NHS FORTH VALLEY OPERATING PROCEDURE FOR CAR LEASING SCHEME

NHS FORTH VALLEY OPERATING PROCEDURE FOR CAR LEASING SCHEME Date of First Issue 01/09/1987 Current Issue Date 02/12/2015 Review Date 31/12/2017 Approved 01/05/2009 Version Version 3.0 Author / Contact Gerald Ferrie (Transport & Waste Manager) 01324 614336 EQIA Yes 04/12/2015 Group / Committee Joint HR/Finance group Final Approval This document can, on request, be made available in alternative formats Version 3.0 02 December 2015 Page 1 of 23

Management of Policies Procedure control sheet (Non clinical documents only) Name of document to be loaded Area to be added to Operating Procedure for Car Leasing Scheme General Policies and Transport Department Policies Type of document Priority Policy Guidance Protocol Other (specify) Procedure Immediate 2 days 7 days 30 days X Questions Understanding Yes No X Options Where to be published External and Internal Internal only X Target audience NHSFV wide X Specific Area / service NHS Forth Valley Consultation and Change Record Contributing Authors: Consultation Process: Car Lease Review Working Group Car Lease Review Working Group Staff Side Distribution: NHSFV Intranet Car Lease Drivers as required Change Record Date Author Nature of Change Reference 22/04/2009 G Ferrie Old procedure Version 1 approved back in 1987 22/04/2009 G Ferrie Existing procedure updated to NHSFV template and current version revised for current practice 1.0 2.0 Version 3.0 02 December 2015 Page 2 of 23

01/10/15 G Ferrie Existing Format updated to comply with NHS Forth Valley Policy on Developing Guidelines and two yearly review of Procedure contents. Contents revised in line with new lease vehicle contract. 3.0 Version 3.0 02 December 2015 Page 3 of 23

Table of Contents Page Introduction... 5 1 General... 5 2 Eligibility... 7 3 Method of Application... 7 4 Use of Vehicle... 8 5 Maintenance... 10 6 Replacement Vehicles... 11 7 Insurance... 11 8 Termination... 12 9 Vehicle Excise Duty... 13 10 Excess Charge/Rebate On Mileage... 13 11 Accessories, Factory Options, etc.... 13 12 Payment By Deduction From Salary... 13 13 Fair Wear And Tear... 14 Appendix 1 - CAR LEASE TRAVEL APPROVAL FORM (Form 1)... 15 Appendix 2 APPLICATION FOR LEASED VEHICLE (Form 2)... 16 Appendix 3 APPLICATION FOR TRANSFER OF LEASED VEHICLE... 19 Appendix 4 CRITERIA FOR BASE AMOUNTS... 20 Appendix 5 - PROCEDURE FOR ASSESSMENT OF VEHICLE STATUS... 21 Appendix 6 - CAR USER DECISION MAKING FLOWCHART... 22 Version 3.0 02 December 2015 Page 4 of 23

Introduction NHS Forth Valley (NHSFV) recognises the importance of providing modern, efficient, cost effective and environmentally responsible arrangements for those posts where car leasing is the most appropriate system for travel between sites and on NHSFV business. Governance Arrangements NHSFV reviewed its mileage rates and created a single system for their regular review during 2008 to ensure these rates reflected the variable economic conditions as far as practicable and also equity and consistency of application across the system. The reviewed procedure was considered by NHSFV s Remuneration Committee in December 2008 and following minor amendment was agreed at Executive Director level. The arrangements were formally put into place from 1 st May 2009. Summary of key changes in Version 3.0 The key changes include: As a result of the National Procurement Contract for Lease Cars determining that four year leases are the optimum length, the base amount contributed by the Board has been amended to reflect the change. As a result of Leasing Companies not automatically extending vehicle leases at end of contract, the period of notice given to staff whose application is not going to be renewed commences in the final months of the lease rather than at the end of contract. 1. General 1.1 Employees as defined in the Agenda for Change: NHS Terms and Conditions of Service Handbook Section 17, Medical & Dental Whitley Council Handbook, Sections 304 to 308 may be offered a leased car. Eligible staff who are offered a Car and reject the scheme will only be entitled to receive reimbursement at the Reserve rate. 1.2 The Scheme is based on Contract Hire Agreements between NHSFV and the Leasing Company, which enables NHSFV to provide an allowance equal to a fully maintained base vehicle for use by the eligible employees in connection with the Business of NHSFV. NHSFV has agreed that the base vehicle will normally be adequate for all normal official duties. The employee makes a monthly payment via payroll deduction (reviewed on anniversary) to NHSFV, in respect of his/her private use of the vehicle, and this payment includes Maintenance, Insurance premium, Road Fund Licence and Breakdown Recovery. The employee is responsible for certain additional payments, which may arise under the terms of contracts in certain circumstances. Details of the additional payments, which can arise, are given later in these conditions and include charges made in the event of premature termination of the Hire, Excess Mileage charges, repair costs due to driver abuse, Insurance Excesses, etc. Version 3.0 02 December 2015 Page 5 of 23

1.3 In exceptional circumstances, the employee may be asked to accept a non-new vehicle previously allocated to another employee. In these circumstances, the employee will continue to benefit from the fixed rental charged by the leasing Company. 1.4 The car will normally be leased for a four-year period and any approved business mileage undertaken in the leased vehicle will be reimbursed at the appropriate rate, calculated as outlined in paragraph 1.9 below. 1.5 Two base allowances will be used to determine the contribution of NHSFV (one for Consultant Medical staff, one for all other staff). These allowances are based on 6666 business miles per annum and will be adjusted to reflect individual approved mileages and lengths of lease contract. Similarly the employee will be required to estimate his/her private mileage over the contract period. The accuracy of the total business and private mileage is important as it determines the Rental rate at which the Leasing Company will supply the vehicle. All applications must be made, in the first instance, to the employee s Head of Department/Exec/GM who will contact the Car Leasing Department for assessment of eligibility. 1.6 After authorisations have been approved, information on the cost to an employee of leasing a particular vehicle can be obtained from the Car Leasing Department. The cost will be based in part on the cost to NHSFV, at the date of delivery and may, therefore, be subject to change between the date of ordering and the date of delivery. Every effort will be made to avoid such changes. Lease Charges will be payable from the date on which the vehicle is available for collection/delivery. 1. Cost to NHSFV The cost of renting a standard base car for business mileage will be borne entirely by NHSFV. The employee will pay additional costs which depend on the following three things: 2. Make and Model If the employee chooses a higher specification car, the annual rental charge to NHSFV of the standard base amount is deducted from the actual cost of the model chosen and the employee will meet the difference in cost. 3. Private Mileage The cost of renting the car over four years of the lease also depends on the Total Mileage; i.e. business and private added together. The costs of business mileage in a standard base car is deducted and the employee will pay the difference. The employee must estimate annual private mileage very carefully to the nearest 500/1000 miles. Under/over estimates will be reviewed on the anniversary and corrective adjustments made. A final review will take place at the end of the contract. Employees may request a review if their estimated mileages vary greatly from actual mileages covered. 4. Fixed Costs The member of staff will meet the full cost of the Road Fund Licence, annual handling charge and 50% of the insurance premium. These charges are all subject to VAT at the appropriate rate. Version 3.0 02 December 2015 Page 6 of 23

1.7 A formal Agreement will be entered into between the employee and NHSFV. 1.8 NHSFV will contribute an agreed amount based on business mileage towards the cost of the vehicle and this amount may be reviewed from time to time. Any such reviewed contribution of NHSFV will apply only to new contracts entered into after the review date. NHSFV will support the acquisition of a vehicle chosen by an employee subject to their being satisfied that the vehicle is in all respects suitable for use on NHSFV business. The Chief Operating Officer will be responsible for determining if a chosen model is unsuitable. 1.9 The employee s fuel costs incurred on official business will be reimbursed in accordance with fuel costs monitored nationally and advised to Payroll Services on a regular basis by the National Payroll Project Team. The rate(s) will be amended from time to time in accordance with the following formula:- = Pence per mile Unleaded Petrol Price (per gallon) Mileage per Gallon (of base vehicle) 2. Eligibility 2.1 Following a financial appraisal, employees may be offered a leased car. 2.2 Eligibility is subject to: (a) (b) (c) (d) Confirmation that the member of staff is required to use a car on NHSFV business. Financial viability assessment. The applicant holding a valid current full driving licence for the class of vehicle applied for. The applicant s ability to comply with conditions laid down by the Leasing Company and this NHSFV procedure. 2.3 NHSFV reserves the right to refuse application and to consider other relevant factors in making a decision. 2.4 The users of cars leased under this scheme are required to notify NHSFV immediately of any event which affects or might affect their eligibility to participate in the scheme. 3. Method of Application 3.1 Applications under the scheme shall be in the form prescribed by NHSFV who shall administer the scheme and in so doing may make any enquiries considered necessary in the financial interest of NHSFV. Version 3.0 02 December 2015 Page 7 of 23

3.2 Appraisals will be done in the Car Leasing Department and the Car Lease Travel Approval Form (Form 1) will be submitted to the General Manager/Director for consideration of financial appraisal, recommendation and authorisation or otherwise. If lease (or extension) approved, the signed Form 1 is returned to the Car Leasing Department. See Appendix 1. After approval, Application Form (Form 2) will be issued to the driver by the Car Leasing Department to complete the information to enable specific vehicle quotations to be obtained. See Appendix 2. The applicant will then be notified of the monthly charge payable after which a formal agreement between NHSFV and the applicant will be completed. The employee will be advised of estimated delivery/collection date, then when vehicle arrives in stock they will then be contacted to finalise time and place where their vehicle will be available for delivery/collection. 3.3 Staff whose business mileage is less than assessed as being financially viable for NHSFV will be assessed to establish whether there is a valid reason for the lower mileage, i.e. maternity leave, sickness absence, secondment, post change, etc. Where a valid explanation cannot be established, NHSFV may decide not to offer a replacement lease car. If approval is not granted, the employee will be notified of the decision by their department manager. If a lease car is not to be renewed, a period of notice of up to 12 months will be given to allow the employee to make alternative arrangements for their business travel. It should be noted that the Leasing Company can demand the return of the lease car any time after the expiry of the contract. They may, however, grant an extension. The period of notice given to the employee will commence in the months prior to the expiry of the contract. The employee will then be eligible for Standard User rate reimbursement as appropriate. 3.4 As specified in paragraph 1.6, the charge payable by the employee will be based in part on the cost of the car to NHSFV at the date of delivery. The Agreement signed by the employee provides for a change in the monthly charge to take account of any change in cost to NHSFV between the date of the Agreement and the date of delivery. In such cases, the employee will be sent an amended Offer Acceptance letter to sign. 3.5 Eligible staff who are offered a lease car and reject the scheme will only be entitled to receive reimbursement at the Reserve rate. 4. Use of Vehicle 4.1 The vehicle must be available at all times, subject to servicing and repairs, for use by the employee in the performance of the employee s official duties as required by NHSFV. 4.2 If an employee has more than one Post with NHSFV, then the lease vehicle should be used for all business miles undertaken, with reimbursement being made at the agreed mileage rate for that vehicle. Version 3.0 02 December 2015 Page 8 of 23

4.3 The vehicle must not be used for:- Driving tuition for commercial gain, racing rallies, speed or time trials, hill climbs or any form of competition. Any purpose for which the vehicle is not designed. Hire, conveyance of passengers or goods for reward. Any unlawful purpose or in any contravention of any statute or regulation. 4.4 The vehicle must not be used for any Non-NHSFV business/commercial activity unless specific approval in writing has been obtained from the employees Director/General Manager, Leasing Company and insurance company. 4.5 Although the vehicle remains the property of the Leasing Company, the employee is liable for its roadworthiness and is required to indemnify NHSFV against parking fines, or other liabilities arising from the way the vehicle is used, particularly breaches of the Road Traffic Act. 4.6 The vehicle should normally be kept at the driver s home address and garaged whenever practicable. In the event of an employee with a staff car moving home, the Human Resources Department and Car Leasing Department must be informed in writing of the change. 4.7 The employee must not lend, let or hire, sell assign, transfer, charge, dispose or part with the control of the leased vehicle or attempt to do so. 4.8 Application in writing must be made through the Car Leasing Department to the Leasing Company for permission to take the vehicle out of the United Kingdom. Foreign Travel, including Ireland, will be permitted subject to the arrangement, by the employee, of satisfactory insurance and adequate breakdown and recovery protection. Responsibility for the vehicle will rest with the employee until it is returned to the UK. Repairs and maintenance which are carried out abroad are not covered by the Maintenance Agreement with the Leasing Company and are the sole responsibility of the employee who must take out appropriate cover (e.g. AA 5-Star Cover or equivalent). On each occasion applications for permission to take vehicles outside of the UK should be submitted at least four weeks before the proposed commencement of the journey. 4.9 An NHSFV Expenses Form must be completed on a monthly basis either electronically or in paper form. Total mileage for the vehicle must be clearly stated on the expense claim form. A further supply of Forms can be obtained from the Payroll Department. Tampering with the vehicle s odometer will be regarded as a serious disciplinary offence. 4.10 Where the employee is absent from duty for a prolonged period (e.g., sickness leave, maternity leave, training courses, extended leave abroad) he/she will normally continue to have the private use of the vehicle. The employee will still be responsible for making payments as appropriate. Version 3.0 02 December 2015 Page 9 of 23

5 Maintenance 5.1 In accordance with the Agreement with NHSFV, the Leasing Company will provide or pay for:- (a) (b) (c) (d) (e) Regular routine maintenance and servicing. All remedial or repair work arising without negligence or misuse or accident on the part of the employee and needed to maintain the vehicle in a roadworthy condition. Replacement batteries. Replacement exhaust systems. Replacement tyres due through normal wear. 5.2 On taking possession of the vehicle, the employee will receive a set of instructions from the Leasing Company (driver's pack) regarding routine servicing and arrangements for repairs and breakdowns and replacement of tyres, batteries and exhaust systems. The employee should make themselves aware of the requirements of the Leasing Company contained in the instructions or otherwise notified to him/her and comply with those requirements at all times. 5.3 When the new vehicle is delivered, the employee will be responsible for ensuring that there are no defects of any kind which are apparent on reasonable inspection and that all standard and optional equipment is present, where this can be ascertained by reasonable inspection. When accepting delivery, employees should bear in mind their responsibility to return the vehicle in good order, repair and condition at the end of the contract. 5.4 The employee may be able to advise the Leasing Company of the garage where the employee wishes maintenance and warranty work to be carried out, and if approved, the Leasing Company will then make arrangements with the selected garage. 5.5 The employee will be responsible for the car s roadworthiness and for routine checking of oil, water, batteries, tyre pressures and other items which a responsible owner would be expected to check from time to time, together with any associated routine maintenance such as topping up of the oil, water levels or adjusting the tyre pressures. Damage to the vehicle or any cost arising from failure to carry out such routine checks and maintenance or from negligent use or deliberate abuse of the vehicle by the employee will be the responsibility of the employee, who will be required to reimburse any resultant cost to NHSFV. This, for example, includes engine damage, wheel/tyre damage. It is the employee s responsibility to keep the car clean inside and outside during the period of hire. Failure to comply with these conditions may result in additional cost penalties. 5.6 In the event of emergency repairs or towing to a local garage, only the appropriate motoring organisation shall be contacted. If settlement has to be made to them for any Version 3.0 02 December 2015 Page 10 of 23

part, the Leasing Company will reimburse by return on production of receipts. Parts must be retained in the event of any claim under warranty. If the part is not available, settlement may be withheld pending investigation. Full details of emergency procedures are contained in the driver s pack from the Leasing Company. 5.7 Repairs and replacements from wilful neglect or deliberate abuse are not included in the Scheme and costs arising from these causes will be borne by the employee. Accident and windscreen damage will be covered by Insurance claims subject to the appropriate Excess. 5.8 The vehicle will be covered by the AA, RAC or other Recovery Company as specified by Leasing Company. 5.9 In the event of an accident the employee should immediately contact the Insurance Company and then advise the Car Leasing Department reporting the circumstances, giving details of: Place of Accident, Date, Time, Registration number of Leased Car, Third party details (if available) and a brief account of the accident. 6. Replacement Vehicles In the event of a mechanical breakdown or if a vehicle is off the road on account of major mechanical repairs which require more than 24 hours to complete and are not due to any act of neglect, default by the employee (or their families or other authorised drivers) or accident, the Leasing Company will arrange for the provision of a replacement vehicle within 24 hours of notice being given to them. Employees should not arrange replacement vehicles themselves but should notify the Car Leasing Department. Mileage run in replacement vehicles will count towards the total contract mileage. 7. Insurance 7.1 A national standard Comprehensive Motor Fleet Policy has been effected in respect of Lease vehicles. A copy is held within the Car leasing Department for inspection should this be required. Drivers will contribute 50% of the insurance premium. 7.2 The Policy allows private use by the employees and private use by certain other persons authorised by the User and advised to the Car Leasing Department provided that the person driving holds a Licence to drive the vehicle and is not disqualified from holding or obtaining such a Licence. Driving Licences of named drivers will be inspected at regular intervals during the contract. This insurance cover for private use is mandatory. Private use of the vehicle without insurance cover is an offence under the Road Traffic Act and unauthorised use in these circumstances will be regarded as a serious disciplinary offence which may result in dismissal. 7.3 Where a vehicle repairer provides a courtesy/replacement car, it will not necessarily be the same type/size as the lease vehicle in for repair. 7.4 Where the official user and/or any other driver is under the age of 25, or is a new driver, additional Claim Excesses may apply. Details of these can be obtained from the Car Leasing Department. All Claim Excesses arising from private use of the vehicle by named drivers will be charged to the employee. Version 3.0 02 December 2015 Page 11 of 23

Where Consultants use a NHSFV vehicle for their private practice, this risk must be insured. 7.5 The employee is required to report to the Car Leasing Department any convictions in connection with any motor vehicle (other than parking offences) for insurance purposes. NHSFV reserves the right to charge to the employee any additional insurance charge or Excess attributable to the employee s driving record. In the event of the employee becoming disqualified from driving, the vehicle will be withdrawn forthwith and the employee will be responsible for meeting any excess or penalty charges which result. 7.6 The cover will exclude use as specified in paragraph 4.3 above. 7.7 Should a User leave the scheme, a letter can be provided by the Insurer confirming the number of claim-free years or otherwise, for submission to Insurance Companies for No Claims Bonus purposes. 8. Termination 8.1 As specified in paragraph 1.4, the car will normally be hired for a four year period and arrangements must be made for the replacement or return of existing vehicles at least four months before the end of an expiring contract. If any contract is terminated prematurely, the Leasing Company may impose certain penalty charges, details of which will be provided on application to the Car Leasing Department. NHSFV can waive all penalties in the event of: - (1) Death in service (2) Retirement due to ill-health (3) Redundancy (4) Retirement in the interest of the efficiency of the service. (5) Imposed internal movement to a post without lease car user status 8.2 In any circumstances other than those referred to in paragraph 8.1, NHSFV will pass on to the employee all penalties incurred. 8.3 In the event of premature termination of the contract, the following courses of action may be available to employees following consultation with their Senior Manager:- (a) The employee may wish to purchase the car, in which case he/she should ask the Car Leasing Department for a quotation of a purchase price. Note there is still a Penalty Charge imposed by the Leasing Company regardless of whether the vehicle is purchased or not. This is based on how long the vehicle had been leased and the Penalties are scaled accordingly. The driver is responsible for the Full Amount, not the monthly contribution made, as this has been subsidised by NHSFV taking into account Business Mileage, etc. (b) If the employee is moving to (or from) another NHS organisation with a lease hire scheme, then the contract may be transferred. Employee payments vary between Health Boards so the employee is advised to clarify this at time of recruitment. 8.4 The lease vehicle must be returned in a condition satisfactory to the Leasing Company and should any financial penalty be incurred by NHSFV, this will be recharged to the Version 3.0 02 December 2015 Page 12 of 23

employee. 8.5 On completion of the contract, the Leasing Company may be willing to sell this vehicle to the employee at an agreed price. The Car Leasing Department can provide details. 8.6 The employee will be responsible for meeting the cost of any penalty fines incurred by him/her, or other person driving the vehicle, whether on business or private use. 9. Vehicle Excise Duty The employee will be required to reimburse NHSFV for the whole of any increase in the cost of the Road Fund Licence as at the date on which the employee s agreement is signed. It should be noted that Road Fund Licence Discs are no longer issued. 10. Excess Charge/Rebate on Mileage Mileages will be reviewed on the contract anniversary and corrective adjustments made. If at the end of the contract period the actual private miles travelled exceeds the estimate mileage, there will be an excess charge to that employee at the rate specified by the Leasing Company. Exceptionally, a repayment plan may be agreed with an employee to recover charges over a set period. If at the end of the contract period the actual private miles travelled is less than the estimated mileage there will be a rebate to the employee at the same rate. 11. Accessories, Factory Options 11.1 At the request of the employee, optional equipment can be fitted by the Leasing Company, but this will increase the monthly payments to be made by the employee and the equipment will remain the property of the Leasing Company at the end of the Contract. 11.2 No accessories may be fitted privately by the employee without prior written consent of the Leasing Company through the Car Leasing Department. If any accessory cannot be removed from the vehicle without substantial or irreparable damage being caused, then such accessories must be surrendered with the vehicle at the end of the period of hire, or the damage sustained should be repaired as such that no previous damage is noticeable on return of the vehicle. 11.3 The employee shall be entirely responsible for restoring the car to a condition satisfactory to the Leasing Company at the end of a contract. 12. Payment by Deduction from Salary 12.1 Payments to cover the vehicle rental, road tax, insurance, handling charge will be deducted from salaries on a monthly basis. Version 3.0 02 December 2015 Page 13 of 23

Deductions for recharges, Claim Excess, etc. will also be made from salaries. 13. Fair Wear and Tear 13.1 The employee will be responsible for keeping the vehicle in good condition, internally and externally subject only to fair wear and tear. Fair wear and tear is determined by the Leasing Company who use detailed criteria. Further information is available to drivers on request from the leasing Company. 13.2 Since Leasing Companies operate their own procedures regarding disputes, drivers are referred to their specific Leasing Company both during the period of the contract and at end of contract should any dispute arise regarding the condition of the vehicle. 13.3 The Leasing Company reserve the right upon giving reasonable notice to inspect during working hours, the state and condition of any vehicle. 13.4 Any failure to comply with these conditions may cause the immediate termination of the Contract hire Agreement. Any penalty charges arising, therefore, will require to be met by the employee. In addition, disciplinary action may be taken by NHSFV in accordance with agreed procedures. 13.5 While the Lease Agreement remains in force, the employee will no longer be entitled to payment of Reserve Rate or Standard Rate Mileage Allowances as defined in the Agenda for Change: NHS Terms and Conditions of Service Handbook, Medical & Dental Whitley Council Handbook. He/she will be entitled to reimbursement as per paragraph 1.9. Version 3.0 02 December 2015 Page 14 of 23

Appendix 1 NHS FORTH VALLEY CAR LEASE TRAVEL APPROVAL FORM FORM 1 Name Position Work Base Current leased vehicle renewal date Estimated Business Miles Base amount to be used (for 3 year leases) AfC/Medical Base amount to be used (for 4 year leases) AfC/Medical Information confirmed by: Cost to NHSFV of lease Cost to NHSFV of Standard User Appraisal done by: General Manager/Director to complete 1 Offer extension of current lease vehicle 2 Offer Standard User 1321.44/ 1242.15/ 1928.64 1812.92 Comments: 3 Offer new leased car based on base car detailed above Approved by: Date: General Manager/Director This form to be returned to: Car Leasing Department Falkirk Community Hospital, Westburn Avenue, Falkirk, FK1 5SU Version 3.0 02 December 2015 Page 15 of 23

Appendix 2 Personal Details APPLICATION FOR A LEASED VEHICLE FORM 2 Name:... Date of Birth:... Address:................. Post Code: Home Tel Number:... National Insurance No:.... Work Details Position: Grade:. Staff Payroll Number:. Work Address:.... Work Tel Number: Work Fax Number: E-mail address:.... Quote Requests Please complete attached Vehicle Request Form and return with this application Form. Car Leasing Department Fax: 01324 811159 Falkirk Community Hospital, Westburn Avenue, Falkirk, FK1 5SU Any queries contact Car Leasing Department on 01324 811122 or 01324 811152. Your quotes will be calculated and returned to you as soon as possible, please highlight which method you would prefer to receive your quotes: POST E-MAIL FAX Requests for quotes will only be accepted on the vehicle request form. A maximum of 6 quotes can be requested. Version 3.0 02 December 2015 Page 16 of 23

Vehicle Request Form Name Personal Mileage: Business Mileage (as approved): Total Mileage: Information to be completed by driver MAKE/MODEL AND NO OF DOORS QUOTE 1 QUOTE 2 QUOTE 3 ENGINE SIZE PETROL OR DIESEL VEHICLE COLOUR TRIM COLOUR OPTIONAL EXTRAS PLEASE NOTE QUOTES ARE ONLY VALID FOR 21 DAYS. Version 3.0 02 December 2015 Page 17 of 23

Vehicle Request Form Name Personal Mileage: Business Mileage (as approved): Total Mileage: Information to be completed by driver MAKE/MODEL AND NO OF DOORS QUOTE 4 QUOTE 5 QUOTE 6 ENGINE SIZE PETROL OR DIESEL VEHICLE COLOUR TRIM COLOUR OPTIONAL EXTRAS PLEASE NOTE QUOTES ARE ONLY VALID FOR 21 DAYS. Version 3.0 02 December 2015 Page 18 of 23

Appendix 3 APPLICATION FOR TRANSFER OF LEASED VEHICLE NAME... GRADE... POSITION... NATIONAL INSURANCE NO:... Date of Transfer (If known)... ESTIMATED MILEAGE PER YEAR PRIVATE MILEAGE APPROVED MILEAGE BUSINESS TO THE NEAREST 500 MILES A NEW QUOTE WILL BE CALCULATED USING THE ABOVE MILEAGES BASED ON THE NHS FORTH VALLEY OPERATING PROCEDURE FOR CAR LEASING SCHEME. Vehicle being transferred from:...nhs Board Car Leasing Contact:... Telephone Number:...Fax Number... Registration Number:... Leasing Company:... Make/Model...PETROL/DIESEL... C.C. The attached Declaration Form with copy of driving licences to be completed and returned to: Car Leasing Department Falkirk Community Hospital, Westburn Avenue, Falkirk, FK1 5SU The Insurance certificate and summary will then be issued accordingly. PLEASE CONFIRM IN WRITING THE ODOMETER READING AT DATE OF TRANSFER Version 3.0 02 December 2015 Page 19 of 23

Appendix 4 Criteria for Base amounts All staff except Consultants 2 year Rental amount - 1321.44 3 year Rental amount - 1321.44 4 year Rental amount 1242.15 Rebate/excess mileage rate 0.03p Fuel reimbursement rate 39.36MPG Consultants 2 year Rental amount 1928.64 3 year Rental amount - 1928.64 4 year Rental amount 1812.92 Rebate/excess mileage rate 0.04p Fuel reimbursement rate 27.60MPG Version 3.0 02 December 2015 Page 20 of 23

Appendix 5 New Applications FORTH VALLEY NHS BOARD PROCEDURE FOR ASSESSMENT OF VEHICLE STATUS Advise Car Leasing Department of driver s name, department and estimate of business Mileage for Financial Appraisal to be carried out. The Director/General Manager will review the information supplied and will recommend either Standard User or Lease Car User status as appropriate. Transfers from another Health Board Advise Car Leasing Department of driver s name, department and estimate of business Mileage for Financial Appraisal to be carried out. Once Transfer has been approved, information will be sent out to driver for quote to be prepared. Replacement of vehicle Financial Appraisal by Car Leasing Department for staff currently using a leased car to take place within four/six months of the expiry of their current contract. 1. Financial Appraisal form will be sent by Car Leasing Department to Director/General Manager for review and recommendation. 2. If the post is be assigned Car Lease, completed Form 1 is then passed to Car Leasing for processing. 3. The driver will be given Form 2 (Personal and Car Details). All sections should be completed and form returned to the Car Leasing Department. Once car details are finalised, new car ordered and delivery arranged, the contract details will be passed to the payroll department to action personal deductions accordingly. 4. If the post is to be assigned Standard User status, their manager will advise staff member and the Payroll Department should be advised so Standard User Application Form can be completed. Version 3.0 02 December 2015 Page 21 of 23

Lease Car User CAR USER DECISION MAKING FLOWCHART Appendix 6 New Employee/New Post Or 1 st Application to Scheme YES YES Accept Lease Car? Financial Appraisal YES Meet criteria for Lease car? NO Meet criteria for Standard User? NO YES Lease Car Order placed Reserve rate YES Standard Car User Version 3.0 02 December 2015 Page 22 of 23

Publications in Alternative Formats NHS Forth Valley is happy to consider requests for publications in other languages or formats such as large print. To request another language for a patient, please contact 01786 434784. For other formats contact 01324 590886, text 07990 690605, fax 01324 590867 or e-mail - fv-uhb.nhsfv-alternativeformats@nhs.net Version 3.0 02 December 2015 Page 23 of 23