Form Application form and guidance to apply for nursing study leave funding Funding is provided from the Sheffield Hospitals Charity bursary award for nursing top-up degrees from the J Sinclair White fund. Sheffield Hospitals Charity (Registered Charity No. 1059043) is the working name for Sheffield Hosptials Charitable Trust and related charities. Sheffield Health and Social Care Charity (Registered Charity No. 1059043-3) and the J Sinclair White fund are two of the related charities of Sheffield Hospitals Charitable Trust. This application form is for all nursing staff employed by an NHS organisation in Sheffield to apply for funding to undertake a degree course or attend one-off training courses or seminars. If you are a member of nursing staff wanting to apply for funding for a top-up or Masters level degree, please use our other application form Form SHC Ref. 2: Application form and guidance to apply for nursing top-up degree study leave funding - that is available on our website or by contacting the Charity. Please ensure you read the following principles of funding carefully as they give further guidance on eligibility, what you can expect in terms of funding and completing the application. If you have any queries about the application or problems completing it, please contact the Charity s finance team on: Tel: 0114 271 1351 Email: charity@shct.nhs.uk Web: sheffieldhospitalscharity.org.uk Explain you are completing an application form for nursing staff study leave funding and a member of our team with be able to assist you. Once you ve completed your application you need to send it for approval. All applications should be sent to: Helen Hanrahan Education Commissioning Manager Education and Development Department Rivermead Training Centre Northern General Hospital Herries Road Sheffield S5 7AU Completed applications should not be returned to the Charity. Once your application has been approved you will need to complete a claim form for your expenses and return it to Sheffield Hospitals Charity for reimbursement. This claim form Form : Nursing study leave funding claim form (a) is available on our website or by calling our finance team, details above. 1
Principles governing the funding of study leave for nursing staff Revision 2012 Introduction The Trustees have agreed that the following principles will be adopted in determining the financial contribution towards the costs of Study Leave for Nursing Staff. Eligibility All nursing staff, including health care assistants, support workers and assistant practitioners, working in, or contracted to hospitals or NHS Trusts in Sheffield shall be eligible for consideration. Applications should relate to assistance with personally incurred course, hotel and travel costs relating to attending organised courses and seminars or fees for approved diploma or degree courses (excluding Top-Up or Masters Level Top-up degrees, for which Form SHC Ref. 2: Application form and guidance to apply for nursing top-up degree study leave funding should be used). Reimbursement to other Trust Funds or other organisations can no longer be made. Support cannot be given for visits to organisations, non-educational purposes or requests with no perceived direct benefit to the NHS. Applicants may make more than one application in any one accounting period, but the maximum amount payable in any one accounting period will be limited to 1,200. (Please note that this figure will be reduced for multiple applications in different categories on a case by case basis.) The accounting period currently runs from 1 April to 31 March. Application Protocol All applications for assistance shall be on the currently approved form (attached) duly signed by the applicant and approved by the Matron. Applications not fully authorised or submitted on any other form will be returned. Requests received for courses already completed will be considered subject to the availability of funding. Completed forms should be forwarded to Helen Hanrahan, Education Commissioning Manager (address details on front page), who will verify the application and forward to the Charity for processing. Method of Costing All applications should provide an estimate of the total costs, in sterling, of: - Course or diploma / degree course registration fees (all categories) - Travel costs incurred in attending the course. Please note that any mileage claims will be reimbursed at public transport rate. (Category 1 and 2 applicants only) - Hotel costs for the duration of the course (Category 2 applicants only) 2
Level of Contribution The Trustees shall assess the merits of each application based on the information provided. It would aid the decision making process if a copy of the course programme or equivalent is enclosed with the application. The level of contribution shall be:- Category 1 Category 2 Category 3 Attendee or Delegate at the Event: Full reimbursement of the relevant course fee and travel expenses of the attendee to a maximum amount under this category of 1,000 per individual in any accounting period. Participating in the event by either presenting an oral paper, displaying a poster, chairing a session or some other special involvement: Full reimbursement of the relevant course fee, travel expenses and hotel costs of the participator to a maximum amount under this category of 1,200 per individual in any accounting period. Approved Diploma or Degree Course: 50% of the Fee Cost to a maximum of 1,000. To qualify for the enhanced support under Category 2, some documentary evidence of qualification should be supplied with the application. This might include, for example, naming of the applicant in the Event Programme or a copy of the Letter of Acceptance for a Presentation. If this is not received prior to the leave period, then approval will be made at the lower delegate rate of Category 1, i.e. reimbursement of course fee and travel expenses only. The formal approval for the enhanced rate will be issued upon receipt of the notification. For Category 3, a copy of the Letter of Acceptance for the diploma or degree course should be attached. Please note that courses are approved on a year by year basis. An application should therefore be submitted for each individual year of the diploma or degree course. Formal approval will be issued as appropriate. In all cases, the confirmation of approval will be notified to the applicant as soon as practicable. Approval shall be in the form of an email from Sheffield Hospitals Charity to the email address entered on the application form. The Trustees shall not accept responsibility for any financial commitment made in anticipation of an approval that is not granted. Telephone messages should not be acted upon until confirmed in writing. PLEASE NOTE: No claim form or receipts should be submitted until notification of approval has been received. Payment Method Agreed sums shall be paid upon submission of the Sheffield Hospitals Charity Form a: Nursing study leave funding claim form. Claims submitted on any other expenses form will not be accepted. Documentary proof of attendance on the course should also be submitted where possible. 3
All claims, together with original receipts, should be authorised by the relevant Matron prior to submission. Any claim not so authorised will be returned. For retrospective applications, no claim form or receipts should be submitted prior to the issue of the formal approval letter. The total grant payable will be the lower of:- i. The estimated costs per the application form. ii. The actual costs incurred. Amounts expended in foreign currency will be converted at the prevailing rate on the day of the expenditure, wherever possible. Claims for reimbursement should be submitted within three months of the end of the period of study leave, or three months from the date of this approval, whichever is the later. Any claims received after this period will not be processed unless prior agreement has been received from the Head of Finance of Sheffield Hospitals Charity. Where fee payments are more frequent than once per year, e.g. payment for individual modules, claims for reimbursement should be submitted within three months of the date of payment. Each claim must be on the approved claim form. 4
Form Application for financial assistance towards nursing study leave Once completed, this application should be sent to: Helen Hanrahan, Education Commissioning Manager, Education and Development Department, Rivermead TrainingCentre, Northern General Hospital, Herries Road, Sheffield S5 7AU. Full name of Claimant.. Grade.. Clinical Speciality. Ward and Hospital / Base / Unit.. Home address (for correspondence)......... Postcode..... Tel.... Mobile.... Email.. Please note: this email address will be used to notify you of the decision on your application. By providing your email address, you consent to receiving email communications, including fundraising messages, from us unless you have indicated otherwise by ticking the box overleaf. Title of event / diploma / degree course....... Event / term dates........ Location of event......... Objectives of event / diploma / degree course..... Status of applicant in relation to event (please tick ONE box as appropriate): Please include evidence of eligibility if you select Category 2 or 3. 5 Category 1 - Attendee or Delegate at the event Category 2 - Participating in the event by either presenting an oral paper, displaying a poster, chairing a session or some other involvement Category 3 - Diploma / Degree course
Estimated costs to be incurred personally by Applicant Details (original receipts are required for all items except mileage) Sterling total p Course registration fees (all categories) Travel expenses (categories 1 & 2 only) Mileage = Estimate of miles to be claimed @ 33p per mile (public transport rates) Hotel charges (category 2 only) Estimated total expenditure p Please remember: - Do not forward receipts with your application, but include evidence of eligibility for Categories 2 and 3. - Original receipts only should be forwarded with the approved claim form and these will be retained by Sheffield Hospitals Charity for audit purposes. Copies will only be accepted in exceptional circumstances. - Claims for reimbursement should be submitted within three months of the end of the period of study leave (or date of payment for diploma or degree course fees), or three months from the date of the approval notification, whichever is the later. Any claims received after this period will not be processed unless prior agreement has been received from Sheffield Hospitals Charity. I confirm that the information I have entered above is to the best of my belief respresentative of the estimated costs incurred. I confirm that I have read and accept the principles as set out in Principles governing the funding of study leave for nursing staff, 2012 Revision. Signature of Applicant Signature... Date.. Signature of Matron Signature... Print name Date.. Sheffield Hospitals Charity is the working name for Sheffield Hospitals Charitable Trust and related charities. Registered Charity No. 1059043. We will respect your privacy and never sell your details to any third party. We would like to add you to our list of supporters so we can send you information (including by email) about our work and our quarterly newsletter. You can unsubscribe easily at any time by emailing charity@shct.nhs.uk or calling 0114 271 1351. If you DO NOT want to receive this information by post please tick here If you DO NOT want to receive this information by email please tick here Verified by (to be signed by Education Commissioning Manager): Signature Date. 6