Occupational Health Service
The Education Centre
St Thomas’ Hospital
Westminster Bridge Road
London SE1 7EH
Tel: 020 7188 4152
Fax: 020 7188 4146
Email: OHAdministrator@gstt.nhs.uk
Dear Manager,
Functional Requirement Form (FRF)
Please complete ALL sections of the Functional Requirement Form (FRF) so as to:
Demonstrate the functional requirements you seek from applicants for your post
Enable the prospective applicant to self assess his/her ability to meet the functional requirements of the job
Identify reasonable adjustments which could be necessary for the applicant to fully undertake the tasks of the job
Identify components of the job that may have a negative impact on the applicant’s health, so that you or the Trust can take preventative measures
Help Guy’s and St Thomas’ NHS Foundation Trust comply with the Equality Act (2010) in providing reasonable adjustments for those who need them.
Further information on the activities identified with an asterisk in the FRF (see the other side) follows:
Psychosocial Demands of the Job (section A)
B12. Work in confined spaces*
It can be any space of an enclosed nature where there is a risk of death or serious injury from hazardous substances or dangerous conditions (e.g. lack of oxygen). Some confined spaces are fairly easy to identify,
e.g. enclosures with limited openings, enclosed drains and sewers. Others may be less obvious e.g. ductwork and unventilated or poorly ventilated rooms. It is not possible to provide a comprehensive list of confined spaces. Some places may become confined spaces when work is carried out, or during their construction, fabrication or subsequent modification.
Further guidance is available at: http://www.hse.gov.uk/pubns/indg258.pdf
Additional screening required pre-commencement (section D)
D1. Undertaking exposure prone procedures (EPP)/ Renal Dialysis*
Exposure prone procedures (EPPs) are those where there is a risk that injury to the worker may result in exposure of the patient’s open tissues to the blood of the worker. These procedures include those where the worker’s gloved hands may be in contact with sharp instruments, needle tips or sharp tissues (spicules of bone or teeth) inside a patient’s open body cavity, wound or confined anatomical space where the hands or fingertips may not be completely visible at all times.
Renal Dialysis staff undertake haemodialysis at dialysis units or other places.
D2. Food handler*
Those involved in producing, preparing and handling foodstuffs.
A completed FRF should be returned to the Recruitment Employee Services Area (RESA) team as part of the relevant job description along with other required documentation as part of the recruitment planning process.
If you require any further information regarding completion of the form, please contact the Occupational Health
Service on the above telephone number or e-mail: OHAdministrator@gstt.nhs.uk.
Functional Requirement Form (To be completed by Manager)
Job Title:
