Page 1: Information Governance

If possible, this form should be completed by the trainee and their Educational Supervisor approximately 2 weeks after their return to work. Please note that this form provides a template for recording the discussion between the ES and Trainee.  HEE receives a copy of this form once submitted however the actions needed to safely return a trainee to training will need to be carried out by the ES and trainee.

The return to work scheme is required for absences of 3 months or more but can be opted into for absences less than 3 months if trainee or Educational Supervisor feel it is necessary.

The information collected in this form will be securely held by HEE and will only be made accessible to those directly involved and necessary to expedite the trainees' return to training journey including any of the following: the Professional Support & Wellbeing Service (PSW), the trainees employing Trust HR Team/Lead Employer, Supported Return to Training Champion, Head of School, Training Programme Director, GP Programme Manager (if applicable), Educational Supervisor and East Midlands Careers Service. Data will not be shared wider without your explicit consent.

1.1. Please confirm that you have read and understood the information provided above and that you consent to your information being processed in this way. Required