V5 - August 2015 Save paper – print double sided

IDENTIFICATION BADGE APPLICATION FORM

You MUST complete ALL the details below in full and in clear capital letters. Any incomplete forms may not be processed and may be returned.

Attach ONE passport sized photograph - write your name clearly on the back of the photograph.

NAME ………………………………………………………………………………....…………… D.O.B ........./........../.........

CONTACT EMAIL (NHS preferred) …………………………………………..…………….…………………………………..…

POST TITLE …………………………………………………………………………..………………………………………….

SERVICE / DEPARTMENT ………………………….………………………………………………………………………....

BUILDING / BASE ……………………………………………….……………………………………………........................

LINE MANAGERS NAME …………………………….……………………………………………………………………..….

LINE MANAGERS EMAIL ……………………….………………………………………………………………………..…….

Is this application for a bank staff position?

Is this your first Sussex Community NHS Trust ID badge?

Yes No

Yes No

IF THIS IS YOUR FIRST SCT ID BADGE:

Please put the date of your Trust induction (if known):

…….…/…………/…………

Your ID badge will be ready to collect at your Trust induction. If you have already attended your Trust induction, please choose a location to collect your badge from the list on the right.

BANK STAFF If your ID badge is for a Bank Staff position, please select a location from the list on the right where you will be able to collect your ID badge. Please read item4.3 on the following page for further guidance.

VOLUNTEERSPlease read item 4.3 on the following page for further guidance.

IF THIS IS A REPLACEMENT SCT ID BADGE / BANK STAFF

Please choose ONE location to collect your ID badge from :

You will be contacted by email when your replacement badge is ready to collect.

Please return this form to: Security Team, Estates Department, First Floor, Arundel Building,Brighton General Hospital, Elm Grove, Brighton, BN2 3EW

Arundel Hospital (Facilities)

Beach Park House, Worthing

Brighton General Hospital (Security)

Bognor Regis War Memorial Hospital (Facilities)

Chailey Heritage (Facilities)

Crawley Hospital (Facilities)

Crowborough War Memorial Hospital

Horsham Hospital (Facilities)

Kleinwort Centre, Haywards Heath (Reception)

Lewes Victoria Hospital

Southgate House, Chichester (Reception)

Uckfield Community Hospital

Zachary Merton Hospital, Littlehampton (Facilities)

V5 - August 2015 Save paper – print double sided

1. Introduction

1.1 All members of Sussex Community NHS Trust (the ‘Trust’) staff are required to wear an authorised ID badge. This enables staff to prove their identity, particularly when they are visiting patients in their homes, or visiting other Health Service premises. It also means that patients and visitors know who they are talking to and who is talking to them.

1.2 The services where staff are exempt from wearing their ID badges are:- Chailey residential unitsHowever, ID badges must still be carried by staff in exempt services, even if not worn openly.

1.3 Service Directors may use their discretion to allow other staff to wear a name badge where this is considered more appropriate for local circumstances. In such cases, staff must still have an ID badge available for verification.

2. Procedure for obtaining an ID badge

2.1 On appointment, or where name or job title change, an application form available from the Security Team must be completed in full by the member of staff. The member of staff should produce one passport sized colour photograph and forward this with the completed form to the Security Team. Badges may take two weeks to process from the date of confirmation by the named line manager.

2.3 Upon receipt of application the named line manager will be contacted via email requesting verification, and once verified, the badge will be produced and either be distributed at induction, or be held for collection at the selected location if it is a replacement badge. If no location/induction is identified, the Security Team will retain the ID badge until further notified. In exceptional circumstances your badge may be forwarded to the base address provided.

2.4 When staff leave employment of the Trust or change department, the existing line manager must make arrangements for the ID badge to be handed in by the staff member on their last day of work and for the badge to be returned to the Security Team.

2.5 If an ID badge is lost, the loss must be reported at once on an incident form and a request for a new form submitted immediately.

2.6 All data is securely recorded for security purposes, a date of birth is requested as a unique identifier for staff with similar names, application forms are destroyed within one week of the ID badge being printed. Photographs are returned upon issue of an ID badge.

2.7 Local arrangements should be made to provide regular visitors, such as contactors, with badges reading ‘Authorised Visitor’. Managers must ensure close control of the issuing and return of such badges.

3. Authorising Officer

3.1 For security reasons, Line Managers must be identified on applications for ID badges, and must provide their email address on the form for verification. The badge will not be created until the line manager has responded to the verification email.

4. ID Badge Issue

4.1 Your first ID badge will be available to collect at your Trust induction. ID badges will only be posted internally to your base in exceptional circumstances. If no collection location/induction is identified, your badge will be held with the Security Team at Brighton General Hospital.

4.2 For verification, replacement badges must be collected from one of the designated locations, where you will be asked to exchange your old badge (if not lost). You must collect your own badge so as to verify the likeness to the photo ID.

4.3 ID badges for new volunteers will be sent to either Volunteer Services at Brighton General Hospital, Volunteer Services at Crawley Hospital, Breastfeeding Peer Support, Sussex Snowdrop Trust or Macmillan Midhurst Service for distribution. If you are a new member of bank staff, please choose one of the locations on the form to collect your ID badge. Any replacement badges need to be collected following the standard procedure.