Page 1: Information Governance

This form should be used to report any variation to the period of Enhanced Supervision that takes place immediately following a trainee's return to clinical practice. It is for use if the trainee intends to undertake any variation on the standard 10 working days of Enhanced Supervision immediately following their return to work (including timing, increased and decreased duration and changes to level of trainee responsibility/supervision).

This is to be completed by the trainee and their Educational Supervisor (or SuppoRTT Champion if the trainee has no ES) at the time of the Pre-return Planning Meeting.

It is important that a copy of the PDF generated by completion of this form is sent by email to the SuppoRTT Hub (supportt.sw@hee.nhs.uk), the local SuppoRTT Champion and the trainee's Training Programme Director.  Approval must be granted by the SuppoRTT Champion before it can proceed.

The information collected in this form will be securely held by HEE and will only be accessible to those directly involved in the Supported Return to Training; including the Professional Support Unit. Information may also be made available to the trainees employing Trusts / GP School Supported Return to Training Champion / administrator, Head of School, Training Programme Director and School Specialty Manager. Data will not be shared wider without your explicit consent.

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If you are completing this survey as a "trial run", please just enter your details as:

Trainee First Name: x

Trainee Last Name: x

GMC / GDC / Public Health Number: 123

This will enable us to delete any completed forms that make it into our database, but are not the official entries.

Please note that it is not possible to save drafts of these data entry forms and return to complete them at a later date.

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