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External Staff Leavers Form (RA02b)
RA02b Leavers
Sponsor details
Name (if known)
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Leaver details
Leaver's name
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Leaver's NHS email address
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Leaver's job title
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Leaver's date of birth
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Smartcard number
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Leaver's last working date
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Domain
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ad.ekhuft.nhs.uk
kpc.ekitn.nhs.uk
sph.spencerprivatehospital.com
op.kentandmedwayservices.nhs.uk
Any additional comments, including systems access to be removed
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Leaver's employer details
Leaver's employer
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Alliance Medical
Benenden Hospital
Circle Health Group
Clinical Trials - EKHUFT
Community Ophthalmic Services- OpenEyes
Dartford and Gravesham NHS Trust (DGT)
DMC Healthcare
EDM Healthcare Consulting
GP Project (Temporary pilot testing only)
Great Ormond Street NHS Trust Consultants
Guy’s and St Thomas’ NHS Foundation Trust (GSTFT)- Renal Surgeons
Health Navigator
Healthshare- MRI
HIDVA - Kent & Medway Information Sharing Partnership
Himatix Health Validators
ID Medical (Endoscopy)
InHealth
Invicta Health - Trust Agency Support
KMCC- (MTW Staff) [Infoflex only]
Kent and Medway NHS and Social Care Partnership Trust (KMPT)
Kent Community Health NHS Foundation Trust (KCHFT)
King's College Hospital - Radiology
Maidstone & Tunbridge Wells NHS Trust (MTW)
MBI Technologies
Medway NHS Foundation Trust (MFT)
North East London Foundation Trust (NELFT) - Eating Disorder
North of England Commissioning Support Unit - NECS Validation
Omnes Healthcare Ltd
One Healthcare
Paula Carr Diabetes Trust
Pilgrims Hospice
Porchlight Ltd
Remote Supplier - IT access only
Southeast Ultrasound Ltd
Spencer Private Hospitals (SPH)
Thanet Health Community Interest Company (THCIC)
If Other, please specify
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Leaver's department
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AAA Screening Programme
Acute Medicine Management
Adult CAT Service
Adult Safeguarding
BHD HCOOP
BHD MIU
BHD Renal Satellite Unit
Best Practice Diabetes Services
Bio Sciences - KC
Booking Office - Womens Health
Breast Screening - K&C
Breast Screening Admin
CH - Child Health Appointments Reservation Team
CH - Child Protection Team
CH - Childrens Centre Seabrook
CH - DSA
CH - Greenbanks Admin
CH - KCH Admin
CH - Matrons
CH - Office Managers - Senior Med Sec
CH - Psychologists
CH - QE Admin
CH - WH Admin
CH Greenbanks Medical
CH WH Paediatrics Medical
CQC Improvement Team
CQUIN
Cancer Services - Palliative Care
Cancer Services Management
Canterbury 1 Community Midwives
Canterbury 2 Community Midwives
Canterbury Maternity Day Care
Car Parking In-House Management
Chaplaincy Services
Childrens Assessment Centre
Clinical Audit
Clinical Biochemistry - E Lamb
Clinical Biochemistry - QEQM
Clinical Biochemistry - WHH
Clinical Coding Department
Clinical Governance
Clinical Haemophilia
Clinical Informations Systems
Clinical Photography & Illustration
Clinical Quality & Patient Safety Mangt
Coastal 1 Community Midwives
Coastal 2 Community Midwives
Cold Team
CommCH - Rainbow Centre Admin
CommCH-Rainbow Center Medical
Communications
Cultural Change Programme
Cytology
Deal and Dover Community Midwives
Dental Nursing
Dermatology - Phototherapy
Design & Construction Services
Development Team
Diversity and Inclusion Team
Divisional Managment A&E
Dover - Comm Child Hlth Medical
Dover Comm Child Health Dover Admin - CCD
E Kent Ophthalmology Medical Staff
ECC/MIU admin
EKLS Distribution
EKLS Engineering & Estate
EKLS Production
EKLS Transport
EME - K&C
East Kent Audiology Service
East Kent Childrens Hearing Service
East Kent ENT Medical Staff
East Kent Maxillo-Facial Medical Staff
East Kent Microbiology Consultants
East Kent Microbiology Service
East Kent Orthoptic Service
Education Centre - K&C
Education Centre - QEQM
Education Centre - WHH
Emergency Planning
Employee Relations
Finance Senior Management
Financial Management
Financial Planning
Financial Services - Accounting
Fit for the Future
Folkestone Central community midwives
Folkestone Shepway Community Midwives
Foundation Trust Membership Administration
General Practice GPVTS Doctors
Governance, Patient Safety and Quality Team
H&N Nursing Specialists
H&N Nursing Specialists - ENT
HCOOP Management
HR Business Partners
HR Directorate Management
HR Systems Team
Haematology - K&C
Haematology - QEQM
Haematology - WHH
Haematology Blood Products - WHH
Haematology Blood Transfusion - K&C
Haematology Blood Transfusion - QEQM
Haemophilia - K&C
Head & Neck Admin Staff
Head & Neck Directorate Management
Health Foundation Project
Heart Failure Multidisciplinary Team
Histology
Histology Admin
Histology Medical Staff
Hospital Management - K&C
Hospital Management - WHH
Hospital at Home
Hotel Services
IT Datacentre Services
IT Development
IT Directorate
IT End User Computing
IT Field Team - KC
IT Field Team - QE
IT Field Team - WH
IT Infrastructure
IT Project Mgt 1
IT Project Mgt 2
IT Service Delivery
IT Service Desk Team
IT Service Support
IT Training
IT Unified Communications
Infection Control
Information Team
Information Technology
Integrated Access Management
Integrated Discharge Team
KC A&E Medical Staffing
KC Acute Medicine Medical Staffing
KC Admin Anaes
KC Admin T&O
KC Ambulatory Care
KC Anaesthetics
KC Bowel Cancer Screening
KC Brabourne Haematology Ward
KC Cancer Compliance
KC Cancer Services
KC Cancer Services Admin
KC Cardiology
KC Cardiology Dept
KC Cathedral Unit
KC Chronic Pain Mangt
KC Clarke Ward
KC Clinical Coders
KC Clinical Haematology
KC Colposcopy Suite
KC Critical Care
KC Day Surgery
KC Day Surgery Theatres
KC Dermatology
KC Dermatology - drs, admin
KC Diabetes
KC Dolphin Ward
KC ECC
KC Endoscopy Administration
KC Endoscopy Dept
KC Estate Management
KC Fracture Clinic
KC Gastroenterology
KC HCOOP
KC Harbledown Ward
KC Harvey Neurorehab
KC Honeybears Nursery
KC Invicta Ward
KC Kent Ward
KC Kingston
KC League of Friends
KC MIU
KC MRI
KC Marlowe Ward
KC Maxillo Facial Laboratory
KC Mount McMaster
KC Neurology
KC Neurophysiology
KC Neurorehab Admin
KC Neurorehab Clinical Staff
KC Neurorehab Core Rehab
KC Neurorehab OT
KC Neurorehab Physio
KC Neurorehab Therapies
KC Operational Management
KC Outreach Critical Care
KC Paediatrics
KC Patient Flow Team
KC Pre-Assessment
KC R&D - Renal
KC Renal Advanced Kidney Care Team
KC Renal Haemodialysis
KC Renal Medical Technology
KC Renal Senior Clinical Staff
KC Respiratory Med
KC Rheumatology
KC Risk Management
KC Site Coordinators
KC Specialist Senior Cover
KC St Lawrence Ward
KC Surgical Wards Senior Cover
KC Taylor CCU
KC Theatres
KC Treble Ward
KC UC & LTC Divisional Senior Nursing
KC Urology Medical Staff
KC Urology Suite
KC Vascular Medical Staff
KC Vascular Specialist Nursing
KC Waiting List Office
Kent & Medway Cancer Collaborative Team
Legal Services
Liaison
Logistics
MLU WHH
Medical Directors Team
Medical Equipment Library
Medical Physics - K&C
Medical Records - BHD
Medical Records - K&C
Medical Records - QEQM
Medical Records - RVH
Medical Records - SUBS
Medical Records - WHH
Medical Workforce
Medicine NMET Nursing
Midwifery Management
Midwifery Supervisors
Modernisation Team
Mortuary
Mstone Renal Satellite Unit
Mway Renal Satellite Unit
Newborn Hearing Screen Service
Nuclear Medicine - K&C
Nuclear Medicine - Medical Staff
O T Services - Medical QEQM
Occupational Health
Occupational Therapy Services - BHD
Occupational Therapy Services - K&C
Occupational Therapy Services - Medical WHH & RVH
Ophthalmic Suite - K&C
Orthotics Service
Out Patient Therapy Services - K&C
Out Patient Therapy Services - QEQM
Out Patient Therapy Services - WHH
Outpatient Management Report
Outpatient Services Clerical - BHD
Outpatient Services Clerical - K&C
Outpatient Services Clerical - QEQM
Outpatient Services Clerical - WHH
Outpatient Services Nursing - BHD
Outpatient Services Nursing - Estuary View
Outpatient Services Nursing - K&C
Outpatient Services Nursing - QEQM
Outpatient Services Nursing - RVH
Outpatient Services Nursing - WHH
PGME Libraries
PGME Medical Education Management
PGME Simulation Training
Pain Services Admin Staff
Palliative Care Nursing
Pathology Directorate Management
Pathology Lab Support - K&C
Pathology Lab Support - QEQM
Pathology Lab Support - WHH
Pathology Support Services - BHD
Pathology Support Services - K&C
Pathology Support Services - QEQM
Pathology Support Services - WHH
Pathology Support Services RVH
Patient Access Governance
Patient Experience
Patient Service Centre K&C
Payroll Service
Pharmacy - Aseptic Suite
Pharmacy - Clinical Trials
Pharmacy - Directorate Management
Pharmacy - Education and Training
Pharmacy - Medicines Optimisation
Pharmacy - Oncology
Pharmacy - Operations
Pharmacy - Procurement and Distribution
Pharmacy - Rotational Pharmacists
Pharmacy - Specialist Pharmacists
Pharmacy - Technicians
Physio Services - Medical QEQM
Physiotherapy Services - BHD
Physiotherapy Services - Medical WHH & RVH
Picture Archiving and Communication System
Psychiatry GPVTS Doctors
QE A&E
QE A&E - ENP
QE A&E - Paeds
QE A&E Medical Staffing
QE A&E Reception
QE Acute Medicine Medical Staffing
QE Admin Gen Surg
QE Admin T&O
QE Ambulatory Care
QE Anaesthetics
QE Bed Management
QE Birchington Ward
QE CDU
QE Cancer Compliance
QE Cancer Services
QE Cardiac Catheter Suite
QE Cardiology
QE Cardiology Dept
QE Central Admissions Lounge
QE Cheerful Sparrow Female
QE Cheerful Sparrow Male
QE Chronic Pain Mangt
QE Clinical Coders
QE Colposcopy
QE Coronary Care Unit
QE Critical Care
QE DSU Theatres
QE DSU Ward
QE Deal Ward
QE Dermatology
QE Diabetes
QE Discharge Lounge
QE Endoscopy Administration
QE Endoscopy Central Booking
QE Endoscopy Dept
QE Estate Management
QE Estates Apprenticeships
QE Fordwich
QE Fracture Clinic
QE Gastroenterology
QE General Surgery
QE HCOOP
QE MLU
QE MRI
QE Maternity Admin Support
QE Maternity Annualised Hrs
QE Maternity Ante Natal Unit
QE Maternity MSW and MCA
QE Maternity Wards
QE Minster
QE Neurology
QE Obs & Gynae
QE Outreach Critical Care
QE Paediatrics
QE Quex Ward
QE Rainbow Ward
QE Renal Satellite Unit
QE Respiratory Med
QE Rheumatology
QE Risk Management
QE SCBU
QE Sandwich Bay Ward
QE Site Coordinators
QE St Augustine Contingency Ward
QE St Margarets Ward
QE Surgical Care Practitioners
QE Surgical Wards Senior Cover
QE Theatres
QE Trauma & Ortho
QE Trauma Floor
QE UC & LTC Divisional Senior Nursing
QE UCLTC Wards Senior Cover
QE Viking Day Unit
QE Waiting List Office
Quality Improvement
R&D - C.L.R.N. Satellite Office - QEQM
R&D - Clinical Trials - Neonatal Unit
R&D - Clinical Trials Haem/Oncology
R&D - Clinical Trials Unit - K&C
R&D - ODEP Surveillance Study
R&D - Opthalmology Research Team
R&D Clinical Trials - Gynae/Oncology
R&D Clinical Trials - Lead Research Nurse
R&D Oncology Clinical Trials - Dr Mithal
R&D Stroke
RVH Urology Suite
Radiology - K&C
Radiology - QEQM
Radiology - WHH
Radiology Admin - KCH
Radiology Admin - QEQM
Radiology Admin - WHH
Radiology Assistants - KCH
Radiology Assistants - QEQM
Radiology Assistants - WHH
Radiology Directorate Management
Radiology Medical Staff - KCH
Radiology Medical Staff - QEQM
Radiology Medical Staff - WHH
Radiology Nurses - K&C
Rehabilitation Engineering - K&C
Renal Admin
Renal Dietitians
Renal Home Therapies
Renal Outpatients
Renal Transplant
Research & Dev Office - K&C
Resourcing Team
Resuscitation - Training
Risk & Assurance
SD&CP Level 2 Management A
SD&CP Level 2 Management B
SD&CP Level 3 Management A
SIFT - K&C
Seabrook Medical - CCH
Service Improvement Team
Shepway Physiotherapy - CCH
Specialist Services Divisional Governance
Specialist Services Divisional Management
Specialty Medicine Management
Speech Therapy Adult - Ashford
Speech Therapy Adult - Canterbury
Speech Therapy Adult - Thanet
Speech therapies Buckland Hospital - CCH
Speech therapies Folkestone - CCH
Speech therapies Rainbow centre - CCH
Stoma Care
Strategic Development Project & Change
Strategic Intelligence Unit
Supplies Change Management
Supplies Contract
Supplies Corporate Category
Supplies Data Team
Supplies General Management
Supplies Materials Mangt
Supplies Procurement
Surgical Services Divisional Admin QEQM
Surgical Services Divisional Management
Sway OccTherapy Comm Child Health
Thanet North Community Midwives
Thanet South Community Midwives
Therapies Admin and Clerical Support - K&C
Therapies Admin and Clerical Support - QEQM
Therapies Admin and Clerical Support - WHH
Therapies Admin and Clerical Support ESP - RVHF
Therapies Directorate Management
Therapies Management - CCH
Therapy Services - Medical K&C
Therapy Services - Rheumatology
Thrombosis
Trust Management
UCLTC - Alcohol & Subs Misuse Team
UCLTC Divisional Discharge Team
UCLTC Divisional Governance & Pat Exp
UCLTC Divisional Management
UCLTC Divisional Tissue Viability
Ultrasound - K&C
Ultrasound - QEQM
Ultrasound - WHH
VIRU Admin
Vascular Access
WH - WHACU
WH A&E
WH A&E - ENP
WH A&E - Majors Clerks
WH A&E - Paeds
WH A&E Medical Staffing
WH A&E Reception
WH Acute Medicine Medical Staffing
WH Admin Anaes
WH Admin Gen Surg
WH Admin T&O
WH Anaesthetics
WH Bed Management
WH CDU/Bethersden
WH Cambridge J2 Ward
WH Cambridge K Ward
WH Cambridge L Rehab Ward
WH Cambridge M2 Ward
WH Cancer Compliance
WH Cancer Services
WH Cardiac Catheter Suite
WH Cardiac Rehab
WH Cardiology Dept
WH Celia Blakey
WH Central Admissions Lounge
WH Chronic Pain Mangt
WH Coronary Care Unit
WH Critical Care
WH Day Surgery - Theatres / Anaesthetic
WH Day Surgery - Ward / Recovery
WH Dermatology
WH Diabetes
WH Discharge Lounge
WH Emergency Assessment Unit
WH Endoscopy Administration
WH Endoscopy Dept
WH Estate Management
WH Estates Apprenticeships
WH Fracture Clinic
WH Gastroenterology
WH General Surgery
WH HCOOP
WH Kennington Ward
WH Kings A2
WH Kings B
WH Kings C
WH Kings C2
WH Kings D
WH MRI
WH Maternity Annualised Hrs & Mgt & Misc
WH Maternity Day Care
WH Maternity Labour and Folkestone
WH Maternity MCAs and MSW
WH Maternity Ward Clerks
WH NICU
WH NICU - Practice Development and Outreach
WH Neurology
WH Obs & Gynae
WH Operational Management
WH Outreach Critical Care
WH Oxford Ward
WH Padua Ward
WH Renal Satellite Unit
WH Respiratory Med
WH Rheumatology
WH Richard Stevens Stroke Unit
WH Risk Management
WH Rotary Suite
WH SEAU
WH Site Coordinators
WH Surgical Care Practitioners
WH Surgical Wards Senior Cover
WH Theatres
WH Theatres - Anaesthetic
WH Theatres - Recovery
WH Trauma & Ortho
WH UC & LTC Divisional Senior Nursing
WH UCLTC Wards Senior Cover
WH Waiting List Office
WH Winter Pressures Ward
WHH Cardiology
WHH Red Community Midwives
WHH Sapphire Community Midwives
Womens Health Directorate Mngt
Workforce Development Education & Training
If Other, please specify
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Leaver's base site
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11 Ethelbert Road
Adult Diabetes Service - Community
Ashford Intergrated Care Team
Ashford PET-CT Centre - Alliance Medical
Attina House
Benenden Hospital
Birchington Medical Centre - Thanet
Buckland
Canterbury Medical Practice - Canterbury
Chaucer Hospital- Canterbury
Community Childrens Nursing Team
Community District Nursing
Community Ophthalmic Services- OpenEyes
Darent Valley Hospital
EKHUFT - Allscripts support ONLY
EKHUFT - Fourways support ONLY
EKHUFT - Soliton support ONLY
EKHUFT - WASP support ONLY
EKHUFT - Wellbeing (Maternity) support ONLY
Eden Neighbourhood Care Team
Elmstone Unit - Margate (CMHSOP)
Eureka Place Medical Centre
External validator -remote site
Faversham Cottage Hospital
Foster Street Clinic - Maidstone
Gregory House
Guys and St Thomas Hospital London
Health Intelligence
Kent and Canterbury
Kent and Medway Cancer Collaborative (KMCC)
Kings College Hospital London
Laurel House - Canterbury
Maidstone Hospital
Medway Maritime Hospital
Musgrove Park Medical Centre - Ashford
One Ashford Hospital
Pilgrims - Ashford
Pilgrims - Canterbury
Pilgrims - Thanet
Queen Elizabeth the Queen Mother
Queen Victoria Memorial Hospital - Herne Bay
Rainbow Centre (MASH)
Remote Supplier - IT access only
Rivendell Rehabilitatin Unit - Eastry
Royal Victoria
Sevenoaks Hospital
St Martins
The Beacon - Ramsgate
The Community
The Courtyard, Pudding Lane - Ashford
The Grange Practice
The Grove Rehabilitation Unit - Ramsgate
The Heathside Centre - Maidstone
Trinity House
Tunbridge Wells Hospital
Victoria Hospital - Deal
Westbrook House
Westview Hospital
Whistable and Tankerton Hopsital
Whitfield Court Dover
William Harvey
If Other, please sepcify
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Leaver's manager
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Leaver's manager email
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AD login name
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