.org
Section 1 — Personal and Professional Details
Full Name
Email Address
example@example.com
Please enter your phone number
Organisation / Consultancy Name
Upload CV

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Summary of Relevant Experience
Professional Accreditation
Section 2 — Consultancy Approach and Values
Method Statement
NHS Employers values include being respectful, inclusive, bold, collaborative, acting with integrity
Areas of Specialist Expertise
Other (please specify below)
Please describe your previous experience within the NHS.
Section 3 — Commercial and Operational Information
Please confirm your standard day rate
Please confirm your current capacity and availability
Please confirm your geographical flexibility
Please outline the regions you are available to work in
Please outline the types of assignments you prefer to undertake.
Section 4 — Governance and Compliance
Conflict of Interest Declaration
Examples of potential conflicts of interest include holding a financial interest in an organisation that could benefit from your consultancy work, providing advice to competing organisations, using confidential information gained through your work for personal or commercial advantage, or being involved in decisions that may affect your own business interests or those of your clients.

Other potential conflicts may arise from close personal relationships with individuals in supplier or partner organisations, accepting gifts, hospitality, or other benefits from parties connected to your consultancy activities, or undertaking work that could compromise, or be perceived to compromise, your independence and impartiality. This also includes any past or current roles, relationships, or engagements that could reasonably be seen as influencing your professional judgement.

Please declare any actual, potential, or perceived conflicts of interest so that they can be appropriately assessed and managed.
If you selected “yes,” please provide further details.
GDPR and Confidentiality Confirmation

I confirm that I comply with all GDPR requirements and adhere to NHS Employers and NHS Alliance standards for data protection, confidentiality and secure information management. I ensure that all sensitive workforce information is handled lawfully, fairly and transparently, and that appropriate technical and organisational measures are in place to protect personal data from unauthorised access, disclosure, loss or misuse. I only process workforce information for agreed purposes, maintain strict confidentiality at all times, and follow NHS information‑governance expectations regarding secure storage, controlled access, retention and disposal of data.
Section 5 — References & Supporting Statements

Please provide written reference statements as part of your application. References should be obtained directly from your referees and submitted alongside their contact details for verification purposes.
Reference Details 1
Reference 1 Full Name

First NameLast Name
Reference 1 Email Address
example@example.com
Upload Reference Statement 1

PDF, DOC, or DOCX
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Reference Details 2
Reference 2 Full Name

First NameLast Name
Reference 2 Email Address
example@example.com
Upload Reference Statement 2

PDF, DOC, or DOCX
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Confirmation of Reference Statements
Supporting Evidence of Impact
Section 6 — Equality and Inclusion Monitoring

We collect this information to help us understand who is registering and to ensure that our work practices remain fair, inclusive and accessible. The information provided in this section is used for monitoring and reporting only and will not be used to make decisions about your participation or eligibility. However, for specific pieces of work or programmes that have clearly defined criteria — such as targeted initiatives or schemes designed to support particular groups — the relevant information may be used solely to confirm eligibility in line with those stated requirements. This approach supports our commitment to equality, diversity and inclusion and ensures that opportunities are offered transparently and appropriately.
Please state your gender identity
If you selected “prefer to self‑describe,” please share how you describe your gender identity, using the wording that feels most comfortable for you.
Please state your sexual orientation
If you selected “prefer to self‑describe,” please share how you describe your sexual orientation, using the wording that feels most comfortable for you.
Optional
Please state your religion or belief
If you selected “prefer to self‑describe,” please share how you describe your religion or belief, using the wording that feels most comfortable for you.
Optional
Please state your ethnic background
Please state whether you have any disability or accessibility needs.
If you selected “yes,” please provide details of any disability or accessibility needs so that we can ensure appropriate support and reasonable adjustments.
Which age group do you belong to?
Section 7 — Final Submission
Additional Notes (Optional)
Declaration
Should be Empty:

Workforce Solutions – Affiliate Registration Form

Section 1 — Personal and Professional Details

Section 2 — Consultancy Approach and Values

Section 3 — Commercial and Operational Information

Section 4 — Governance and Compliance

Section 5 — References & Supporting Statements

Reference Details 1

Reference Details 2

Section 6 — Equality and Inclusion Monitoring

Section 7 — Final Submission