Nomination Form for Existing Directors – London Regional Talent Board Application Form

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Application-ID Optional
Privacy Agreement
Any information you provide in completing this application will be stored and processed in accordance with our Data Privacy Policy which you are required to read and accept before completing your application.
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I confirm I have read and accept the Academy’s Data Privacy Policy

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Contact Details
Name

First Last
Email

Your primary email address
Post Code

Your home post code
Phone

Your main telephone number with international dialing code and extension if necessary

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Nomination
How were you nominated for the Aspire Together Talent Pool: Existing Directors?
My organisation nominated me
I put myself forward

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Job Role
Please enter the details of your current main job role.
Organisation
Country

Please select your country
Organisation Type

Please enter the type of organisation
New Organisation
Hidden section that is only shown when the organisation is unknown
Organisation Name

Please enter the name of the organisation
Organisation Post Code

Please enter the post code of the organisation
Is this an NHS organisation?
Yes
No
Role
Job Title

Please enter your job title
Salary/Band

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Nominated Executive Leader
Please provide the details of your line manager or Nominated Executive Leader (Chief Executive / Accountable Officer / Regional Director). Please note the nominated executive needs to be operating at Chief Executive or Chair level. If self-nominating they may well be an executive or Human Resource Director (or equivalent).
Name

First Last
Email
Phone
Role
Job Title

Please enter your nominated senior leader's job title

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Career Conversation

As part of the nomination process, we highly recommend that individuals have discussed their career aspirations with a senior leader (someone typically working at an executive level or equivalent).

It is important to remember that a career conversation is not a performance management discussion and should be a jointly agreed process.

We suggest you follow these steps:
- Hold a career / talent conversation using your organisation’s talent management processes and tools or, those produced by the Leadership Academy with your ‘Nominated Executive Leader’ (board / governing body executive director or equivalent).
- Consider your skills, knowledge and experience against the Success Profile such that where possible you can both agree you are ready for your next board / governing body executive director level role. Please note that we do not expect you to have all of the competencies and experiences listed in the Success Profile and understand that we need different styles and types of leadership. We'll be looking for those who understand the board / governing body executive director role, have a good range of experience and demonstrate a range of strengths in the competencies.
Please note below whether you were able to hold a career conversation and which talent conversation tool you used.
Write your answers here

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Supporting documents
Please upload the following documents:
- Your completed Success Profile Review (Mandatory)
- Your completed Nominated Executive Leader sign-off (Mandatory)
Drop files here or

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Equality & Diversity
We hold the principles of equality and inclusion at the heart of everything we do and all that we stand for. Each programme is held to account for its inclusion practice through a review of anonymised statistics based on this data. Your equality and diversity data is not used to determine the success of your application. This data is stored securely in compliance with the General Data Protection Regulation (GDPR) 2016. The Regional Talent Boards are committed to improving equality, diversity and inclusion in talent management across the NHS. By answering these questions, you are helping us to ensure that we work in a way that reduces discrimination on the basis of race, gender, sexual orientation, disability and other protected characteristics. Any data we hold is stored securely and in compliance with the General Data Protection Regulation (GDPR) 2016. If you have any questions or concerns about the collection of this data, please contact aspire.togetherlondon@nhs.net
Which of the following best describes your gender?
Are you now or have you ever defined yourself as Transgender?
Which of the following best describes your sexuality?
Do you consider yourself to have a disability?
Which of the following best describes your ethnic background?
Which of the following best describes your religion or belief system?

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Agreement
Please check the box below to accept our Terms and Conditions

Regional Talent Board Terms & Conditions

1. I confirm that all the information provided in the Nomination Form is up to date and accurate.

2. I understand that by applying I am identifying myself as an individual looking for a new role in the NHS or Healthcare Sector which may include NHS England and NHS Improvement, Health Education England or Public Health England.

3. I understand that by submitting this nomination I am agreeing to be supported by NHS Executive Search to gain my next executive position.

4. My personal data will be kept confidential; however, my name will be known to the Regional Talent Board members should you be ready to be placed within an executive talent pool. (NB – this will be explained in detail following profiling processes).

5. If organisationally sponsored: Your executive sponsor is supportive of your application and will enable you to take part in all elements of the gateway process.

6. If self-nominating: You agree that you are able to attend take part in all elements of the gateway process (e.g. manager support)

7. I will ensure I provide feedback for evaluation purposes when asked to do so, recognising that this will help inform future development of the Gateway Assessment Process.

8. I agree to advise the Aspire Together team as soon as possible if I am successful at interview elsewhere or if I am no longer looking to join the Talent Pool and that this will result in withdrawal from the process.

9. I understand that my information will be used for reporting purposes as part of the NHS Leadership Academies work.

10. I understand that if at any time I wish my contact details not to be shared I must advise in writing that I do not wish this to happen. Any requests should be made to: aspire.together@nhs.net.

11. I understand that the Aspire Together team will be in touch to discuss my application. This will be to discuss some of the information contained within this form and only if we feel that we need more detail from you. This will be via the contact details I have shared in this form or otherwise stated.

12. I understand that I may be contacted during the process and following assessment regarding (but not limited to) potential development opportunities and various programmes, workshops, newsletters or networking events which may be of interest to me in developing my career.

I agree to the Terms and Conditions

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Summary
Please check your details and, if correct, submit this form.
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Privacy Agreement

Contact Details

Nomination

Job Role

New Organisation

Nominated Executive Leader

Career Conversation

Supporting documents

Equality & Diversity

Agreement

Summary

Problems?