11.Compliance and Regulation Are you currently or have you in the past 5 Yes No years been the subject of a GDC If you have answered yes, please provide brief details, including the date(s) of the investigation and the findings investigation? Yes No Have you been under any investigation by If you have answered yes, please provide brief details, including NHS England in relation to your GDS the date(s) of the investigation and the findings contract during the last 5 years? What was the outcome of your most recent Totally compliant Partially compliant CQC visit If partially compliant, please outline areas designated for improvement? What was the date of your most recent NHS practice inspection (if you are in KSS) or LDET practice inspection (if you are in London)? 12.References Please provide the names, job title, 1. address, e-mail and contact telephone number of two dental professional referees 2. Please note that current LDET or HEKSS employees including Patch Associate Deans (in London) and Training Programme Directors (in HEKSS) cannot be nominated as referees as this may create a conflict of interest.
11.Compliance and Regulation Are you currently or have you in the past 5 years been the subject of a GDC investigation? Have you been under any investigation by NHS England in relation to your GDS contract during the last 5 years? What was the outcome of your most recent CQC visit What was the date of your most recent NHS practice inspection (if you are in KSS) or LDET practice inspection (if you are in London)? Yes No If you have answered yes, please provide brief details, including the date(s) of the investigation and the findings Yes No If you have answered yes, please provide brief details, including the date(s) of the investigation and the findings Totally compliant Partially compliant If partially compliant, please outline areas designated for improvement? 12.References Please provide the names, job title, address, e-mail and contact telephone number of two dental professional referees Please note that current LDET or HEKSS employees including Patch Associate Deans (in London) and Training Programme Directors (in HEKSS) cannot be nominated as referees as this may create a conflict of interest. 1. 2.
Trainer%20Application%20Form%202015_0.docx