Job ref: 390-R5048-TCC-B Job title: Deputy team leader Orthopedics

Application for employment

Application for: Deputy team leader Orthopedics

Job reference: 390-R5048-TCC-B Closing date: 22-Mar-2019

Application submitted: 22-Mar-2019 22:10 Application ID: 14792122

Applicant: Sara Fernández Barreira

Personal details
Answers given in this part of the form are to help the Recruitment Centre to manage your application.
If you have any difficulty completing this form please ask someone to help you.
We would like to take this opportunity to thank you for applying.

Personal details

Title Miss
Forename Sara
Middle name(s) Fernández
Surname Barreira
Address Flat 19
The View
847 London Road
City / town Westcliff-On-Sea
County
Country United Kingdom
Postcode SS0 9FA
Email sara.fernandez.barreira@gmail.com
Work telephone 07935813904
Mobile telephone 07935813904
Home telephone
UK National Insurance number SZ017612A
First available date for employment ASAP

Disclosure of information

a) Are you related to a member or employee of Southend University No

Hospital NHS Foundation Trust?
Relations name
Relations post
Relationship
b) Have you ever been dismissed from previous employment? No
Post dismissed from
Date dismissed
Reason for dismissal

Rehabilitation of Offenders Act 1974

The Rehabilitation of Offenders Act helps rehabilitated ex-offenders back into work by allowing them not to declare criminal convictions after the rehabilitation period set by the
Court has elapsed and the convictions become "spent". During the rehabilitation period, convictions are referred to as "unspent" convictions and must be declared to employers.

Before you can be considered for appointment we need to be satisfied about your character and suitability

Southend University Hospital NHS Foundation Trust aims to promote equality of opportunity and is committed to treating all applicants for positions fairly and on merit regardless of
race, gender, marital status, religion, disability, sexual orientation and age. We undertake not to discriminate unfairly against applicants on the basis of a criminal conviction or other
information declared.

If you are applying for a post involving access to persons in receipt of health services, your offer of employment may be subject to a satisfactory disclosure from the Disclosure and
Barring Service. Failure to reveal information relating to any convictions could lead to withdrawal of an offer of employment.

Have you any unspent criminal convictions or bindovers, or any cautions, warnings or reprimands?
No

If yes, please give details

Application: 14792122 [Vac: 1630854] Page 1 of 8

 Job ref: 390-R5048-TCC-B Job title: Deputy team leader Orthopedics

The position you are applying for has been identified as being an 'eligible position' under the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 [the Exceptions Order]
and, in certain circumstances, the Police Act 1997. As such, it meets the eligibility criteria for a standard or an enhanced disclosure to be requested through the Disclosure and
Barring Service (DBS).

As such you are required to declare any convictions, cautions and reprimands that are not covered by the 'filtering' rules.

Please read the guidance available here BEFORE completing this section.

Have you at any time received or had pending a criminal conviction, caution, warning, reprimand or bind-over (known as a spent
conviction) that is not covered by the 'filtering' rules?
No

If yes, please give details

Protection of Vulnerable Groups Act Lists

Does your name appear on the Protection of Children or Vulnerable Adult lists?
No

If yes, please give details

Internal/external and immigration

Before being given access to the online application form, the applicant was asked the following.

Are you currently an employee of Southend University Hospital NHS Foundation Trust ?
Yes

Choose your immigration status

UK/EC/EEA Citizen with Right to work in the UK

Please supply details of any permit currently held including number, validity and expiry date

Declaration

I confirm that the information that I have provided in this application and in any accompanying documents is to the best of my knowledge correct and complete. I understand and
accept that if I withhold information or provide false or misleading information this may result in my application being rejected, or if I am appointed, to disciplinary action and /or
dismissal.

In addition I acknowledge that the canvassing of a member or senior officer of Southend University Hospital NHS Foundation Trust, failure to disclose a relationship with a
member or employee of Southend University Hospital NHS Foundation Trust and/or the provision of false information either expressly or implicitly will also result in disqualification
or dismissal.

Security and Probity checks:

All new staff may be required to provide proof of any of the matters set out in their application form and Southend University Hospital NHS Foundation Trust reserves its right to
make appropriate additional checks in respect of the information provided by you.

In addition if you are successful you may be required to complete a declaration of interests form and provide proof of identity and nationality before your first day of employment.
If acceptable evidence is not provided or if the declaration of interest form indicates there is a potential for an unacceptable conflict of interest, which cannot be resolved, then
any appointment cannot commence.

Please note: Your documentation i.e. Passport, Visa, (photographic) Driving Licence will be checked by a 'Document Authenticator' to confirm their validity should you be
shortlisted and invited for assessment and/or interview.

(For signing at interview) Signed:________________________________________ Date:_________________

Please note: if you wish to withdraw your consent at any time after completing this Declaration Form, please contact the Recruitment Centre.

Page 2 of 8 Application: 14792122 [Vac: 1630854]

Job ref: 390-R5048-TCC-B Job title: Deputy team leader Orthopedics

Application for: Deputy team leader Orthopedics

Job reference: 390-R5048-TCC-B Closing date: 22-Mar-2019

Application submitted: 22-Mar-2019 22:10 Application ID: 14792122

Applicant: Sara Fernández Barreira

Application questions
Details entered in this part of the form will be made available to the shortlisting panel. Please make sure that you have read the job description and person specification before
completing the application form, and ensure that your answers clearly and honestly demonstrate how your skills and experience are relevant to the post for which you are applying.

Education and Training - Schools / Colleges / Universities

Place of study University of Santiago de Compostela

Subject / qualification Grade / result Date obtained

Nursing degree 8.04/10 15/06/2015

Place of study Southend University Hospital

Subject / qualification Grade / result Date obtained

Theatre practitioner Passed 10/02/2018

Training Courses Attended

Please give details of other formal training courses attended and dates
-Oversea nurse induction programme.
- Mandatory training
- Orthopaedics and trauma scrub nurse competencies
-IV oral drug administration competencies
- IV cannulation training
- male catheterisation training

Proposed Further Qualifications

Please provide details of any proposed further qualifications

Mentorship course

Professional registration

If you are state registered please complete the following section.

Professional body Nursing and Midwifery Council

Registration no 16E0973C
Expiry / renewal date 31/05/19
NMC revalidation date 01/05/19
Any other information relevant to your registration such as sections of register or restrictions on practice.

Current Job, Course or other main activity

What is your current main activity Employed Full or Part Time

Start date 26/06/17
Job title, if applicable Staff nurse, theatre pratitioner

Application: 14792122 [Vac: 1630854] Page 3 of 8

 Job ref: 390-R5048-TCC-B Job title: Deputy team leader Orthopedics

Description of your duties & responsibilities and hours (if employed)

- Scrub nurse full time employed in Southend University Hospital
I am currently part of the orthopaedics and trauma scrub team.
As part of the team I have to accomplish tasks as:
1. preparing the day list at the beginning of the shift (instruments and soft packs) making sure that sets required have been processed
by sterile services.
2. To ensure that each patient receives individualised patient care and perform as an assistant to the operating surgeon by providing the
necessary skill to anticipate the surgeon’s specific needs.
3. To perform the swab, needle and instrument checks as per policy
4. To manage the safe handling and recording of all specimens according to the
surgeons specification.
5. To ensure the safe disposal of all sharps as per Trust Policy
6. To ensure the safe management of all equipment
7. To ensure the safe disposal of all clinical waste as per Trust Policy
8. To accurately record the operative procedure according to the direction of the
operating surgeon
9. To ensure the patient is managed safely whilst in the Theatre Department
10. To ensure the privacy and dignity of patients is maintained at all times
11. ensuring WHO safe checklist is undertaken before commencing the procedure and once is finished before the patient leaves the
operating table.
12. Prior to the start of the Operating Theatre List all staff concerned with the list are
required to be present in the allocated theatre for a team brief and debrief once the procedure is complete.
13. Prosthesis management, which includes checks before, during and after the procedure, as well as ordering to stock up.

Employer or college name Southend University hospital

Employer or college address 1 Main theatres
Employer or college address 2 Prittewell Chase
Employer or college city/town Westcliff- on -Sea
Employer or college county/state
Country United Kingdom
Employer or college postcode SS0 0RY
Telephone number
Grade Band 5
Salary 23.951

Activities prior to above starting with most recent

Please include all periods of employment, unemployment, study, travel etc as necessary to cover a minimum period of the last 3 years. There should be no gaps in your activity
history for the last three years.. You may also add as many other periods of employment, unemployment, study, travel etc as you wish which took place prior to the last three
years. If you have other current part time jobs please add these first

Type of activity Employed Full or Part Time

Employer/College Name Southend university hospital
Employer/College address 1 Southbourne ward
Employer/College address 2 Prittewell Chase
Employer/College city/town Westcliff on Sea
Employer/College county/state
Country United Kingdom
Employer/College postcode SS0 0RY
Job title, if applicable Staff nurse band 5
Grade Band 5
Start date 03/10/16
End date 25/06/17
Description of your duties & responsibilities and hours (if employed)
Full time employed in a Urology/Ent ward.

Reason for leaving, if applicable

Change in my career

Type of activity Employed Full or Part Time

Employer/College Name SESPA (Public health service in Asturias)
Employer/College address 1
Employer/College address 2
Employer/College city/town
Employer/College county/state
Country Spain

Page 4 of 8 Application: 14792122 [Vac: 1630854]

Job ref: 390-R5048-TCC-B Job title: Deputy team leader Orthopedics

Employer/College postcode
Job title, if applicable Registeres nurse
Grade band 5
Start date 25/06/16
End date 07/09/16
Description of your duties & responsibilities and hours (if employed)
Registered nurse in several wards and as district nurse

Reason for leaving, if applicable

Moving to the UK

Type of activity Employed Full or Part Time

Employer/College Name Rio Mayor Care Home
Employer/College address 1
Employer/College address 2
Employer/College city/town
Employer/College county/state
Country Spain
Employer/College postcode
Job title, if applicable
Grade Band 5
Start date 20/07/15
End date 31/03/16
Description of your duties & responsibilities and hours (if employed)
Registered nurse in an elderly care home

Reason for leaving, if applicable

End of contract

Supporting information

Please read the job description and person specification carefully and make full use of this section, to provide further information in support of your application.

Please be sure to include:

i. The reasons why you are applying for the post.

ii. Details of any relevant experience gained either in a paid or voluntary capacity.
iii. Details of any training, education or other interests relevant to the post.
iv. Details of Personal Attributes you have to support your application.

Supporting information
During the last year and a half, I have been taking part in the main theatre's department, where I have developed the required scrub
competencies in different specialities, namely, general and vascular, gyne and urology, ENT, and orthopaedics and trauma, in which I
am currently working.

Apart from mastering the skills within the team and complete the main theatre mandatory training courses, I have also attended different
workshops offered by the medical equipment companies that we work with, such as Zimmer or Jhonson and Jhonson.

Additionally, I have already worked as a team leader when the situation has required. I believe building a strong team is crucial in order
to sort out the issues that might occur in the theatre on a daily basis.

Finally, due to the reasons provided above, I think I am enough qualified to promote the Band 6 position, as my intention is to keep
growing personally and professionally in this speciality while I keep on learning and assuming new responsibilities.

Inter Authority Transfers

If you currently work in the NHS and your application for this post is successful it will speed up the pre-employment checks process and help to ensure that you are paid from the
correct grade if you are prepared to give your consent to the Trust obtaining details of your previous NHS continuous service records via Inter Authority Transfer process. (This will
only be done if you are offered a post)

Do you give consent to the Trust obtaining details of your previous NHS continuous service records via the Internal Authority Transfer
Process?
I give my consent

References

If you are successful, prior to appointment, we will take up as many references as needed to cover all activities, including periods of employment and full time education,
that you have undertaken over the past three years. Any offer will be subject to these being satisfactory. Please ensure that you provide full contact details for your Employer/Line
Managers or Course Tutors for each activity. Please include their work email address where possible to avoid any unnecessary delays.

If during the last three years you have any periods in which you have not been in either employment or full-time education please provide details of someone who can provide a
character reference for you to cover this period. Character references should be provided by a person of standing in the community such as a Teacher, Health Care Professional

Application: 14792122 [Vac: 1630854] Page 5 of 8

 Job ref: 390-R5048-TCC-B Job title: Deputy team leader Orthopedics

(i.e. Doctor, Physiotherapist, Registered Nurse), Minister of Religion, Police Officer or Solicitor. Character references should only be used in EXCEPTIONAL circumstances to
cover periods of time when you have not been in either employment or education.

Please use the "Add another" button below to add as many referees as required to meet the above requirements. Periods that referees cover may overlap but there
should not be any gaps over the past three years.

Referee's title Mr
Referee's first name(s) Neil
Referee's surname Davis
Referee's organisation name Southend University hospital
Job title Trauma an d orthopaedics team manager
How do they know you? Employer / Line Manager
Address 1 Southend University Hospital
Address 2
Address 3
City / Town Westcliff on Sea
County / State
Postcode SS0 0RY
Country United Kingdom
Telephone no.
Mobile no.
Fax no.
Email address neil.davis@southend.nhs.uk
Can the referee be approached prior to the interview? Yes
Period this reference covers from: February 2018
Period this reference covers to: March 2019
What name will the referee know you by if different from your
current name?
Why has your name changed?

Declaration

I am making an online application and confirm that the information that I have provided in this application is to the best of my knowledge
correct and complete. I understand and accept that if I withhold information or provide false or misleading information this may result in
my application being rejected, or if I am appointed, to disciplinary and/or dismissal. By marking this box I indicate that I agree with the
above declaration and that I will sign printed copies of this application form upon request. I understand that if I wish to withdraw my
consent at any time after completing this declaration I can do so by contacting the Recruitment Centre
Yes

Page 6 of 8 Application: 14792122 [Vac: 1630854]

Job ref: 390-R5048-TCC-B Job title: Deputy team leader Orthopedics

Application for: Deputy team leader Orthopedics

Job reference: 390-R5048-TCC-B Closing date: 22-Mar-2019

Application submitted: 22-Mar-2019 22:10 Application ID: 14792122

Applicant: Sara Fernández Barreira

Equal opportunities
Equal opportunities

As a large, public employer we have a legal duty to monitor our recruitment and selection processes to ensure that all applicants are treated fairly.

The information that we collect is stored in a secure database and is only used for statutory monitoring purposes. Please note that any monitoring reports produced from the
database do not include any data that will link to named individuals. Furthermore, our staff involved in the recruitment and selection process do not have access to this part of
your application form.

There are two exceptions to the above. The first relates to some of the information about disabilities, and this is explained below. The second is that for successful applicants
some of the monitoring information will be stored against their permanent staff record. This information is recorded for all of the organisation's employees to ensure that the profile
of the staff we employ reflects the community in which we are based.

The Equality Act 2010 protects people against discrimination on the grounds of:

• their age and sex.

• their race which includes colour, nationality, ethnic or national origin.
• their religion or belief, including a lack of any belief.
• their sexual orientation, be it bisexual, gay, heterosexual and lesbian.

The Equality Act 2010 also protects people who are married or in a civil partnership.

General questions

Gender Female
Marital status Single
Date of Birth 12/03/92

Ethnic Origin

Ethnic origin does not mean nationality, but normally refers to the people or culture with which a person's immediate family identify.

I would describe my ethnic origin as follows: White Other European

Equality and Diversity Monitoring

Do you have a sexual orientation towards: I do not wish to describe my sexual orientation.
Do you now or have you ever identified as trans or transgender? No
Please indicate your religious belief: Atheism

Disability

The answer to the question about the Guaranteed Interview Scheme is presented to the lead short-lister before they make the final decision on who to invite to interview. This is
done so that we can meet our obligation as a 'Two Ticks' employer to invite to interview any applicant, who has a disability, who meets the essential criteria for a post that they have
applied for. If you are invited to interview you will need to let us know if you will need any special help or adaptations.

Do you consider yourself to have a disability?

No

Guidance on types of disabilities

• Physical impairment, such as difficulty using your arms or mobility issues which means using a wheelchair or crutches
• Sensory impairment, such as being blind/having a serious visual impairment or being deaf/having a serious hearing impairment
• Mental health condition, such as depression or schizophrenia
• Learning disability/difficulty, (such as Down's syndrome or dyslexia) or cognitive impairment (such as autistic spectrum disorder)
• Longstanding illness or health condition such as cancer, HIV, diabetes, chronic heart disease, or epilepsy
• Other is anything that does not fall into one of the categories detailed above

If you are selected for interview you will have the chance to let the recruitment centre know about any particular needs you have. This will enable us to offer you a fair interview
if, for example, you have a speech difficulty or need a wheelchair accessible room.

I would describe my main disability as:

None / Not Applicable

If you have a disability, do you wish to be considered under the Guaranteed Interview Scheme if you meet the minimum criteria as
specified in the Person Specification?

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 Job ref: 390-R5048-TCC-B Job title: Deputy team leader Orthopedics

How did you learn of this vacancy?

Please state where you first saw this post advertised

NHS Jobs - nhsjobs.com or nhsjobs.net

Privacy notice

Application for: Deputy team leader Orthopedics

Job reference: 390-R5048-TCC-B Closing date: 22-Mar-2019

Application submitted: 22-Mar-2019 22:10 Application ID: 14792122

Applicant: Sara Fernández Barreira

Privacy notice
This privacy notice is about how your personally identifiable information will be managed from job application through to starting work. The
information is needed to help recruit the best people, perform the necessary employment checks, arrange a contract of employment, get new
recruits started in their work and fulfil legal/regulatory requirements. These are necessary steps prior to being able to establish, continue or vary a
contract of employment.

In some special cases your information may have been entered without your having completed a job application. For example, where students are
being placed from a training provider (and your information has been received from that training provider) or where employment checks need to be
carried out on existing staff.

During recruitment, the recruiters consider the information provided on the job application form and that provided for assessments and interviews.

As you get further through the process, employment checks may need to be performed such as identity, right-to-work (immigration), criminal
records, professional registration, qualifications, references, occupational health and other checks. More information or documentation, such as
proof of identity documents, may be needed from you. Only the necessary information is shared with organisations where they assist us with these
checks and it is only for the purpose of performing those checks.

To get a new recruit started in their work, induction training and some administrative requirements are completed. Some information will be
requested from you at that time, such as bank details for your salary payments and emergency contact details in case you have an emergency at
work. The information for those who have been recruited is entered into the employee management and records keeping systems that are used by
the employer.

If you do not provide information as needed, this may hinder or prevent your application or employment.

Any information you provide about your ethnic origin, religious beliefs and sexual orientation is used only for equal opportunities statistical monitoring
of the recruitment process and workforce. It is protected throughout the process, is not visible to those assessing your application or to hiring
managers, and cannot be used in a way which can identify you. It will not affect your application if you choose to not provide this information.

If you indicate that you can be considered for a preferential or guaranteed interview owing to a disability you have, that information is used only for
the purposes of arranging interviews.

If you decide that you wish to leave a job application process, you can login to your applicant account then withdraw your application. For special
cases (examples above) you should instead contact the employer.

Your information about your application through to starting work is automatically deleted from this recruitment management system once it is no
longer regarded as necessary for the purpose for which it was collected. This is 399 days after the date the application was entered in this
recruitment system or 199 days after your proposed/actual start date, whichever is the greater. This period allows obligations relating to lawful
employment practices to be fulfilled such as statistical reporting and the defending of potential legal claims.

The data controller for this information is Southend University Hospital NHS Foundation Trust. This application tracking system is provided by Trac
Systems Ltd (www.trac.systems) as a data processor. Trac Systems provide some recruitment support services and have staff and secure data
storage located entirely in the UK.

To make an enquiry, a request for your personal information held as part of this process, or to arrange for any mistakes to be corrected, you may
contact either the team who are handling your application or the Data Protection Officer (informationgovernance@btuh.nhs.uk). If you agree, we will
try to deal with your request informally, for example by providing you with the specific information you need over the telephone.

If you have a complaint, please contact us so that we can investigate. If you believe that the processing of your information is in breach of the
General Data Protection Regulation then you also have the right to lodge a complaint with the GDPR supervisory authority in the EU Member State
of your habitual residence, place of work or of the alleged infringement.

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