POLICY DOCUMENT Travel Choices for Staff and Visitors to the Great Western Hospital Owner: Date Created: Director of Finance 28/10/2010 The following fields are updated automatically: Version No: Status: Next Review Date: Approved By: 1.0 Approved 01/11/2011 Non-clinical PAG Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital Table of Contents 1. 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 2. 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Document Definition ......................................................................................... 3 References & Further Reading ........................................................................... 3 Glossary/Definitions ............................................................................................ 3 Purpose .............................................................................................................. 3 Scope ................................................................................................................. 3 Regulatory Position ............................................................................................. 4 Equality Impact Statement .................................................................................. 4 Special Cases ..................................................................................................... 4 Comments .......................................................................................................... 4 Visitor Transport ............................................................................................... 4 Visitor Motorcycle Parking................................................................................... 4 Visitor Bicycle Parking ........................................................................................ 4 Public Transport .................................................................................................. 4 Public Car Parks ................................................................................................. 4 Visitor Disabled Parking ...................................................................................... 5 Link Drivers ......................................................................................................... 5 Public Barrier Passes.......................................................................................... 5 2.7.1 2.8 3. 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.10.1 3.11 3.12 3.13 3.13.1 3.14 3.15 3.16 3.17 3.18 4. 5. 6. 6.1 6.2 6.3 6.4 6.5 6.6 7. 8. 9. 10. Eligible Groups and circumstances of issue ..................................................................... 5 Shalbourne Suite Patients................................................................................... 5 Staff Travel Choices ......................................................................................... 6 Staff are considered to be all people who: .......................................................... 6 Staff Car Share Schemes ................................................................................... 6 Staff Cycle Schemes and Parking ....................................................................... 7 Staff Bus Schemes ............................................................................................. 7 Staff Train Tickets Scheme ................................................................................. 7 Staff Motorcycle Schemes and Parking............................................................... 8 Staff Parking ....................................................................................................... 8 Priority Users ...................................................................................................... 8 Priority Charges .................................................................................................. 8 Standard Users ................................................................................................... 8 Eligibility Criteria to register as a Standard User ............................................................... 9 30 minute Public Transport Zone ...................................................................... 10 Fixed Fortnights ................................................................................................ 10 Restricted Days ................................................................................................ 11 Table 1: Restricted Days ................................................................................................. 11 Staff Smartcard ................................................................................................. 11 Standard User Charging ................................................................................... 11 Transitional Relief ............................................................................................. 12 Pool Cars .......................................................................................................... 12 Staff Disabled Drivers ....................................................................................... 13 New Starters .................................................................................................... 13 Non Staff Members Requiring Access to Staff Parking Areas ..................... 13 Appeals............................................................................................................ 14 Appeals............................................................................................................. 14 Transport Appeals Board .................................................................................. 14 Process of Appeal ............................................................................................. 14 Transport Arrangements in the Appeal Period (criteria appeals only) ................ 14 Outcome of Appeal ........................................................................................... 14 Outcome of Appeal against Penalty Notice ....................................................... 15 Enforcement .................................................................................................... 15 Transport Administrator Contact Details ...................................................... 15 APPENDIX 1: Applying for a Staff Smartcard – A Quick Guide ................... 16 APPENDIX 2: Maps ......................................................................................... 18 Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 2 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 11. APPENDIX 3: Taxi Service Terms and Conditions ....................................... 19 12. APPENDIX 4: Cycle Centre Users .................................................................. 20 12.1 Terms and Conditions ....................................................................................... 20 13. APPENDIX 5: Free Hospital Travelpass ........................................................ 21 13.1 Free Hospital Travelpass Terms and Conditions............................................... 21 13.2 Free Hospital Travelpass Application Form ....................................................... 21 14. APPENDIX 6: Hospital Travelpass ................................................................. 23 14.1 Hospital Travelpass / Travelpass Plus Terms and Conditions ........................... 23 14.2 Hospital Travelpass / Travelpass plus Application Form ................................... 26 14.3 Smartcard Terms & Conditions ......................................................................... 28 15. APPENDIX 7: Loan to Purchase a Public Transport Season Ticket (available from 31st Jan 2011) ............................................................................................................ 30 15.1 Loan to Purchase a Public Transport Season Ticket Terms and Conditions ..... 30 15.2 Loan to Purchase a Public Transport Season Ticket Application Form ............. 32 16. APPENDIX 8: Priority Users Application Form ............................................. 33 17. APPENDIX 9: Standard User Application Form ............................................ 35 18. APPENDIX 10: Transitional Relief Application Form .................................... 37 19. APPENDIX 11: Pool Cars: Terms and Conditions ........................................ 39 20. APPENDIX 12: Free Barrier Pass Application Form ..................................... 41 21. APPENDIX 13: FAQs ....................................................................................... 42 Please note: Copies of this document obtained electronically i.e. via e-mail, Intranet or Web site may not contain Appendices 9 (maps) and 10 (site plan) which contain large graphics files. These will be available separately from the same location or provider, as will the Standard Staff Parking Permit application form in Appendix 2. 1. Document Definition 1.1 References & Further Reading Ref Number 1.2 Document Title Document Location Glossary/Definitions The following acronyms are used within the document: PCN – Penalty Charge Notice PTZ – Public Transport Zone 1.3 Purpose This policy aims to manage the use of the car parking spaces at the hospital, to reduce the number of journeys made in a private car, and to allow those who need to access the site by vehicle the best chance of parking. 1.4 Scope This document outlines the policies and procedures that are enforced on the site of the Great Western Hospital. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 3 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 1.5 Regulatory Position 1.6 Equality Impact Statement Great Western Hospitals NHS Foundation Trust aims to design and implement services, policies and measures that meet the diverse needs of its service, population and workforce, ensuring that none are placed at a disadvantage over others. This document has been assessed against the Trust’s Equality Impact Assessment Tool. 1.7 Special Cases 1.8 Comments Any comments on this document should, in the first instance, be addressed to the Director of Estates and Facilities. 2. Visitor Transport 2.1 Visitor Motorcycle Parking Motorcycle parking for visitors is free of charge and is located so as not to be affected by barrier access control. Visitors are responsible for the safety and security of their own vehicles. (see APPENDIX 2 for locations). 2.2 Visitor Bicycle Parking Bicycle parking is provided for visitors under the crescent outside of the main entrance to The Great Western Hospital and by the entrance to SwICC (see APPENDIX 2 for locations). 2.3 Public Transport Several local and cross county busses stop outside of the main entrance to The Great Western Hospital. Under the crescent there is real time information showing arrival times for local Thamesdown Transport services, and timetable information is displayed at the bus stops. The Hospital Express (number 16) travels around the site and will pick up and drop down passengers outside of the Brunel Treatment Centre, and closer to the SwICC entrance. 2.4 Public Car Parks The public car parking shall change to “pay on exit” from April 2011. The public car parks (see APPENDIX 2 for locations) have barriers at the entrance and exit. The entrance barrier will lift when a ticket is taken and close once a vehicle has past underneath. To exit the car parks the dispensed ticket must have been validated within a reasonable timeframe at one of the on site pay on exit machines (see APPENDIX 2 for locations). The pay on exit machines will all accept cash and allow for payment to be made on debit/credit cards. The cost of parking in the public pay and display car parks will continue to reflect the cost of parking in a Swindon Borough Council long stay car park. If a barrier fails to operate or a ticket is not produced, the intercom system should be used to contact help immediately. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 4 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 2.5 Visitor Disabled Parking Public disabled parking spaces are provided close to the entrances of all buildings on site. The car parking spaces will not be barrier protected, and users must display a valid blue disabled badge at all times. There will be no charge for parking in these areas, and there is no length of stay restriction in place. 2.6 Link Drivers Link Drivers must register their organisation with the Transport Administrator and will be given visitor barrier passes allowing the free egress from the public car parks. The barrier passes must only be used when attending the hospital on Link business. The barrier pass remains the property of the Trust and must be returned if the driver leaves the Link scheme. 2.7 Public Barrier Passes Passes are available for use by members of the public either receiving treatment or visiting patients for whom it is inappropriate to pay the standard public pay on exit charges. 2.7.1 Eligible Groups and circumstances of issue Barrier passes requiring the payment of the first hours charge for parking will only be issued by departments at the hospital. They may be issued in the following circumstances: - Patients who regularly attend the hospital for ongoing treatment on a daily (more than one day in any given week) or weekly (more than one occasion in any one month) basis and who can demonstrate that they have no alternative but to drive to the hospital. - Visitors of patients or patients whose current condition is judged by clinical staff responsible for their care as being of a “very serious” or “life threatening” character. - Patients (and/or their supporters/carers) whose stay and hence occupation of a parking space is extended beyond an excessively long period which they could not reasonably have expected, either from information provided to them relating to their appointment or displayed in the relevant area. In addition free barrier passes may be issued in the following circumstances: - Patients or patient visitors/supporters/carers who arrive in emergency circumstances without money to cover parking charges. - Patients whose treatment is not NHS funded and whose insurer has an agreement with The Great Western Hospitals NHS Foundation Trust that free parking for their client will be provided. - Valid blue badge holders who have parked in the visitor car park. 2.8 Shalbourne Suite Patients Patients attending the Great Western Hospital site for treatment that is being funded by an insurer who has agreed with The Great Western Hospitals NHS Foundation Trust to pay the cost of parking will be issued with Shalbourne Suite parking permits, or free barrier passes, depending on which is most appropriate. Users of these permits should be attending the hospital site for treatment, not for work related reasons. Vehicles displaying a validated Shalbourne Suite permit are the only vehicles eligible to park in the yellow permit holders spaces (see APPENDIX 2 for locations). To validate the permit the following must be completed. - The month and date that the permit is valid from must be removed. The number of days the permit is valid for (from the date above) must be removed. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 5 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital The registration number of the vehicle must be clearly written on the permit – it is not transferable between vehicles. - These instructions are printed on the reverse of the permit. Failure to follow the instructions may result in a Penalty Charge Notice being issued. 3. Staff Travel Choices 3.1 Staff are considered to be all people who: - Attend the Great Western Hospital site on at least a fortnightly basis for the purposes of paid employment by any organisation. - Attend the Great Western Hospital site for educational reasons. The Trust will not be able to accept liability for any personal increase in costs due to the implementation of this policy. 3.2 Staff Car Share Schemes Whilst recognising that individuals may not always wish or be able to share their car with others the Trust is seeking ways to encourage car sharing amongst staff. ‘Car Sharing’ is: “Two or more people who would otherwise drive alone in separate vehicles to the hospital taking turns to do so or only going in one car on a regular basis.” The Trust has a car sharing database into which staff are encouraged to enter their details. Only staff based on the site of the Great Western Hospital can access the details of your journey and personal details will not be seen by anyone else until permission has been received from both parties. Car sharers do not need to alternate which car they bring on site, as long as the individuals involved do not use their smartcard on more occasions than their restricted days allowance. Only one smartcard needs to be activated to allow the vehicle out of the car park. It is inevitable that occasions will arise where an arranged car share cannot take place due unexpected sickness etc. To cover these incidences the Trust will issue each standard user with 12 public barrier passes per year. The year will commence at the date of registration, and a new allocation of passes will not automatically be sent out, but will have to be requested. Staff will be entitled to park in the North visitor car park for £1 per day. These passes must be validated at one of the pay on exit machines before leaving the car park. Each pass can only be used once, and if you have a genuine need to visit the hospital on several occasions in one day, you should contact the Transport Administrator with suitable evidence, who will be able to ensure, at their discretion, parking does not cost more than £1 per day. Staff in existing car share arrangements who find themselves with no other option but to bring in their vehicle without car sharing for extended periods (no more than 6 weeks) must contact the Transport Administrator. An example of this may be a member of staff on a phased return to work following sickness. They should submit evidence of their situation and at the Head of Sustainability, Accommodation and Transport’s discretion additional public barrier passes may be granted. Please see terms and conditions in APPENDIX 3. The car sharing website can be access by clicking on the following link www.GWH.liftshare.com. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 6 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 3.3 Staff Cycle Schemes and Parking The Trust participates in the NHS Cycle to Work Initiative and this scheme is open to all members of staff who are paid by the Great Western Hospitals NHS Foundation Trust (except bank staff). Other organisations based on site may offer a similar scheme to their employees. The scheme allows staff to loan a bike of their choice from NHS Cycle to Work, for a period of 12 months before deciding to purchase the bike out right (under a separate agreement after the loan period has finished) or return it for a nominal payment. During the loan period deductions to cover the cost of the loan are taken directly from salary before tax. Staff who wish to participate can take advantage of up to £1000 worth of benefits. Application forms are and more information is available in APPENDIX 4. More information is available on the Environmental Services intranet pages. There is secure cycle parking, and secure lockers and changing facilities provided on site for staff (see APPENDIX 2 for locations). For access details please contact the Transport Administrator. Staff who are registered cycle users will be eligible to 10 free visitor barrier passes per two months. These passes allow the user to park in the North car park (see APPENDIX 2 for locations) free of charge. This supply is worked out on a pro rata according to the number of days the cycle user attends site. 3.4 Staff Bus Schemes The Trust runs the following schemes that are available to all staff based on site. Network Card – this can be purchased from the cashiers office for £17, and is loaded with £20 worth of travel. The user simply places the card on the ‘bullseye’ on the drivers machine and the appropriate fare is deducted from the card. New cards can be purchased at any time. Free one month travel pass – This scheme is designed to encourage staff who are eligible to register as a standard user to try commuting by public transport to The Great Western Hospital. Whilst retaining a future entitlement to a barrier pass staff can try out the bus service in Swindon for one month for free. If they find that they would like to continue commuting by bus they can move on to the Hospital Travelpass scheme or have their barrier pass returned. Terms and conditions and application forms are available from APPENDIX 5. Annual bus pass scheme – This scheme is designed for staff who want to commute to work by bus all year. Applicants commit to a years' worth of discounted bus travel. This scheme currently gives a discount of nearly 20% on the equivalent bus pass price to the public. Staff can use the pass whenever they want - not just for getting to work. The Trust will purchase the annual pass on behalf of the employee, who will reimburse the Trust either in quarterly payments or monthly deductions direct from salary. Staff who are participants of the annual Hospital Travelpass scheme will be eligible to 10 free visitor barrier passes per two months. These passes allow the user to park in the North car park (see APPENDIX 2 for locations) free of charge. This supply is worked out on a pro rata according to the number of days the bus user attends site. Terms and conditions and applications forms are available in APPENDIX 6. 3.5 Staff Train Tickets Scheme Staff of Great Western Hospitals NHS Foundation Trust can apply for an annual train season ticket. The employee is still required to purchase the ticket in line with the operating company terms and conditions, but if a loan has been agreed will be reimbursed in full, minus one month’s payment. The member of staff will then continue to repay the cost of the ticket over the next 9 months by monthly Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 7 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital instalments directly from their salary. The maximum value of the loan available is £4,500. Please note that this is subject to individual approval. Terms and conditions and application forms are available in APPENDIX 7. 3.6 Staff Motorcycle Schemes and Parking Motorcycle parking is free of charge and it not affected by barrier controls. Staff who are not registered car users will be eligible to 10 free visitor barrier passes per every two months. These passes allow the user to park in the North car park (see APPENDIX 2 for locations) free of charge. This supply is worked out on a pro rata according to the number of days the user attends site. 3.7 Staff Parking The location of staff car parking is shown in APPENDIX 2. Staff should only park in staff car parks when they are at the hospital for work related reasons. On other occasions staff should park in the visitor pay on exit car park areas. Staff are able to register as either priority users (see criteria below), or standard users if they live outside of the 30minute public transport zone. Those applying to be a standard user will be able to activate their barrier pass a restricted number of times, over a fixed period. To cover the other times there are a number of different travel options available to staff. 3.8 Priority Users A priority user is defined as: someone whose late arrival could cause the complete cancellation of a theatre or clinic. If someone is eligible to apply to be a priority user, where they live is not considered, and they will be able to bring a vehicle onto site for 10 days in each fixed fortnight (see section 3.12 Fixed Fortnights). An application will only be considered if it is supported by their AMD or the Medical Director as appropriate. The number of staff registered as a priority users will be capped at a ratio of two registered users per available car parking space, when this ratio is reached a waiting list will be established, with further registration being on a first come first served basis. Although the aim of limiting the supply of these permits is the availability of a parking space for all Priority users at all times, such availability is not guaranteed. Priority permit holders who have difficulties parking in a Priority space are able to park in any other staff car park, but will still be charged at the priority rate. Application Form available in APPENDIX 8. 3.9 Priority Charges Registered priority users accessing any staff car parks between the hours of 06.30 and 19.00 will be charged £2.50 per day, Monday to Friday, for the first six days in each fixed fortnight period. Each subsequent day will then be charged at £7.40 (8 hours parking in the public car park) until the next fixed fortnight period commences. The barrier pass will only deduct the appropriate charge for parking once in any 24 hour period, commencing at 06.30. Thereafter access to the parking areas is without further charge. Parking over night and at weekends and bank holidays is free of charge. 3.10 Standard Users Staff who live outside of the 30 minute PTZ, are eligible to register as a standard user. Standard Users are only able to activate the barrier on the staff car park entrance a limited number of times in a fixed fortnight. Barrier passes that are activated on more than their limited number of days will be Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 8 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital charged £35 to exit the car park. Cards that do not have sufficient credit will need to be topped – up at one of the pay on exit machines on site. These machines are able to accept cash and credit/debit cards. Staff who live outside of the PTZ who believe that they are unable to park as a “restricted day” user due to care commitments should appeal under the criteria listed in 3.10.1. Application Form available in APPENDIX 9. 3.10.1 Eligibility Criteria to register as a Standard User The PTZ location is non negotiable and where the boundary runs down a road it is intended that the residents of that road are inside the zone irrespective of which side of the line they live. Criterion A: Home location relative to the ‘GWH 30minute PTZ’ The designation of the public transport zone is represented graphically in the following link http://www.gmap-pedometer.com/?r=4128501. ‘Home location’ is taken to be the location of residence when working for the majority of time during a working week. Any applicant living outside the zone as marked by the blue line qualifies automatically for a permit – they do not need to satisfy any other criteria. But they do need to apply! Any applicant living inside the GWH 30 Minute PTZ will only qualify for a permit if they satisfy at least one of the following criteria B to D. Criterion B: Non-daytime Weekday Hours Applicants can qualify if they either start or finish work on a regular basis before 0630 and/or after 1900 Monday to Friday, and/or if they regular work on weekends or bank holidays. A ‘regular basis’ is for at least 20% of any working week on average for a 3 month period retrospectively and evidence should be provided. New starters and initial applicants must provide ‘forecast’ evidence or testimony of this future requirement from their line manager and this should be initialled by the applicants Deputy General Manager or Head of Department in the corporate directorate. Criterion C: Disability or Medical Condition Although they may not have a disabled driver badge to use at the hospital applicants may cite a medical condition or disability as justification for registering as a standard car user, or requiring daily access to the hospital site if it can be shown that driving by car is the only viable means of their accessing the hospital site. Applications under this criterion must be accompanied by a signed letter of confirmation from: Great Western Hospitals NHS Foundation Trust Occupational Health Department Commonhead Offices The Great Western Hospital (01793 604481) Criterion D: Care Commitments An application may be accepted on the basis that registering as a standard user or driving to work by car everyday is essential in order to be able to assure commitments of care to immediate family members or other close relatives or associates. Applicants must add an explanation of this requirement and attach this to their application form. Evidence should be provided relating to the existence of the person requiring care, and that the applicant is the most appropriate provider of that care. If the care commitment relates to a need for children to be taken to and picked up from nursery or school then evidence to show that their attendance could not reasonably be assured by any other means other than undertaking a ‘school run’ should be provided. Applications under this criterion relating to childcare should provide the address and postcode of the school (if applicable) which will be compared with the home address. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 9 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital Children - In general if the locations of the applicant’s home, the school attended by the children and/or the location of the person providing childcare are all within the ’30 Minute Zone’ the permit application will not be successful. However if one of these locations is outside the ’30 Minute Zone’ positive consideration may be given to the application. Children of secondary school age (i.e. above 11 years of age) will only be considered as representing a ‘care commitment’ if they have special needs and evidence is submitted to corroborate this. Having children attending the Buffer Bear crèche at The Great Western Hospital may be considered as a ‘care commitment’ under this criterion. The exact circumstances will be considered and staff will need to show why they would not be able to car share or find alternative transport to the hospital. Children of pre-nursery age (under six months) – pass allowed to park on site full time allowed under any circumstances. Partner, spouses and other relatives The applicant must be acting in the capacity of a ‘carer’ to the individual(s) as well being an employee at the hospital. Definition of ‘Carer’: “A carer is someone who, by looking after a partner/relative/friend or neighbour, enables them to stay at home, or to return to it. Without the carer’s input, the cared-for person might remain longer in hospital than necessary, or seek placement in intermediate care or in a home. These beds are in short supply; carers are providing a service which frees the healthcare professionals to care for those who need acute care or specific rehabilitation. These carers are not paid, although some are eligible for benefits payments. At least one third of carers are 60 or older; many others care for an older person. Carers do have rights, including the right to refuse to take on the responsibility of caring for someone.” (Source: Carers’ Development Project, The Great Western Hospital) 3.11 30 minute Public Transport Zone The hospital has a 30minute public transport zone surrounding, to view map click on the following link http://www.gmap-pedometer.com/?r=4128501. From home addresses within the zone it is possible to travel directly to the hospital via public transport, (the service needs to run at least half hourly frequency at peak times) within 30 minutes. As such staff that live inside the zone are not eligible to apply to be a standard user, unless they are appealing using criteria B, C or D. It is acknowledged that for some staff a half hourly service does not tie in with working patterns. This is not a reason to appeal on its own, and Line Managers should be approached in the first instances to discuss working patterns around timetables and operational needs. Staff who live inside the zone, but are unable to complete their commute by public transport due to bus timetables not being sufficiently aligned to their work times will be able to appeal. The PTZ location is non negotiable by appeal and where the boundary runs down a road it is intended that the residents of that road are inside the zone irrespective of which side of the line they live. 3.12 Fixed Fortnights Fixed fortnights will always start at 06.30 on Monday and finish at 19.00 on Friday. On bank holidays during the fixed fortnight period, parking will be free of charge and parking on site will not count towards your entitlement. I.e. assuming there is one bank holiday in the fixed period, a full time member of staff would then be able to park a vehicle on site 7 times in that fixed period without receiving a fine, assuming one day was the bank holiday. Parking restrictions will be lifted between Christmas and New Year, and the fixed week period will follow on, i.e. if the Christmas week should be week two, the first week of January will become week two instead. The commencement date for the current fixed fortnight period will be shown on the intranet at all times and displayed in all staff car park areas. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 10 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 3.13 Restricted Days Restricted days applies to vehicles entering and leaving staff car parks in between 06:30 and 19.00 Monday to Friday excluding bank holidays and the week between Christmas and New Year. Part time staff will have their restricted days applied as shown in table 1. 3.13.1 Table 1: Restricted Days Number of days on site per week Number of days vehicle allowed on site in fixed fortnight 1 1 2 3 3 4 4 5 5 6 Bank staff will participate in the scheme as if they were full time members of staff, i.e. on site every day each week, unless pattern of work is fixed. 3.14 Staff Smartcard Staff whose application to register as a standard user is accepted will receive a staff barrier pass through the internal mail. The user must load credit onto the barrier pass, at one of the pay on exit machines before being able to leave the car park. The pay on exit machines are able to accept cash and debit/credit cards. The amount of credit left on the card will be displayed when the pass is used to activate the barrier. Passes with insufficient credit will not allow the user egress from the staff parking areas. Barrier passes will be uniquely identifiable, and their issue to individuals will be recorded for monitoring of use and fraud prevention. If a barrier pass is lost or stolen the user must inform the Transport Administrator who will be able to issue a new pass, for a £5 replacement fee. The Transport Administrator will be able to load the new barrier pass with any remaining credit from the lost pass. If the lost pass is found it will no longer work. Staff leaving the organisation must ensure that they reduce the amount of credit on their barrier pass as this will be non refundable. Barrier passes that have not been activated for a 3 month period will be stopped and any remaining credit will be lost. A new barrier pass can be given to members of staff if eligible for a £5 charge. If staff are on long term sick leave or maternity leave they should hand their barrier pass to the Transport Administrator who will ensure that passes are returned with any remaining credit as required. 3.15 Standard User Charging Registered standard users accessing any standard staff car parks between the hours of 06.30 and 19.00 will be charged £1 per day, Monday to Friday. The barrier pass will only deduct the appropriate charge for parking once in any 24 hour period, commencing at 06.30. Thereafter, access to the Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 11 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital parking areas is without further charge. Parking over night (entering the car park after 19.00) and at weekends and bank holidays is free of charge. The barrier technology will allow staff 30 minutes in the car park area until charging commences. After this time it will be assumed that the vehicle has parked. If a vehicle enters and leaves the car park such that the times are considered to be a restricted day, after the users entitlement has been reached, a charge of £35 will be made to leave the car park. If the member of staff has a genuine reason for their vehicle leaving they must provide evidence supported by the Line Manager to the Transport Administrator. The appeal will be heard at the next Transport Appeals Board. 3.16 Transitional Relief For staff who are currently paying £40 per annum to park on site there will be some transitional relief available. This will only be available to staff who fulfil all the following criteria: - have started employment before the 1st Nov 2010 - earn less than £10,000 per annum - have the site of the Great Western Hospital as their main base - can prove that car sharing or other low cost options are not a practical option for them to commute to work. Applications will be processed on a first come first served basis until the budget has been allocated. This fund will expire on the 31st Jan 2013 after which time all staff will be expected to pay their travel expenses in full. Successful applicant will be informed in writing and will have to contact the Transport Administrator who will be able to add an amount of credit to their barrier pass. Payments will be made every four months upon presentation of a valid barrier pass and the above criteria still being met. Staff wishing to apply for transitional relief will need to fill out the application form in APPENDIX 10 and supply evidence of meeting the above criteria to the Transport Administrator. This evidence will be treated in the strictest confidence and will be returned to the applicant once a decision has been reached. Staff are not able to appeal against the decision, but may submit a new application to be considered if circumstances significantly change. 3.17 Pool Cars The Trust will operate a fleet of pool cars that are available for use for work purposes by members of staff who do not have access to their own vehicle. These vehicles will be parked in dedicated bays in the North car park (see location map, appendix 2) and must be there over night. The vehicles are insured for business use only and must not be used for commuting to/from home or work. These vehicles will be available on a first come first served basis, and can be booked by emailing your request to poolcars@gwh.nhs.uk. Your email will be receipted within 48 hours, and you will be informed if your booking has been successful. Bookings can be taken up to 4 weeks in advance, however departments will be charged at a rate of £50 per day or part day if vehicles are booked and not used. You should email the above address to inform of any cancellation of booking as soon as possible, and failure to pick up a vehicle within an hour of the booking time may mean the vehicle is issued to another user. It will be the responsibility of the individual to pay any fines that are occurred whilst using the vehicle. They will not be paid by the Trust. For terms and conditions and procedures for the use of pool cars see APPENDIX 11. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 12 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 3.18 Staff Disabled Drivers Staff who are blue badge holders will be expected to participate in the Travel Choices scheme, unless Occupational Health give an exemption through the appeals process. There will be a number of disabled spaces in staff car parks. A valid blue badge should be displayed when using these spaces and there will be no time limit set on the use of these spaces. If all the disabled spaces in staff areas are occupied staff may park in the visitor areas. 4. New Starters New starters will be instructed to park in the visitor pay on exit North car park. At induction they will be given sufficient barrier passes to reach the end of the current fixed two week period, (or enough time to process an application), if they live outside the 30 minute PTZ. After this time it is anticipated that new starters should participate fully in the scheme. The barrier passes will charge the new starter £1 per day, and must be validated in one of the pay on exit machines just before the time of exit. New starters that live inside the 30 minute PTZ will not be issued with barrier passes, except to cover their first day if they have commuted by car. Staff should read the appeals policy if they wish to challenge this decision. If a new starter is requiring the use of their car for work, they must inform the Transport Administrator who will be able to ensure that they are charged no more than £1 per day and are able to come and go from the visitor car park as required. 5. Non Staff Members Requiring Access to Staff Parking Areas The Trust recognises that there are from time to time other groups of people who have the need to access site for work related reasons, who are either not paid or are infrequent visitors and therefore do not fall into the scope of this policy. The groups shown below are able to bring a vehicle onto site as many times as required and will park in the North visitor car park. - Clergy (free of charge) Volunteers (free of charge) Public Governors (free of charge) Visiting Clinicians e.g. Clinical Assistants, General Practitioners, Hospital Practitioners Agency Staff Visitors to the postgraduate centre who are on site less frequently than fortnightly Contractors who are not routinely based on site Locum staff who are on a two week or less contract Other users as may be agreed with the Transport Administrator on an individual or departmental basis. Users who will be issued with free of charge barrier pass will need to apply for a supply of these passes, using the application form in APPENDIX 12. An agreed number of passes (estimated to last approximately six months) will be issued to the individual, who will need to ensure they have contacted the Transport Administrator to replenish stocks before their allowance runs out. Users of the fee paying barrier pass will be able to pick them up from hospital departments or the Transport Administrator. These passes remain the property of The Great Western Hospitals NHS Foundation Trust and must not be used if visiting the hospital for personal reasons. Pass requiring payment will be made available to various departments for further distribution. The Transport Administrator will be the only person who can issue free of charge barrier passes to the eligible groups. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 13 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 6. Appeals 6.1 Appeals When a Standard User application is declined the applicant is informed without delay and advised that they may appeal against the decision if they wish. When raising an appeal staff must ensure all relevant information to support their appeal is included. All evidence should be initialled by the appellants Deputy General Manager, or Head of Department for the Corporate Directorate. The Transport Appeals Board will consider all appeals against the policy and the decision of the panel is final. Subsequent appeals will only be heard if there is a significant change in circumstances. In addition, any member of staff who receives a penalty charge of £35 may appeal to the Transport Appeals Board within 14 days of receiving the charge should they feel that the charge was issued inappropriately. In order for the appeal to be considered the employee will have to demonstrate that the charge was issued inappropriately given the content of this policy. 6.2 Transport Appeals Board To provide staff with a fair review of their situation the Transport Appeals Board will consist of a staff side and transport representative, together with a hospital manager. The Transport Appeals Board will meet once a month. The purpose of this panel is to investigate the grounds of appeal and provide the final decision on this matter. The employee will not be entitled to attend the appeal hearing, but will be informed in writing of the outcome. The Chair of the panel will try to ensure that the panel members do not hear appeals for departmental colleagues, and all information submitted will be kept confidential. 6.3 Process of Appeal Appeals must be submitted in writing. The evidence submitted should clearly including the reason for the need to register as a Standard User or why the penalty charge was issued inappropriately. Applications will be reviewed by the Parking Administrator. Applications that are supported by Occupational Health, or are clear as complying with the policy (e.g. baby at Buffer Bear under the age of 6 months) will be processed without the need to be heard by an appeals panel. Other applications will be submitted to the next available Transport Appeals Panel. Appellants will be informed of the date of their appeal, and they will be informed in writing of the outcome within 5 working days. If the appeal is successful a standard barrier pass will be sent to the applicant in the internal post, or a refund will be arranged. Once a smartcard has been received the user will be able to park in the staff standard car parks. 6.4 Transport Arrangements in the Appeal Period (criteria appeals only) Appellants must make their own transport arrangements in the period before they receive the final decision. The Transport Administrator will endeavour to provide information on such alternatives both during this period and afterward should their appeal be denied by the Transport Appeals Board. Appellants will not be able to park as a Standard User. 6.5 Outcome of Appeal There are a number of possible outcomes of an appeal. The appeals process is final and you will not have recourse to raise a grievance. Appeal outcomes for addresses inside the PTZ Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 14 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital The appellant may lose the appeal and will not be able to bring a vehicle on site. The appellant may win the appeal and is able to access the car park as a restricted days user. The appellant may win the appeal and is able to access site by car every day. Appeal outcomes for addresses outside the PTZ The appellant may lose the appeal, but will still be entitled to drive onto site a restricted days user. The appellant may win the appeal and is able to access site by car every day. 6.6 Outcome of Appeal against Penalty Notice There are a number of possible outcomes of an appeal: The appellant may be refused a refund, and the £35 penalty charge will stand. The appellant may be given a partial refund, deducting the public car park rate from the fine. The appellant may be given a full refund. 7. Enforcement Most service roads on the site are clearly marked with either single or double yellow lines. Vehicles parking on these roads may be towed away (including vehicles displaying a disabled drivers badge) wherever such a sanction is advertised. On the hospital site enforcement measures will be taken. 8. Transport Administrator Contact Details Car Park Administrator Commonhead Offices Great Western Hospital Marlborough Road Swindon SN3 6BB 01793 605278 Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 15 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 9. APPENDIX 1: Applying for a Staff Smartcard – A Quick Guide This policy document is intended to provide as much information as possible for all matters related to the transport schemes run by the hospital for individuals working there and the public. You will not need to read the whole document to apply for a barrier pass, but we recommend you read section 3 to understand what other travel choices are available. To determine if you are eligible to apply for and obtain a Staff Smartcard please review the 30 minute zone, and ensure that you fulfil the definition of staff. If your home address (considered to be where you live mainly when commuting to work) is outside this zone, you will be eligible to receive a smartcard for restricted days access to site. If you wish to appeal this restricted access please indicate this on the application form. Your application will need to be submitted with sufficient information to allow an appeals panel to reach a decision. The hearing will have two possible outcomes. 1. Your application is rejected; however you will continue to have restricted days access. 2. Your application is accepted and you are able to park on site every day. Living inside the Public Transport Zone means you will not automatically be eligible to register as a standard user, but you can ask for your application to be reviewed by an appeals panel – please indicate this on the application form. The appeal will have three possible outcomes: 1. Your application is rejected – the Parking Administrator may be able to assist you with alternative travel arrangements if contacted. 2. Your application is accepted and you are allowed access to site as per restricted days. 3. Your application is accepted and you are able to park on site every day. It is your responsibility to ensure that your completed application form is received by the Transport Administrator. You must sign your application and have the application counter-signed by your deputy general manager (or equivalent). Applications that are not complete will be returned. Once your completed application form is received it will be processed as soon as possible. If your application is successful you will be notified by receipt of your barrier pass in the internal post (unless you provide a stamped home addressed envelope). You will need to load credit onto the smartcard, and can then start using the staff car parks. Once you have started to park in the staff car parks you will be expected to abide by your restricted days allocation. Restricted days Restricted days applies to vehicles entering and leaving staff car parks in between 06:30 and 19.00 Monday to Friday excluding bank holidays and the week between Christmas and New Year. Part time staff will have their restricted days applied as shown in table 1. Table 1 Number of days on site per week Number of days vehicle allowed on site in fixed fortnight 1 1 2 3 3 4 Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 16 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 4 5 5 6 Bank staff will participate in the scheme as if they were full time members of staff, i.e. on site every day each week, unless pattern of work is fixed. Charging Registered standard users accessing any standard staff car parks between the hours of 06.30 and 19.00 will be charged £1 per day, Monday to Friday. The smartcard will only deduct the appropriate charge for parking once in any 24 hour period, commencing at 06.30. Thereafter access to the parking areas is without further charge. Parking over night (entering the car park after 19.00) and at weekends and bank holidays is free of charge. The barrier technology will allow staff 30 minutes in the car park area until charging commences. After this time it will be assumed that the vehicle has parked. If a vehicle enters and leaves the car park such that the times are considered to be a restricted day, when the users entitlement has been reached, a charge of £35 will be made to leave the car park. If the member of staff has a genuine reason for their vehicle leaving they must provide evidence supported by the Line Manager to the Transport Administrator who at their discretion may reimburse the individual. If you are ineligible please do not apply. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 17 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 10. APPENDIX 2: Maps Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 18 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 11. APPENDIX 3: Taxi Service Terms and Conditions Car Share Club Get-You-Home - The Get-You-Home taxi service is only available to those who have car shared on the way to work. - All taxi services within this scheme must be co-ordinated by the Transport Administrator who will be available during normal office hours Monday to Friday. In their absence such arrangements may be co-ordinated by another person nominated by them. - The taxi journey will normally be direct between The Great Western Hospital and the home of the person requesting the service. Stops en route will not normally be possible unless the purpose is to collect children from school or child carer (or similar requirement) and in any case this requirement should be agreed with the Transport Administrator before hand. - There is no limit on the distance that the Trust taxi will travel. However, there is a limit of £70 for the fare. Reimbursement of any fare over this amount will be sought at the Transport Administrators discretion. - Any person requesting the service, who has been authorised by the Transport Administrator, must be ready on-time to board the taxi and present their hospital photo ID card, or equivalent. - Any person requesting the service who subsequently does not require it should advise the Transport Administrator immediately. - The use of this service will be recorded and monitored. - All the taxis used will be prepaid by the Trust, and any tip paid to the driver may not be claimed for on expenses. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 19 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 12. APPENDIX 4: Cycle Centre Users 12.1 Terms and Conditions 1. The Cycle Centre at The Great Western Hospital is the property of Great Western Hospitals NHS Foundation Trust. 2. The Cycle Centre is available for use by any person working at the hospital site, regardless of employer or any other distinction. However priority of access will be given to persons who are not registered car users. In instances of over-subscription of the facility a waiting list system will be maintained on a first-come-first-served basis. 3. Persons visiting the site should not attempt to enter the changing area of the other gender under any circumstances. 4. Staff allocated a locker agree to make a returnable deposit of £10.00 in return for their locker key. If they lose that key the deposit will be forfeited and another deposit will be required. 5. Should any locker key holder wish to relinquish their locker an inspection of their locker will be necessary before the deposit will be refunded. Locker holders undertake not to adorn their locker with any materials and to maintain them in a clean condition. 6. Any persons contravening any of these terms will be required to surrender their locker key and they will be de-registered from accessing both the changing rooms. 7. Access to the changing facilities may be given at the discretion of the Transport Administrator. 8. Cycle Centre users must not leave articles outside of their own designated locker when they leave the changing facilities. Any articles left outside lockers may be removed. 9. Spare keys to each locker will be retained by the Transport Administrator. In the case of a problem the Transport Administrator will attempt to contact the locker user. However should this not be possible the locker may be entered to rectify the problem. 10. Cycle Centre users must not leave any windows open at any time when they are not present in the changing area. 11. Any property left at the cycle centre is left entirely at the owners own risk. The Trust will not be liable for any loss or damage to property left in the cycle centre. Cycle Centre users must not leave external doors to either changing area or the cycle store ajar. 12. Records of access made to the Cycle Centre may be used for the purposes of researching the use of the facility and reviewing eligibility to retain access to the facility and/or other benefits enjoyed by members of the Cycle User Group at The Great Western Hospital. Date Print Name Signed Department Employer Locker Deposit No: Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 20 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 13. APPENDIX 5: Free Hospital Travelpass Office Use OnlyHere: Applicant Number: Handled by (Initial): Status: Notes: Date Received – Stamp Free 1 Month Hospital Travelpass To support staff to explore alternatives methods of travel the Trust will provide any employee based at the hospital with a free 1 Month bus pass, with which they can try out commuting to work by bus at The Great Western Hospital. The bus pass is just like other bus passes available in Swindon – except it costs the user nothing! Once this has expired the user is able to join the regular Hospital Travelpass scheme and save money on the cost of annual bus travel. The offer is subject to the terms and conditions below – please read these carefully before completing the application form. 13.1 Free Hospital Travelpass Terms and Conditions 1. The offer is open to employees of any organisation represented at the site of The Great Western Hospital, including the Swindon Intermediate Care Centre, Commonhead Offices, Créche and residences provided that the areas described herein constitute their main base of work (i.e. where they spend the majority of their working time). 2. Existing members of the Hospital Travelpass scheme are not eligible to take part. 3. In order to take part existing staff must be eligible to register as a standard or priority car user on the site of The Great Western Hospital. 4. Anybody currently registered as a standard or priority car user on the site of The Great Western Hospital may take part in this offer. In order to take part they must surrender their smartcard to the Transport Administrator for the months period. They are free to resume this entitlement upon surrender/expiry of their free bus pass. 5. All successful applicants for the scheme must sign for receipt. The 1 Month Hospital Travelpass is not to be used by any other person under any circumstances. 6. Only one pass may be issued to any one person, regardless of how many concurrent or consecutive contracts of employment they may have at The Great Western Hospital site. 7. Any abuse of these terms and conditions will lead to the applicant being required to surrender their 1 Month Hospital Travelpass immediately and disciplinary action may be taken against them. 8. Taking part in the scheme will not affect the tax or national insurance status of the employee. 9. Basic personal information including name, department etc may be shared with the bus operating companies taking part in the scheme. 10. The Trust and bus operating companies reserve the right to change these terms and conditions without warning. 13.2 Free Hospital Travelpass Application Form Personal Information Title: (Mr / Mrs / Ms / Dr / Revd/Other) (please delete as appropriate) Name: Department: Telephone Extension: Employer: Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 21 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital Full home address: Postcode: (It is essential that you provide your full and correct postcode) Declaration I have read and understood the terms and conditions of the Free Hospital Travelpass scheme attached to this application form. I agree to abide by the terms and conditions of this offer and understand that any abuse of these terms or the submission of false information may result in disciplinary action being taken against me. Name:……………………………………………………………………………………………………… Date:………………………………….. Signature:…………………………………………………………………………………………………. (Completion of all fields in this declaration section is required in order for the application to be processed). Transport Administrator Commonhead Offices The Great Western Hospital Marlborough Road Swindon SN3 6BB What happens next? Provided that you are eligible to take part in this scheme we will contact you shortly with an authorisation letter. Please be aware that the processing of applications may take several working days. All free bus passes must be collected from the cashier’s office upon presentation of your authorisation letter and you will have to sign for receipt of the bus pass, and hand in your smartcard at the same time if applicable. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 22 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 14. APPENDIX 6: Hospital Travelpass 14.1 Hospital Travelpass / Travelpass Plus Terms and Conditions 1. Throughout this document reference is made to the Hospital Travelpass. The Terms and Conditions contained herein apply equally to the Hospital Travelpass Plus. 2. You will be issued with a smartcard and the product that you buy will be the Travelpass or Travelpass Plus. 3. The Application Form and the Terms and Conditions contained herein constitute a contract between Great Western Hospitals NHS Foundation Trust (‘The Trust’) and its employees. Employees of other organisations similarly enter into a contract with ‘The Trust’ by signing this agreement. 4. Acceptance onto the scheme is at the sole discretion of the Trust. 5. Passes will be available for purchase by staff from the Great Western Hospitals NHS Foundation Trust, or staff from any other organisation whose main location of work is The Great Western Hospital at the discretion of the Head of Sustainability, Accommodation and Transport. 6. Staff who join the scheme will be entitled to a year of reduced cost bus travel in Swindon. The Hospital Travelpass will be valid for travel only on the scheduled services of the participant bus companies. The participant bus companies to this scheme as of the date of issue of the terms and conditions are Thamesdown Transport Limited and Stagecoach Swindon and District. Travel can be made on all of the participant bus companies scheduled services within the areas for which the passes are valid unless otherwise stated. The Travelpass cards are not valid for travel on private or non-scheduled services e.g. ‘Park and Ride’ (P&R) services. The same normal conditions apply as per the standard Travelpass or Travelpass Plus (available from Thamesdown Transport Ltd). 7. The price of annual scheme membership is guaranteed once the member has joined the scheme and hence monthly or weekly deductions will remain the same throughout the period of that year. Annual membership prices may vary from time to time for new scheme members. Any changes in the price of subsequent annual membership will be notified to scheme members. 8. The Travelpass is valid for travel only by the purchaser and bears the hospital logo. If requested to do so by a representative of the participating bus companies, you must be able to provide identification that you are an employee based at the hospital site. It is not transferable. 9. The Travelpass remains the property of the Thamesdown Transport at all times. 10. Any breach of these terms and conditions may result, at the Trust’s and/or Thamesdown Transport’s discretion, in revocation of your Hospital Travelpass and/or a right by the Trust to refuse any future application from you to obtain a Hospital Travelpass in future. 11. The Trust and participating bus companies reserve the right to alter these Terms and Conditions at any time. Scheme members will be notified of any changes in writing as soon as practicable after any such changes are finalised. 12. Data Protection Act: Information supplied by scheme applicants and scheme members will be used solely for the purposes of operating the scheme and any information shared with bus operating companies will be solely for the purposes of account auditing. 13. Travelpasses issued under the hospital bus pass scheme cannot be used to load up publiclyavailable Thamesdown Transport products. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 23 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital Payment Options 14. There are two payment options available to staff. The Annual Travelpass can either be purchased quarterly by payments made in cash/debit card at the cashiers office, or for some organisations payment will be deducted monthly by payroll. 15. The scheme will not affect Income Tax or National Insurance. Monthly Payroll deductions 16. The date the voucher (see vouchers below) is collected from the cashiers office will act as the first date from which deductions for the pass will be made. Each deduction from monthly wages or salary will be the annual price divided by twelve. Weekly deductions will be at the purchase price divided by fifty two. 17. If possible, the first deduction will be made in the same month or week as the voucher is issued to the user. If this is not possible due to payroll process deadlines the first deduction will occur in the following month, and will cover a two month period. 18. Staff paid weekly will have deductions made pro rata. 19. Deductions will be shown on the pay slip. Quarterly payment 20. Payment will be taken when the voucher is collected from cashiers office. 21. Vouchers must be picked up from the cashiers office in a timely manner. If more than two weeks has elapsed between the expiry of one quarterly pass and the issue of the next you will be deemed to have left the scheme. 22. Once a voucher has been purchased no refunds are available on the pass. Vouchers for new starters and renewals 23. New starters will be issued with a voucher for the appropriate value once payment has either been received, or agreed if using monthly payroll deductions. 24. By picking up the voucher, users are accepting that they are wishing to commence a new period of membership of the scheme. Charging will commence once the voucher has been picked up. 25. Vouchers will only be accepted by the Thamesdown Travel shop if a valid staff ID is also presented. 26. The voucher will need to be redeemed at the Thamesdown Travel Shop before the current Travelpass runs out to ensure continuous entitlement to travel is maintained. 27. When the voucher is redeemed for new starters the Travelpass will be available for immediate use. 28. When the voucher is redeemed for existing members the new period of travel that is put onto the smartcard will commence the day after the current travel entitlement expires, irrespective of when the Thamesdown Travel shop is visited. Leaving the Scheme 29. Membership of the Hospital Bus Travelpass/Travelpass Plus Scheme runs for a year. Readmission to the scheme once left is at the discretion of the Head of Sustainability, Accommodation and Transport and will not be allowed within three months of leaving the scheme. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 24 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital Monthly Payroll Deductions 30. If the member does not wish to renew their annual membership they must return their Travelpass to the Transport Administrator so that payroll deductions can be ceased. 31. If the member wishes to leave the scheme before the annual membership is due to expire, their Travelpass needs to be returned to the Transport Administrator. Payroll deductions will be stopped, however part months used will have to be paid for in full. The Travelpass will be returned to Thamesdown Transport for cancellation. 32. Failure to hand in your smart card will result in your Travelpass being cancelled by Thamesdown on instruction from the Trust and a legally enforceable invoice will be sent to you for the full remaining value of the card. Quarterly Payment 33. If the member does not wish to renew their quarterly Travelpass they must return their pass to the Transport Administrator. 34. If the member leaves wishes to leave the scheme prior to the expiry of their current quarterly Travelpass, no refund is given on the remaining period of validity. The pass must still be returned to the Transport Administrator. Failure to do so may result in the Travelpass being hotlisted. Lost or stolen passes 35. If you lose your Smartcard you must contact Thamesdown Transport as soon as possible, either in person at the Thamesdown Travel Shop, or by phoning Thamesdown’s Customer Helpline on 01793 428428. Thamesdown will cancel your current card stopping it being used by anyone else. 36. Thamesdown will issue a replacement card, which has been loaded with the remaining period of travel you had left, either to you in person at the Thamesdown Travel Shop or in the post. There is a charge for this service. 37. If you subsequently find your old pass, it cannot be used again as it will have been cancelled. 38. If your pass is stolen you must follow the same procedure. 39. It is your responsibility to keep the pass in good condition so that it can be validated every time you wish to use it. Replacements may be available at the discretion of Thamesdown Transport and may be charged for. Should any Hospital Travelpass become unusable, for whatever reason, this should be reported to Thamesdown Transport either in person at the Thamesdown Travel Shop, or by phoning Thamesdown’s Customer Helpline on 01793 428428. 40. It is the responsibility of the pass user to cover their interim travel expenses between their not having a pass because it is lost, stolen or damaged and receiving a new pass. The Trust will not be liable for this expense and no refund will be made. Furthermore no rebate for days of use lost will be payable on the original pass if it is unusable for these reasons. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 25 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital Office Use OnlyHere: Applicant Number: Handled by (Initial): Status: Notes: Date Received – Stamp 14.2 Hospital Travelpass / Travelpass plus Application Form Please complete all the following information boxes on this form and read all the associated terms and conditions. Title: Full Name (as you would like it shown on your smartcard - max 18 letters) Date of Birth Job Title: Employee Number: (code on wage slip) Employer: Department Name: Telephone number: Full Home Address: Postcode: Please circle the option required. I wish to apply for a Hospital Travelpass (Urban Swindon)/ Hospital Travelpass Plus (Urban Swindon + outlying areas) I would like to pay on a regular basis by: payroll deductions (Great Western Hospitals NHS Foundation Trust, and Carillion staff only) / cash / cheque / debit card / credit card Pass word – required to replace lost travel passes (max 12 letters) Agreement to Terms and Conditions of the Great Western Hospitals NHS Foundation Trust’s Staff Hospital Travelpass scheme and Mandate authorising deductions from payroll in respect of use of the pass. 1. I have read and understood the complete Terms and Conditions contained in the Application Pack 2. I hereby give my consent for the appropriate sums to be deducted from my wages or salary on a pro rata basis each month or week until the price of each pass issued to me has been paid in full. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 26 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 3. I understand that I am agreeing to participate in an annual scheme and will be expected to remain a member for this period. If the Trust has reason to suspect that this is not the case. I understand that a Hospital Travelpass is valid for a fixed period once I start using it and that it cannot be adjusted or transferred. Signed: Print Name: Date: Please send via internal or external post to: Car Park Administrator (Hospital Travelpass Scheme) Commonhead Offices The Great Western Hospital Marlborough Road, Swindon SN3 6BN transportadmin@gwh.nhs.uk What happens next? Once you have completed the form return it to the scheme co-ordinator, at the above address. We will notify you by post when your application has been processed. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 27 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 14.3 Smartcard Terms & Conditions 1. 1.1 1.2 1.3 1.4 Use of a smartcard is subject to these terms. A smartcard is not a cheque guarantee card, debit or credit card. Drivers and officials of Thamesdown Transport may inspect the card at any time. A smartcard remains the property of Thamesdown Transport at all times. Thamesdown Transport reserves the right to withdraw a smartcard at any time. The registered holder should notify Thamesdown Transport in writing of any change to their name, address or telephone number. This will enable contact to be made to issue a replacement for a lost card or to return a found card (if not cancelled). Smartcards are not transferable and will be withdrawn without refund if presented for travel by anyone other than the person to whom it was issued. 2. Use 2.1 Smartcards can be used on all Thamesdown Transport buses on local bus services as advertised. 2.2 On boarding a bus, the smartcard must be placed on the bullseye on top of the ticket machine with any photograph clearly visible to the driver. In case of difficulty, the cash fare for the journey should be paid and the smartcard returned to the Thamesdown Transport Travel Shop where it can be checked and replaced if necessary. Thamesdown Transport will make appropriate compensation for valid cards which have failed. 2.3 Once the smartcard has been used it cannot be used again on the same bus for a period of 5 minutes. 2.4 Thamesdown Transport will withdraw any smartcard which they believe has been tampered with, is being misused or which has become electronically or visually unreadable. 3. Loss / Failure 3.1 Thamesdown Transport cannot prevent the unauthorized use of a lost or stolen smartcard until it has been reported by the registered holder and the card cancelled. 3.2 The loss, theft or failure of a smartcard must be notified to Thamesdown Transport as soon as possible. This can be done at the Thamesdown Transport Travel Shop or by phoning 01793 428428 (Mon-Thu 0830-1700; Fri 0830-1630). On receipt of the registered holder’s details, including name, address and password Thamesdown Transport will cancel the card as soon as possible. 3.3 Once cancelled, smartcards cannot be re-activated. If a card is reported lost and subsequently found it will not work, but we will issue a replacement card. 3.4 Once the card has been cancelled the registered holder will be issued with a replacement card. The charge for a replacement card is £5, payable on collection. The replacement card will have the same credit balance or expiry date as the lost card. 3.5 Replacement smartcards will be available for collection from the Thamesdown Transport Travel Shop in Fleming Way (open Mondays to Fridays 0900-1730, Saturdays 0900-1700), four working weekdays after notification of loss has been received. 4. Refunds 4.1 To apply for a refund of stored value the registered holder should take the smartcard to the Travel Shop in Fleming Way. Refunds will be paid by cheque and sent by post. 5. Offers Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 28 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 5.1 Thamesdown Transport may from time to time contact the registered holder with details of service information or special offers. Any registered holder who would like to be removed from this promotional list should write to Thamesdown Transport at the address below. 6. Exclusions 6.1 Thamesdown Transport shall not be liable for any reason (except any act or omission of Thamesdown Transport or any of their approved agents or employees) for cards that fail to reach the registered holder by post. Thamesdown Transport reserves the right to vary these Terms and Conditions at any time. Thamesdown Transport Ltd, Barnfield Road, Swindon SN2 2DJ Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 29 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 15. APPENDIX 7: Loan to Purchase a Public Transport Season Ticket (available from 31 Jan 2011) st 15.1 Loan to Purchase a Public Transport Season Ticket Terms and Conditions Applying for a Loan Loans are available to assist eligible employees of the Trust with the purchase of train season tickets, which are suitable for, and purchased primarily for, the employee’s home to work travel. The season ticket purchased with the loan must be for a period of one year. The maximum loan available to an employee for the purchase of season tickets is £4,500 subject to individual approval. An employee may only receive one loan per year. Before granting a loan the Trust may, at its discretion, require applicants to provide: - Evidence as to the affordability of the loan repayments the applicant would be required to make if the loan was granted. Evidence of working in the Trust. Loans will not be agreed until applicants have commenced work for the Trust. Provision of inaccurate information or failure to disclose to the Trust information which, if known, may have influenced the decision as to whether to grant a loan will disqualify the employee’s application. It will also result in cancellation of any loans already granted to the employee with full repayment of all outstanding balances being required immediately. It may also result in the Trust considering whether more formal action is appropriate. The Trust reserves the right to refuse any application for a loan. Interest Loans are interest free. Repayments Repayment is by deduction of instalments from the employee’s salary or wages. The instalments are 10 equal monthly instalments. Deductions commence on the first available pay date following the date that the season ticket comes into operation. The loan repayment period is determined when the loan is approved and will remain unchanged even if the travel company subsequently agrees to amend the season ticket period. If an employee leaves the employment of the Trust before the whole loan has been repaid, the balance of the loan becomes immediately payable and will be deducted from the employee’s final monthly pay. If the outstanding balance on the loan exceeds the employee’s final pay cheque, the employee is required to pay the full outstanding balance before their last date of employment. The employee may be eligible for a part refund if they no longer wish to make use of the ticket. The employee should contact the travel provider directly to progress this. If at any time the borrower fails to comply with these conditions the Trust is entitled to terminate the loan agreement and deduct any outstanding amounts from any sums due to the borrower, including amounts due in respect of salary, and to demand immediate repayment of any sums not so discharged. Season Tickets Season tickets purchased by the Trust for employees are subject to the issuing company’s terms and conditions. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 30 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital Care of the season ticket is the employee’s responsibility. The Trust accepts no responsibility for any losses arising from theft, loss or damage to the ticket. If the ticket is lost or stolen this should be reported to the police and a crime reference number obtained. Replacement tickets should be organised via the relevant transport operator. If for any reason an employee no longer wishes to use their season ticket, the employee should contact the relevant travel operator to organise a refund under the operator’s terms and conditions. Please note that payments via salary will continue until the loan is repaid. Season tickets will not be renewed automatically. The onus is on the employee to apply to the Trust in a timely manner if renewal is required. The application for the loan to purchase the new season ticket should be submitted at least 4 weeks prior to the old ticket’s expiry date. How the Scheme Operates A member of staff can apply for an annual train season ticket loan. Assuming this is approved the Trust will reimburse the member of staff the cost of their annual season ticket (minus one months payment) on receipt of a receipt. The member of staff then repays the cost of the ticket by monthly instalments directly from their salary. How to apply for a public transport season ticket loan: 1. Complete the application form. Please note: - Applicants must be a salaried employee of The Great Western Hospitals NHS Foundation Trust, paid monthly through its payroll system and have a payroll number. - Season tickets must be for one year. - The maximum value of the loan available is £4,500. Please note that this is subject to individual approval. Whether you are renewing your season ticket or making an application for the first time, you will need to complete the Trust’s loan application form. Please note: You MUST purchase a 12 months season ticket, otherwise the agreement will be annulled. 2. The applicant should take the completed application form to the Transport Administrator. 3. The Transport Administrator will check the application to ensure the applicant is eligible to apply and that their application meets all of the loan criteria. If the loan application is successful and is approved by the Transport Administrator the applicant will be informed. 4. The applicant must then purchase a season ticket with the relevant travel company and retain the receipt. 5. The receipt must be taken to the Transport Administrator (within two weeks of purchase) who will organise a reimbursement. 6. The Transport Administrator will inform the Payroll Office who will then arrange for deductions to be made commencing the first month that the season ticket comes into operation. How to repay the loan Repayment of the loan will be by direct deductions from the applicant’s net salary and will commence from the first available pay date after the season ticket comes into operation. Repayment will be made in 10 equal monthly instalments. If the applicant ceases to be employed by the Trust before the loan is fully repaid, the outstanding balance on the loan must be cleared before the last day of employment by the Trust. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 31 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 15.2 Loan to Purchase a Public Transport Season Ticket Application Form Date Received – Stamp Here: Office Use OnlyApplicant Number: Handled by (Initial): Status: Notes: Before completing this form please read the terms and conditions of the Loan Scheme and determine the cost of your particular season ticket. Please complete this form in Block Capitals and take it to the Transport Administrator at least 4 weeks before the start date of your season ticket. The personal information which you have provided by completing this form, and any other information provided in connection with your application, will be used to process your application and to set up and administer the loan process, which will include arrangements for calculating and making payments. We will keep the information you have supplied confidential and will not disclose it to any third party, unless we are required to do so by law, or you have given your consent. Personal Information Title: (Mr / Mrs / Ms / Dr / Revd/Other) (please delete as appropriate) Forename(s): Surname: Work contact details: Department:…………………………………………………………………………………………………………………….. Telephone number:……………………………………………………………………………………………………………… Email address:…………………………………………………………………………………………………………………… Employee Number (8 digit number – check your payslip) Total cost of season ticket Loan Applied for What is your current grade (job banding) £ £ Applicant Signature I confirm that the information which I have given in this form is correct and authorise the Great Western Hospital NHS Foundation Trust to make appropriate deductions from my salary each month to repay the loan. None of the terms of this agreement constitute a hire purchase agreement. Signed: Date: Print Name: Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 32 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 16. APPENDIX 8: Priority Users Application Form Office Use OnlyApplicant Number: Handled by (Initial): Status: Notes: Date Received – Stamp Here: Terms and Conditions of use and Application Form to obtain a Great Western Hospital Priority Smartcard Terms and Conditions 1. Great Western Hospital Priority Smartcard shall remain the property of Great Western Hospitals NHS Foundation Trust at all times. 2. Smartcards may not be transferred between individuals. 3. Smartcards may be used at the hospital to park in recognised Priority and Standard Staff parking areas at the Great Western Hospital. 4. Holders of a Priority Smartcard must notify the Transport Administrator of any changes in their circumstances that may affect their eligibility immediately. 5. Damaged Smartcards should be returned to the Transport Administrator, who will replace the card with the remaining credit- there may be a discretionary £5 for the new card. 6. Lost Smartcards can be replaced by the Transport Administrator for a £5 charge. Instructions to Applicants 1. Please apply only if you believe that you are eligible under the Trust’s Policy and criteria as detailed in the Parking Policy. 2. The information that you provide is essential for making a decision on any application. It will only be used for these purposes. 3. Where indicated please either tick the appropriate box or enter the required information clearly in BLOCK CAPITALS and in either blue or black ink (illegible submissions will be returned). Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 33 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital Personal Information Title: (Mr / Mrs / Ms / Dr / Revd/Other) (please delete as appropriate) Forename(s): Surname: Home address: Postcode: (It is essential that you provide your full and correct postcode) Employer or Sponsor (please tick) Great Western Hospitals NHS Foundation Trust NHS Wiltshire NHS Swindon GP Practice (Please name) Avon and Wiltshire Mental Health Trust Other NHS Trust (indicate in ‘Other’) Staff Group Medical & Dental Nursing and Midwifery Technician Scientist Other (please name): ……………………………………………… Other (please name): ………………………………………………………… Job Title Department / Section (This will be used for correspondence and issue of your Smartcard – please be specific) Applicant Signature I have read the Car Parking Policy and Procedure including eligibility criteria and conditions of use for Smartcard and have understood them. If I am issued with a Smartcard I agree to adhere to the conditions of use and I know that abuse of these conditions may lead to withdrawal of the permit and disciplinary action may be taken against me. Signed: Date: Management Statement (This must be completed and signed by the applicant’s Associate Medical Director or Medical Director equivalent before the application can be processed.) Form submitted that are incomplete will be returned I confirm that all the above information is correct and I agree that this person meets the criteria for a priority permit.: Signed: ……………………………………… Date: Name (in capitals): Position: Tel Ext. No: Location: Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 34 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 17. APPENDIX 9: Standard User Application Form Date Received – Stamp Here: Office Use OnlyApplicant Number: Handled by (Initial): Status: Notes: Terms and Conditions of use and Application Form to obtain a Great Western Hospital Standard Barrier Pass Terms and Conditions 1. Great Western Hospital Standard Barrier Pass remains the property of Great Western Hospitals NHS Foundation Trust at all times. 2. Barrier Passes may not be transferred between individuals. 3. Passes may be used on the site to park in recognised Standard Staff parking areas at the Great Western Hospital. 4. Holders of a Standard barrier pass must notify the Transport Administrator of any changes in their circumstances that may affect their eligibility immediately. 5. Damaged barrier passes should be returned to the Transport Administrator, who will replace the pass with the remaining credit- there may be a discretionary £5 for the new pass. 6. Lost passes can be replaced by the Transport Administrator for a £5 charge. Instructions to Applicants Apply only if you believe that you are eligible under the Trust’s Policy and criteria as detailed in the Parking Policy. The information that you provide is essential for making a decision on any application. It will only be used for these purposes. Where indicated please either tick the appropriate box or enter the required information clearly in BLOCK CAPITALS and in either blue or black ink (illegible submissions will be returned). Personal Information Title: (Mr / Mrs / Ms / Dr / Revd/Other) (please delete as appropriate) Forename(s): Surname: Home address: Postcode: (It is essential that you provide your full and correct postcode) Employer or Sponsor (please tick) Great Western Hospitals NHS Foundation Trust Carillion Services Limited Swindon Borough Council NHS Swindon NHS Wiltshire GP Practice (Please name) Avon and Wiltshire Mental Health Trust Other NHS Trust (indicate in ‘Other’) Oxford Brookes University University of West of England Other (please name): Staff Group Ancillary/Maintenance Admin/Clerical/Senior Manager Medical & Dental Nursing and Midwifery PAMs Technician Scientist Medical student Nursing Student Volunteer Other (please name): ……………………………………………. ………………………………………………….. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 35 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital Job Title Department / Section (This will be used for correspondence and issue of your pass – please be specific) Number of days on site each week – please use an average if this alters Appeals Do you wish your application to be presented to the Transport Appeals Board? If yes we may contact you for more information Yes / No Permit Criteria Qualification Please state criteria through which you qualify for a permit. For example, if you live outside the 30 Minute Zone please tick in box A. If you live within the zone but do shift work then tick box B etc. Also see supporting notes. Tick Criteria A Please describe supporting information or documents that you have attached with your application eg off duties, on call rota etc Postcode: The information below only needs to be supplied if you live inside the 30 minute zone Criteria B Working Hours or Shifts: PLEASE PROVIDE COPY OF LATEST OFF DUTY Criteria C Medical Condition or Disability: PLEASE PROVIDE COVERING LETTER FROM OCCUPATIONAL HEALTH Criteria D Care Commitments: PLEASE PROVIDE SCHOOL/CHILD CARE ADDRESSES AND AGES OF CHILDREN: Applicant Signature I have read the Car Parking Policy and Procedure including eligibility criteria and conditions of use for barrier pass and have understood them. If I am issued with a barrier pass I agree to adhere to the conditions of use and I know that abuse of these conditions may lead to withdrawal of the permit and disciplinary action may be taken against me. Signed: Date: Management Statement (This must be completed and signed by the applicant’s deputy general manager or equivalent before the application can be processed.) Form submitted that are incomplete will be returned to the Line Manager I confirm that all the above information, including appended information or documentation, all of which I have initialled, is correct: Signed: ……………………………………… Date: Tel Ext. No: Name (in capitals): Position: Location: Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 36 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 18. APPENDIX 10: Transitional Relief Application Form Office Use OnlyApplicant Number: Handled by (Initial): Status: Date Received – Stamp Here: Notes Terms and Conditions and Application Form for Transitional Relief To apply you must fulfil all the following criteria: - have started employment at the hospital site before the 1st Nov 2010 earn less than £10,000 per annum have the site of the Great Western Hospital as their main base can prove that car sharing or other low cost options are not a practical option for them to commute to work. Instructions to Applicants Please apply only if you believe that you are eligible under the Trust’s Policy and criteria as detailed in the Parking Policy. The information that you provide is essential for making a decision on any application. It will be kept confidential and only be used for these purposes. All evidence submitted will be returned. Where indicated please either tick the appropriate box or enter the required information clearly in BLOCK CAPITALS and in either blue or black ink (illegible submissions will be returned). Personal Information Title: (Mr / Mrs / Ms / Dr / Revd/Other) (please delete as appropriate) Forename(s): Surname: Full home address: Postcode: (It is essential that you provide your full and correct postcode) Job Title Department / Section (This will be used for correspondence– please be specific) Tel Extension (if available) Bleep (if available) Internal E-mail (if available) Please indicate which documents you have provided as evidence Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 37 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital Payslip Employment contract Job description Others – please list below Please use this page to explain why car sharing or other low cost options of commuting are not suitable for your use. As much detail should be provided as possible. Applicant Signature I agree that all the information provided is correct, and will inform the Transport Administrator immediately of any changes in circumstances that may influence this decision. Signed: Date: Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 38 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 19. APPENDIX 11: Pool Cars: Terms and Conditions The pool cars are insured for business use only. Private use is forbidden and the vehicles must not be used for commuting from/to home or work or for carrying patients. It is the users responsibility to collect the keys at the time the vehicle is booked. If the car is not collected within one hour of it booked time the car may be allocated to another user. Cars must be left in the dedicated pool car spaces in the north car park over night. You must return the car with at least quarter of a tank of petrol. All petrol should be purchased for the vehicle using the fuel card. Instructions for use are in the vehicle. You must observe the correct fuel type for your vehicle. You must leave the fuel card in the vehicle. Drivers must be over 21 years of age. It is the staff member’s responsibility to inform their Line Manager of any driving bans, endorsements or fines on their driving license. Bookings can be taken up to 4 weeks in advance, however departments will be charged if vehicles are booked and not used. Failure to pick up a vehicle within an hour of the booking time may mean the vehicle is issued to another user. Payment of fines is the responsibility of the user at the time the fine was received. Fines will not be paid by the Trust under any circumstance. Users must keep the vehicle in a clean and tidy condition. Additional cleaning costs will be passed onto departments. Users must inform the Transport Administrator about any damage to the vehicle immediately. Users who fail to report damage may be barred from further use of the vehicles. Users must report to the Transport Administrator any vehicle incident as a matter of urgency. If there is a breakdown of the vehicle you must stay with the vehicle until the recovery services arrive If there is an incident resulting in damage to the vehicle, all unrecoverable damage repair costs will be charged to your department. The Trust will be responsible for ensuring all cars are serviced in accordance with the lease agreement and manufacturers instructions. However it is the responsibility of each individual to check each vehicle before leaving the hospital. Procedure These vehicles will be available on a first come first served basis. Bookings are made by emailing your request to poolcars@gwh.nhs.uk. Your email will be receipted within 48 hours, and you will be informed if your booking has been successful. You should inform by email of any cancellation of booking as soon as possible. Keys for each vehicle are kept by the Carillion FM Helpdesk. Before they are released the user must produce ID. The keys must be signed in and signed out. By signing out the keys you are agreeing to abide by the terms and conditions laid out in this document. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 39 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital When the keys are signed out, a free exit barrier pass will be issued at the same time by the FM Helpdesk. It is essential that the vehicles are returned to the dedicated parking area in the North car park, and the keys must be returned immediately and on time to the FM helpdesk. The vehicle must be left locked, with the windows closed. If there is a breakdown you must follow the instructions in the vehicle to contact assistance and remain with the vehicle at all times. If you are involved in any incident resulting in damage to the vehicle you must Report this to the Transport Administrator as soon as possible, giving full details of the damage so the lease company can be informed Assist in the completion of an Insurnace claim form if required Fill in an IR1 (Great Western Hospitals NHS Foundation Trust staff) If the vehicle is unsafe to drive you need to follow the instructions in the vehicle to contact assistance and remain with the vehicle at all times. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 40 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 20. APPENDIX 12: Free Barrier Pass Application Form Office Use Only- Date Received – Stamp Here: Applicant Number: Handled by (Initial): Status: Notes: Application form for use of free visitor barrier passes - Please only submit this form is you belong to one of the following groups - Clergy (free of charge) Volunteers (free of charge) Public Governors (free of charge) Once this form has been processed you will be sent enough barrier passes to last for approximately six months. It is your responsibility to contact the Transport Administrator when you require more passes. Passes will only be sent to internal departments unless a prepaid self addresses envelope is provided. The passes will allow the user to exit from the North visitors car park free of charge. Personal Information Title: (Mr / Mrs / Ms / Dr / Revd/Other) (please delete as appropriate) Forename(s): Surname: Internal post details: (these will be used for distributing passes so please be specific) Department:………………………………………………………………………………………………………………. Exact location: …………………………………………………………………………………………………………… Approximate number of visits to site per month:………………………………………………………………………………. Applicant Signature I confirm that the information which I have given in this form is correct and I understand the use of these barrier passes. I undertake to return any unused passes if I am no longer eligible to use them. Signed: Date: Print Name: Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 41 of 42 Document Title: Travel Choices for Staff and Visitors to the Great Western Hospital 21. APPENDIX 13: FAQs I have left work earlier than planned, is this now counted as a restricted day shift? If you have arrived and left the staff car parks in between the hours of 06:30 and 19:00 this will be considered a restricted day shift, even if you have left earlier than anticipated. You will need to make sure that you allow for this in your entitlement over the current fixed two week period. What if I have already used my entitlement and I have left early? If you have left earlier than planned and have already used your restricted days allowance, you will be charged £35 to leave the staff car parks. If you have a genuine reason for this you must submit your case, supported by your Line Manager, to the Transport Administrator who may reimburse at their discretion. Their decision is final. What happens if my pre-arrange car share falls through? If you have exceeded the number of days that you are able to park on site you will need to try and find an alternative. The Trust may be able to provide a taxi to assist in certain circumstances. What happens if my car sharer is called off site in an emergency and I need to get home? In this instance at your Line Managers or the Transport Administrator’s discretion the Trust will pay for a taxi to get you home, if there are no other options available. See terms and conditions for use of emergency taxi home. Can two car sharers use the same vehicle each day? Yes, as long as both individuals are registered car users and each barrier pass is not used more than the individuals restricted days allocation allows. What about my car insurance if I am car sharing? As long as you are not making any money from car sharing above covering your costs your insurance should not affected. However we strongly recommend that you let your insurer know that you’ve joined the scheme. Note: This document is electronically controlled. The master copy of the latest approved version is maintained by the owner department. If this document is downloaded from a website or printed, it becomes uncontrolled. Version 1.0 Printed on 08/02/2016 at 10:56 PM Page 42 of 42