This application form is for candidates wishing to register for the Medicines Optimisation Programme. There are two courses within the programme: POD Assessment and Medicines Reconciliation, an optional module can be added to either course called Transcribing for Supply. Please choose the correct options below when completing this form.

Please note you will need an Educational Supervisor to support you with completing this programme. Discuss the course requirements with them prior to applying and ensure you choose the correct combination using the drop downs below to apply for the right course/s.

This programme is delivered in cohorts which start every two months, choose your preferred cohort dates from the drop-down list. Applications must be completed within the stated deadlines. Late applications will not be considered.

Selecting the correct course

There are two courses available, POD Assessment and Medicines Reconciliation. There is also an optional module called Transcribing for Supply.
Please choose the correct option from the drop down choices below.

Forename
Surname
Work Email
Telephone (work)
Mobile Number (emergencies only)

Please ensure you meet the entry criteria prior to applying for this programme. Please note you must be able to complete all relevant on-line learning and meet any local training requirements relevant to each module to meet course criteria.

Job Title
Please confirm your Agenda for Change Band/Grade here

If your Trust is not listed on the dropdown above, please contact us via lasepharmacy@hee.nhs.uk and we will advise if you are able to register for this programme.

Base Name

If there are any special facilities that you require (e.g. because of disability) Please inform us at this time. We will endeavour to make reasonable adjustments to accommodate your needs.

Any reasonable adjustments required?
Yes
No
If yes please give details

Educational Supervision & Line Manager approval

Please confirm the name and email address of your Educational Supervisor.

Educational Supervisor Forename
Educational Supervisor Surname
Educational Supervisor email
Please select Yes below to confirm agreed participation and completion of this course with your line manager.
Yes
No
Line Manager Forename
Line Manager Surname
Line Manager email
I agree to the Terms & Conditions

Please refer to the HEE privacy notice https://hee.nhs.uk/about/privacy-notice for information on how HEE manage your data.