Nursing & MidwiferyExchange Program

Queensland Health

Clinical Excellence Queensland

Program Guidelines

Version 8

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Nursing and Midwifery Exchange Program Guidelines v8 Published by the State of Queensland (Queensland Health), April 2020

This document is licensed under a Creative Commons Attribution 3.0 Australia licence. To view a copy of this licence, visit creativecommons.org/licenses/by/3.0/au

© State of Queensland (Queensland Health) 2020

You are free to copy, communicate and adapt the work, as long as you attribute the State of Queensland (Queensland Health).

For more information contact: Office of the Chief Nursing and Midwifery Officer, Clinical Excellence Queensland, Department of Health, GPO Box 48, Brisbane QLD 4001, email OCNMO_ProfessionalCapability@health.qld.gov.au, phone 3328 9678.

Disclaimer: The content presented in this publication is distributed by the Queensland Government as an information source only. The State of Queensland makes no statements, representations or warranties about the accuracy, completeness or reliability of any information contained in this publication. The State of Queensland disclaims all responsibility and all liability (including without limitation for liability in negligence for all expenses, losses, damages and costs you might incur as a result of the information being inaccurate or incomplete in any way, and for any reason reliance was placed on such information. Document History: Version 1 (Initial Document Development) June 2017. Amy Byrne State Wide Coordinator Nursing and Midwifery Exchange Program Version 2 September 2017. Nardia Burey Administration Officer Nursing and Midwifery Exchange Program Version 3. Nardia Burey Administration Officer Nursing and Midwifery Exchange Program Version 4. Amy Byrne State Wide Coordinator Nursing and Midwifery Exchange Program. Version 5. Andrew Hughes Statewide Coordinator Nursing Midwifery Exchange Program. Version 6. Andrew Hughes Statewide Coordinator Nursing and Midwifery Exchange Program. Kirstin Cochrane Administration Officer Nursing and Midwifery Exchange Program. Version 7. Andrew Hughes Statewide Coordinator Nursing and Midwifery Exchange Program. Version 8. Stephanie Little, Project Officer, The Office of the Chief Nursing and Midwifery Officer.

Acknowledgements

The Nursing and Midwifery Exchange Program would like to acknowledge and thank Children’s Health Queensland (CHQ) for permission to review and adapt materials from the Regional Development Program. We would like to acknowledge and thank all those who have provided input into this program. Shelley Nowlan, Chief Nurse and Midwifery Officer for Queensland Health, Debra Nizette, Director of Nursing and Diana Schmalkuche, former Nursing Director Workforce and Careers with the Office of the Chief Nurse and Midwifery Officer, Chris Small Executive Director of Nursing and Midwifery, South West HHS, Rachel Borger, Director Industrial Relations, Wendy Fennah, Nursing Director Lady Cilento Children’s Hospital, Sarah Worth, Nurse Educator Torres and Cape HHS (TCHHS), Jane Davies, Nursing Director TCHHS, Linda Zimitat, Nurse Manager Central Queensland HHS, Paolo La Penna, Nurse Manager Mackay HHS, Billie-Jo Hurle, Nursing and Midwifery Service Manager SWHHS, Leanne Pound, Director of Nursing/Facility Manager (DON/FM) Central QLD HHS, Matthew Boyd, DON/FM, the Association of Queensland Nursing Leaders (AQNL), Nicole White, Nurse Manager Sunshine Coast HHS (SCHHS), Bradley Greentree, Clinical Nurse SWHHS and to all of the nurses and midwives who provided valuable feedback around this program.

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Contents Foreword ......................................................................................................................... 4

Terms ............................................................................................................................... 5

1. Overview ................................................................................................................ 6

2. Aims ........................................................................................................................ 6

3. Program Structure ................................................................................................ 6

4. Applications ........................................................................................................... 6

5. Orientation ............................................................................................................. 6

6. Funding .................................................................................................................. 7 6.1 Accommodation .................................................................................................7 6.2 Flights .................................................................................................................7 6.3 Use of Private Motor Vehicle .............................................................................7 6.2 Claiming Public Transport, Parking Fees and Taxi Costs Incurred ..................8 6.5 Fringe Benefits Taxation (FBT) Implications .....................................................8 6.6 Meal and Incidentals ..........................................................................................8 6.7 Remote Area Nurse Incentive Payment (RANIP) .............................................8

7. Accommodation .................................................................................................... 8

8. Eligibility and Selection ........................................................................................ 9

9. Employee Movement Forms ............................................................................. 10

10. Termination of Placement ................................................................................. 10

11. Entitlements and Particulars ............................................................................. 11 11.1 Shift Work .....................................................................................................11 11.2 Annual Leave .................................................................................................11 11.3 Sick Leave ......................................................................................................11 11.4 Work Cover ....................................................................................................11

12. Code of Conduct and Confidentiality ............................................................... 11

13. Contact Details.................................................................................................... 12

Appendix One – NMEP Application Form ................................................................ 13

Instructions .................................................................................................................... 13

Appendix 2 – Referee Report – Nursing and Midwifery Exchange Program ..... 16

Instructions .................................................................................................................... 16

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Foreword I am delighted to announce the continuation of the Nursing and Midwifery Exchange Program (NMEP). NMEP is an initiative made possible due to the ongoing commitment of Queensland Health to provide innovative professional development strategies for nurses and midwives. The statewide NMEP provides opportunities for nurses and midwives to experience new practice environments, within a supportive mentoring framework. The NMEP matches applicants and arranges exchanges between Queensland Health metropolitan, regional, rural and/or remote nurses and midwives. These exchanges provide many collective benefits. The participating nurse/midwife has the opportunity to acquire new clinical, organisational and professional skills; develop a different perspective; and expand their professional network. This broadens the participants experience, supporting Queensland Health’s overall capability in the provision of safe, high quality services. The hosting Hospital and Health Service gains a temporary staff member who brings different skills and perspectives thereby contributing to best practice care. To gain maximum benefits from the Program, the recommended period for an exchange is three months, however this can be negotiated. It is envisaged that the NMEP will not only see increased skills and understanding between different settings, but also encourage nurses and midwives to take up opportunities in rural and remote practice. These Program Guidelines outline the processes and policies relevant to the NMEP and include an application form. I encourage you to consider the contents of the Guidelines and discuss your interest in the NMEP with your Line Manager, before submitting an application. This is a wonderful opportunity and I encourage nurses and midwives statewide to become involved. Adjunct Professor Shelley Nowlan Chief Nursing and Midwifery Officer April 2020

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Terms Host Facility: The facility in which the candidate works for the program duration. Home Facility: The facility in which the candidate usually works i.e. where they hold their substantive position. Metropolitan/Regional Candidate: The Candidate whose home facility is in a Metropolitan or Regional area as dictated by the Clinical Services Capability Framework (CSCF) and the Australian Institute of Health and Welfare (AIHW) public hospitals classification. Rural/Remote Candidate: The Candidate whose home facility is in a Rural or Remote area as dictated by the Clinical Services Capability Framework (CSCF) and the Australian Institute of Health and Welfare (AIHW) public hospitals classification.

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1. Overview The Nursing and Midwifery Exchange Program (NMEP) is a Queensland Health (QH) statewide initiative for the nursing and midwifery workforces. NMEP matches and exchanges metropolitan/regional with rural/remote nurses and/or midwives to achieve professional goals and further develop clinical skills. 2. Aims The program aims include, but are not limited to:

• Professional development for QH nurses and midwives • Enables networking between QH facilities and Hospital and Health Services (HHS) • Exposure to different clinical areas/locations and environments • Fostering leadership and mentoring.

3. Program Structure Candidates express interest via the NMEP coordinator. The coordinator matches candidates based on skill mix and areas of interest; and facilitates an exchange between a rural/remote candidate and a metropolitan/regional candidate. Candidates identify goals and desired outcomes for their placement. Candidates then complete a 12-week (three month) placement in their respective facilities. If candidates are unable to commit for the entire 12-week program, they can contact the NMEP coordinator to discuss options. Candidates may also choose to complete a six-month placement in negotiation with their line manager, the host HHS and the NMEP coordinator. Candidates will be supported by a pool of mentors at the host HHS site and their exchange partner. 4. Applications Applications are made by submitting the Application Form (Appendix One), along with a current resume to the NMEP coordinator. Applicants must:

• Have line manager and Director of Nursing/Nursing Director level approval or equivalent • Have currency with Queensland Government/QH mandatory training requirements • Be willing to travel and work away from home for a continuous period of 3 to 6 months. • Meet all requirements of the application.

5. Orientation Managers are required to develop an orientation strategy for the exchange participant in order to maintain clinical services. The orientation should align with the following QH documents:

• Framework for Lifelong Learning for Nurses and Midwives June 2018 with a focus on the local Work Unit Developmental Map (refer to page 46 of the Framework) https://qheps.health.qld.gov.au/nmoq/education/framework-for-lifelong-learning

• Relevant Career Pathway https://qheps.health.qld.gov.au/nmoq/education/career-pathways • Classification specific Orientation to Role Package (available here:

https://qheps.health.qld.gov.au/metronorth/nursing-midwifery/education/classification-specific-orientation-to-role-packages )

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Individual facilities will take on the responsibility of the orientation, usually 1 day offline, then 3-4 days supernumerary. This will be completed using the usual orientation procedure of the respective facilities. The minimum requirement of supernumerary days is 3, but can be extended in negotiation with the host HHS line manager. 6. Funding A rural participant travelling to a metropolitan site attracts greater costs related to travel and accommodation. Each candidate is allocated funds to cover the cost of travel and accommodation expenses which is capped at a maximum of $5,000 per candidate for the duration of the program. The funding allocated is flexible for candidates. Candidates may choose to use their funding for costs incurred during their exchange placement for the following:

• Accommodation • Flights to and from exchange • Use of private motor vehicle to and from exchange • Public transport • Parking fees • Taxis • Trips home

6.1 Accommodation All candidates are to use the Staff Travel and Accommodation Request Form to ensure appropriate confirmation of travel and where applicable, for use in validating expense claims in line with the guidelines. These forms are to be completed by successful applicants and returned to nmep@health.qld.gov.au for processing. Please refer to Section 7 of the guidelines for more information regarding accommodation. 6.2 Flights Flights are to be booked using the Staff Travel and Accommodation Request Form. These forms are to be completed by successful applicants and returned to nmep@health.qld.gov.au for processing. 6.3 Use of Private Motor Vehicle Candidates who choose to drive a private motor vehicle to their host facility do so in accordance with Directive 20/16 and QH Human Resources Policy C15.

Employees who use their private motor vehicle are to seek approval by submitting an application on the Application For Approval To Use Privately Owned Vehicle For Official Purposes, prior to travel taking place. This application must be accompanied by a current vehicle registration and proof of comprehensive car insurance endorsed for work related use. This is to be submitted to nmep@health.qld.gov.au.

Candidates may claim mileage to their destination and again for the purposes of travelling home. Only one claim can be made per car. In circumstances where an employee chooses to use their private motor vehicle rather than take up flights, clause 14.1 of the Minister for Industrial Relations Directive 20/16 provides:

14.1 where the approved means of travel is other than the use of an employee’s private motor vehicle, and the employee requests and is granted permission to use his or her motor vehicle, the allowance paid is to be determined by the chief executive. This allowance is not to exceed the rates specified below:

(a) Automobiles – 37.5 cents per km;

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(b) motorcycles – 15.0 cents per km.

To claim mileage expenses, please complete a Motor Vehicle (Mileage) Allowance Claim Form and forward to nmep@health.qld.gov.au.

6.2 Claiming Public Transport, Parking Fees and Taxi Costs

Incurred To claim these expenses, candidates need to complete the Expense Reimbursement or Advance Claim Form.

All forms are to be returned with original receipts to:

Nursing and Midwifery Exchange Program Rural and Remote Clinical Support Unit PO Box 7193 Cairns, QLD, 4870

6.5 Fringe Benefits Taxation (FBT) Implications Benefits provided, or reimbursement of expenses to candidates, may be considered a Fringe Benefit for Taxation purposes. Candidates who currently salary sacrifice are directed to seek independent advice on how receipt of funding for this program may affect their taxation liability. It is the responsibility of each candidate to seek advice on FBT and salary sacrifice. Any liability borne from the program is the responsibility of the candidate.

6.6 Meal and Incidentals Candidates are to be aware that this program does not give any entitlement to claim any allowances as per Directive 9/11: Domestic Travelling and Relieving Expenses (e.g. incidental or meal allowance). Entitlements found in that directive arise only in circumstances where QH requires an employee to travel on official duty, or to relieve another employee away from the employee’s usual place of work. Participation in the NMEP is on a voluntary basis, is purposeful professional development and does not meet the requirements for eligibility under the directive. 6.7 Remote Area Nurse Incentive Payment (RANIP) Under HR Policy C2- Remote Area Nursing Incentive Payment (RANIP) RANIP is only payable for nurses/midwives after 12 months of service. Therefore, candidates completing a 12-week placement in a RANIP area are not eligible for this payment. Nurses/midwives currently working in a RANIP area undergoing placement should seek clarity from their HR business partner/delegate on how placement may affect their RANIP payment.

Candidates who accrue RANIP payment as part of their substantive position need to be aware that participating in the NMEP program may delay the payout date for the RANIP payment.

7. Accommodation All efforts will be made to ensure that candidates are provided with accommodation for the duration of the exchange. QH hospital accommodation is the preferred accommodation for all candidates. Candidates travelling to rural/remote areas may receive a private room in shared accommodation. In the event this is not available, candidates will then be eligible to use their allocated funding to cover accommodation. The total allocated funding is capped at $5,000 per candidate.

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Rural/remote candidates may be required to relinquish their current hospital provided accommodation to ensure their exchange program partner can be housed. This is only applicable for the duration of the program and nurses/midwives will return to their regular housing at the completion of the program. Accommodation types and options may vary depending on demand and availability. Where QH accommodation is not available, accommodation types may include but are not limited to:

• Serviced apartment • Private lease arrangement sharing with other exchange candidates • Hotel/motel • Family and friends (N.B. there is no provision for funding a relative or friend for accommodation

expenses). Nurses/midwives attending an exchange may be required to share accommodation (own room) with other exchange program participants. Please indicate on the letter of acceptance any accommodation requirements. Candidates are required to contact the NMEP team once they have been selected to discuss their accommodation needs. Please do not book accommodation without first speaking to the NMEP coordinator. Please note that exceptional circumstances for accommodation will be reviewed on a case by case basis. 8. Eligibility and Selection Eligibility includes:

• Enrolled Nurses (EN) with a minimum of one-year experience • Nurses and Midwives NG 5.2 - 10 with a minimum of one-year experience • Employed by QH in a permanent capacity • Up to date with mandatory training and have both Line Manager and Director of Nursing/Nursing

Director approval • Ability to commit to a 12-week program (unless negotiated otherwise) • Currency in certain clinical skills for rural/remote areas in line with the particular needs of clinical

placement areas. Examples include: o Advanced Life Support o Paediatric Advanced Life Support o Imminent Birth o Cannulation/Venepuncture skills

Please discuss any specific needs with the NMEP coordinator Applicants are required to provide details of how the exchange program will support their current professional development and how they will use their experiences in their work place. Participation in the exchange program is subject to Human Resources (HR) Policy B1 (QH-POL-212) Recruitment and Selection. Candidates are required to provide evidence of the following with their application:

• Application form with line manager and Director of Nursing/Nursing Director endorsement

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• Resume (CV) • Certified copies of qualifications including any relevant post graduate qualifications • Certified copies of THREE forms of identification as described in Policy B1 • Evidence of Vaccine Preventable Disease (VPD) as described in Policy B1 and completion of

Vaccine Preventable Diseases Evidence Certification form • Criminal history check is valid if received within the last 3 years. If a new criminal history check is

required, please complete the Employment Screening Consent form and submit with your application. The fee for the criminal history check will be taken from your allocated funding. The NMEP team will lodge this on your behalf.

• If you are placed in a Multipurpose Health Service (MPHS) or residential aged care facility you are required to have an Aged Care Criminal History Check. If you do not already have this, please await details of your placement. If you are required to complete an Aged Care Criminal History Check please complete the form and return to nmep@health.qld.gov.au. The fee for the aged care criminal history will be taken from your allocated funding. The NMEP team will lodge this on your behalf.

See application form checklist at Appendix One for a comprehensive list of requirements for the application. If you are awaiting results or correspondence, you are encouraged to apply and contact the NMEP team to discuss your needs. Should you or your line manager require an electronic version of any of these documents please contact the NMEP team on nmep@health.qld.gov.au. Where possible, applicants will be offered a position on the program with at least four weeks’ notice prior to placement. Employees under current performance review are not eligible to apply for this program. The NMEP coordinator will endeavour to place you in your preferred location and unit as per your learning goals; however, preferences cannot be guaranteed. Please note that Emergency Department and critical care placements are limited and highly sought. There is much to be learned from all areas across the state of Queensland and candidates are encouraged to consider placement offers outside of their preferred locations. Declining a placement offer may affect your ability to reapply. This is assessed on a case by case basis.

9. Employee Movement Forms The host facility is responsible for wages for the candidate, including all allowances and shift penalties. An employee movement form (EMF) (temporary movement) will be used to move employees to their host facility for the duration of the program. This form will need to be completed in MyHR. The NMEP coordinator will liaise with the respective line managers regarding the EMF completion and submission. Part time employees are eligible to apply but may need to commit to working full time for the duration of the program. Line managers approving applications from part time employees may receive a full-time employee during the exchange. Any increase in costs for full time employment is allocated to the host facility. Placement will be negotiated between the line manager and the NMEP coordinator to offer a suitable placement for part time employees. 10. Termination of Placement To get the full benefits of the exchange program, it is important that candidates commit to the full twelve-

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week program. Funding provided to candidates is done so with the understanding that participants will complete the twelve-week program in full. In the event a candidate is not able to complete the program, contact must first be made with the NMEP coordinator and the facility line manager to negotiate this process. Candidates need to be mindful that asking to terminate the placement agreement will not only affect themselves, but their exchange partner, as they may be asked to return to their substantive position. Candidates who terminate the program early may be subject to reduced funding and may be required to pay for their own travel home. This will be assessed on a case by case basis. In the event of urgent leave for family or extenuating circumstances, candidates are eligible for bereavement and annual leave and should discuss this with the line manager. If the placement agreement is terminated due to Code of Conduct or poor performance issues prior to the 12 weeks, candidates may receive reduced funding allocation. This will be assessed on a case by case basis and candidates may be required to pay for their return trip home. Line managers are asked to contact the program coordinator with any concerns prior to the termination of the placement, as a swap or waiting list may be facilitated. All efforts will be made to ensure the placement is successful for those who are placed. If you have any concerns at all, please contact the NMEP coordinator for advice and support.

11. Entitlements and Particulars All wages, entitlements, on-call and other allowances are paid as per the Nurses and Midwives (Queensland Health) Award - State 2015 by the host facility. Candidates receive all award entitlements in conjunction with the allocated funding. 11.1 Shift Work Successful applicants are required to work across all shifts, including weekends, public holidays and on-call as required by the host facility line manager. Roster requests are at the discretion of host facility line manager. 11.2 Annual Leave To ensure candidates get the most out of the program, it is recommended that annual leave is not taken for the duration of the program. Short term annual leave of less than one week may be considered and will be approved at the discretion of the manager of the host facility. Please check entitlements here. 11.3 Sick Leave Staff are entitled to sick leave as per the Nurses and Midwives (Queensland Health) Award - State 2015. Local protocols and policies should be followed to inform line managers of sick leave. 11.4 Work Cover All injuries need to be reported immediately to the line manager and documented as per local policy and procedure. Inform the line manager and complete an incident report as soon as possible. 12. Code of Conduct and Confidentiality All candidates work under the Code of Conduct for the Queensland Public Service. Consistent inappropriate workplace conduct may lead to termination of the placement.

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13. Contact Details The NMEP is coordinated by the Rural and Remote Clinical Support Unit (RRCSU) based in Cairns. For all enquiries please contact:

RRSCU Level 1 William McCormack Place 5B Sheridan Street, Cairns QLD 4870 PO Box 7193 Cairns, QLD, 4870 Phone: (07) 4226 3000 Fax: (07) 4226 3040 Email: nmep@health.qld.gov.au

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Appendix One – NMEP Application Form Instructions Before completing this form please read the Nursing and Midwifery Exchange Program Guidelines. To apply, please complete the form below and submit to your Line Manager for approval. The form must be signed by your Line Manager and the Nursing/Midwifery Director or Director of Nursing/Midwifery. Once you have approval prepare the other application documentation as indicated on the checklist. Once the application form and checklist requirements are completed please scan and email all documentation to nmep@health.qld.gov.au

Name:

Current place of employment:

Clinical Area:

Length of time in this area of practice:

Payroll No:

Employment Status: Full Time: Part Time: Hours/ fortnight:

Nursing Grade: Registration Endorsements:

AHPRA no: Registration Limitations:

Placement Preferences

Placement Length Clinical Area/s of Interest Preferred city/towns or locations

3 Months 6 Months

(check preference)

Contact Details

Postal Address:

Email:

Mobile No: Home or Work No:

Emergency Contact Details

Name:

Address:

Relationship:

Mobile No: Home or Work No:

Please outline why you would like to participate in this program

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How will you use the knowledge and experience that you gain? What strategies will be used when improving practice at your home hospital/service?

What are your learning objectives for this program and how will these benefit your home facility and community? Please list 3 objectives

1

2

3

Applicants signature:

Date:

Applicants Line Manager and Nursing/Midwifery Director or Director of Nursing/Midwifery Endorsement

Reason for endorsement:

Is the Applicant up-to-date with mandatory training? Yes No

Line Manager Name: Signature:

Phone No: Date:

DON/M or Nursing/Midwifery Director Name: Signature:

Phone No: Date:

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Nursing and Midwifery Exchange Program Application Check List

All items below must be completed before submitting application Check when completed

I have completed the application and have had line manager and Nursing/Midwifery Director or Director Nursing/Midwifery approval

I have attached a copy of my resume

I have attached a signed copy of a referee report from my line manager (Refer to Appendix Two)

I have included certified copies of THREE (3) forms of identification (and change of name documents if applicable) as per Queensland Health policy B1

I have included my AHPRA number on my application

I have attached certified copies of my qualifications and any post graduate qualifications e.g.: Bachelor of Nursing/Diploma of Nursing

I have included evidence of Vaccine Preventable Disease (VDP) as per Queensland Health policy B1 and have completed the VDP form

• Hepatitis B

• Measles/ Mumps/Rubella

• Varicella

• Pertussis

If placed in a remote Aboriginal and Torres Strait Islander community I am willing to undertake any additional required vaccinations including Hepatitis A and Japanese encephalitis

I am aware that my Criminal History Status will be checked against the VADER systems and if expired I will be required to complete a new Criminal History Check application

If placed in a Multi-Purpose Health Service or Residential Aged Care facility I am willing to complete an Aged Care Criminal History Check https://qheps.health.qld.gov.au/__data/assets/pdf_file/0030/617655/aged-qps-application-2018.pdf

Signature

Date:

Once the application form and checklist requirements are completed please scan and email all documentation to nmep@health.qld.gov.au

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Appendix 2 – Referee Report – Nursing and Midwifery Exchange Program Instructions

The applicant listed below has applied to be considered for the Queensland Health Nursing and Midwifery Exchange Program (NMEP). Information about the NMEP can be found here: https://qheps.health.qld.gov.au/nmoq/education/nursing-and-midwifery-exchange-program

In completing the referee report, you are being asked to provide information about the applicant’s knowledge, skills and ability against particular criterion, as well as general information relating to their performance and conduct. In providing this information, please consider the classification level applicable to this role.

If you are an existing public service employee, please note that the omission of relevant information or the provision of untruthful information by a referee to the referee’s own agency or to another agency is a breach of the recruitment and selection directive and may result in a discipline process being commenced.

The NMEP coordinator will be contacting you directly to discuss this report.

Information provided in a referee report may be released in accordance with the Right to Information Act 2009 and may be incorporated into feedback for successful or unsuccessful applicants.

Should your referee report contain any adverse comments that may affect the selection outcome, the report may be discussed with the applicant.

Thank you for completing the report. Please email the completed report to nmep@health.qld.gov.au

Applicant details

Name:

Position Applying for: Nursing and Midwifery Exchange Program

Referee Details

Name:

Role:

Organisation:

Relationship with the applicant (incl. duration):

Comments against key capabilities

Key Capability One: Team work and engagement with the facility unit

The applicant:

• Does not generally meet this key capability ☒

• Generally meets this key capability ☐

• Usually exceeds this key capability ☐

Please provide, from your knowledge, your assessment of the applicant against this key capability.

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Key Capability Two: Adaptability to new situations

The applicant:

• Does not generally meet this key capability ☐

• Generally meets this key capability ☐

• Usually exceeds this key capability ☐

Please provide, from your knowledge, your assessment of the applicant against this key capability.

Key Capability Three: Eagerness to learn

The applicant:

• Does not generally meet this key capability ☐

• Generally meets this key capability ☐

• Usually exceeds this key capability ☐

Please provide, from your knowledge, your assessment of the applicant against this key capability.

Key Capability Four: Ability to apply new skills and theories to practice

The applicant:

• Does not generally meet this key capability ☐

• Generally meets this key capability ☐

• Usually exceeds this key capability ☐

Please provide, from your knowledge, your assessment of the applicant against this key capability.

PTO

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Comments about performance and conduct

Questions Comments

If you are currently the applicant’s supervisor/manager, please comment on the applicant’s most recent performance and development assessment.

Please comment on the applicant’s commitment to organisational goals and values, integrity and client focus.

Please comment on the applicant’s focus on productivity, perseverance and delivering results on time.

Please comment on the applicant’s decision making and problem solving.

Please comment on the applicant’s openness to change and ability to learn from mistakes.

Current or past discipline

Are you aware of any current discipline process or past discipline findings against the applicant? If so, please provide relevant details.

General comments

Are there any additional comments you wish to make about the applicant?

Referee Name:

Signature* Date:

Reviewers Name:

Signature Date:

*if report taken over the telephone, reviewer is to verify date and time here:

Once the referee report is completed please email to nmep@health.qld.gov.au