NHS Wales Student Awards Services: Practice Placement Costs Claim Form, Exercises of Community Health

Download NHS Wales Student Awards Services: Practice Placement Costs Claim Form and more Exercises Community Health in PDF only on Docsity! NHS Wales Student Awards Services * Only Complete if you have submitted an Online BOSS application for your Bursary* PRACTICE PLACEMENT COSTS CLAIM FORM FOR AN NHS WALES FUNDED STUDENT NHS Wales Student Ref Number Your Name Only complete this form if you are an NHS Wales funded student and have received a Notification of Award from NHS Wales Student Awards Services. If you knowingly withhold information, or provide false information, in order to receive a reimbursement of practice placement travel costs, you will be committing fraud. If at any time NHS Wales Student Awards Services suspects that an application is fraudulent a referral will be made to the NHS Counter Fraud and Security Management Service (CFSMS) for further investigation. Before making a claim, please note :- Completed claim forms should be returned to your university who will authenticate them and send them to us. You are advised to keep a copy of your form and any accompanying receipts/evidence before passing your claim to your university. All claims must be received within six months of the date of the last day of the practice placement for which you are claiming. You MUST remember to include a copy of your student coversheet with each form as your claim cannot be processed without this. Universities should send completed forms to :- Document Scanning Team – NWSSP, Cwmbran House, Mamhilad Park Estate, Pontypool, NP4 0XS.  Read the guidance notes on pages 2 and 3  Answer in FULL all relevant questions  Ensure the claim form is completed clearly and accurately in BLOCK CAPITALS  Provide FULL postal term time address and FULL postal address of place of study  Provide FULL postal address(es) of ALL practice placement sites  Ensure your claim is supported by relevant receipts  Pass original claim and supporting documentation to your tutor or course administrator who will arrange for your university to check and authenticate it. The university will then forward your claim directly to the Document Scanning Team address above. NB We recommend that you keep photocopies of all claim forms and receipts before passing them to your university for authentication. NHS Wales Student Awards Services is unable to reimburse any claim without this information. 1 OFFICE USE ONLY: Claims should be submitted as soon as possible following completion of each individual placement and no later than 6 months after the last day of each placement. Claims received outside of this period will not be considered. S A S GUIDANCE NOTES FOR STUDENTS CLAIMING PRACTICE PLACEMENT COSTS NHS funded students who have to undertake a practice placement, which involves training in hospitals or community health services rather than a classroom, may be entitled to have the cost of journeys to and from the practice placement site (which is not part of the university), reimbursed. Note 1: Who can claim? All NHS Wales funded students in receipt of a Notification of Award from NHS Wales Student Awards Services are eligible to claim except:-  a European Fees Only award holder; Note 2: What travel expenses may I claim? You may only claim for travel between your term time or practice placement address and your practice placement site. You may also claim for any additional mileage/travel costs, if you have to travel in the community to other practice placement sites, and/or to patient’s home address if you are not given free transport. You should use the cheapest form of transport available for your journeys, taking full advantage of any free and concessionary schemes. If you travel by public transport you may claim the costs of your fares, including carriage of luggage and bicycles. (NB the cost of taxis is only allowable in exceptional circumstances. The cost of airfares is prohibited). You will need to keep all receipts (i.e. bus/train tickets, parking, tunnel and toll receipts) and attach these to your claim as proof of the journeys undertaken. Claims not accompanied by receipts will not be refunded. Note 3: Can I use my own motor vehicle? Normally, you will be expected to use public transport. The use of a claimant’s own motor vehicle is restricted and subject to prior approval from your university. If you choose to use your own motor vehicle you should claim public transport fares if these are lower than the mileage costs. If public transport is unavailable or unsuitable for placement travel, you should gain, in advance of your placement, agreement from your university that they will certify that you have to use your own motor vehicle. You will also need to get confirmation from your insurers that you have adequate cover for all costs and claims and that no liability is placed on your university or any NHS body, and notify your university accordingly. You may claim the following mileage rates:  Bicycle 20 pence per mile  Motor vehicles 27 pence per mile Note 4: Can I claim other costs? The costs of taxis are not allowable unless, exceptionally, your university certifies by letter that they were unavoidably incurred, in which case, reimbursement of taxi fares will be limited to the maximum motor vehicle rate (i.e. 27 pence per mile). The costs of tips, refreshments, sleeper berths and phone calls, and of any other expenses which are related to your placement, are not allowable and therefore will not be reimbursed. The costs of airfares are not allowable but you can claim for travel by public transport between your term time UK residence and UK airport, subject to providing appropriate receipts. 2 SECTION 4 – Details of travel to and from ALL practice placement(s) – you must provide the FULL POSTAL address for each of your placement site(s). Placement Address 1 Post Code Placement Address 2 Post Code Placement Address 3 Post Code Placement Address 4 Post Code Placement Placement Placement Placement Address 1 Address 2 Address 3 Address 4 How did you travel to your practice placement site? If you used public transport, please indicate the cost of your daily return journey? If you drove or cycled to placement, please indicate the daily return mileage. 5 £ £ £ £ Section 5 Details of Claim - you must complete this section in full Please show full details of each journey for which you are claiming (for all placement addresses) and attach receipts as necessary. Date I Journeys (See Note 2) I Private Mileage (See Note 3) Public Transport Other Allowable Costs From I To I Mileage I Mileage Amount Mode of Amount Details (ie Amount rate due transport due parking, due (p ease refer to (eg bus, (provide tunnel,tolls) (provide guidance notes) • • train) receipts) receipts) "' TOTALS £ £ £ Claims shou ld be submitted as soon as possi ble following completion of each indi vidual placement and no later than 6 months after the last day of each placement. Clai ms received outside of this period wi ll not be considered. Section 5 (cont} Details of Claim - you must complete this section in full Please show full details of each journey for which you are claiming (for all placement addresses) and attach receipts as necessary. Date I Journeys (See Note 2) I Private Mileage (See Note 3) Public Transport Other Allowable Costs From I To I Mileage I Mileage Amount Mode of Amount Details (ie Amount rate due transport due parking, due (p ease refer to (eg bus, (provide tunnel,tolls) (provide guidance notes) • • train) receipts) receipts) "'.j TOTALS £ £ £ 10 11