Regulation 12(1)
1. Name, address, date of birth and telephone number.
2. Name, address and telephone number of next of kin.
3. Proof of identity, including a recent photograph.
4. Either —
(a)where the position which the nurse is supplied to perform falls within section 115(3) or (4) of the Police Act 1997, an enhanced criminal record certificate issued under section 115 of that Act; or
(b)in any other case, a criminal record certificate issued under section 113 of that Act,
including, where applicable, the matters specified in sections 113(3A) and 115(6A) of that Act and the following provisions once they are in force, namely section 113(3C)(a) and (b) and section 115(6B)(a) and (b) of that Act.
5. A police check, being a report produced by or on behalf of a chief officer of police within the meaning of the Police Act 1997 which records, as at the time the report is produced, all criminal offences —
(a)which may be disclosed by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975(1); or
(b)in respect of which the person has been cautioned and which, at the time the caution was given, the person admitted.
6. Two written references from nurses or other health professionals, including a reference relating to the last period of employment as a nurse of not less than three months duration.
7. Where a nurse has previously worked in a position which involved work with children or vulnerable adults, verification of the reason why he or she ceased to work in that position, except where the National Assembly has determined that all reasonable steps have been taken to obtain such verification but it is not available.
8. Evidence of a satisfactory knowledge of the English language, where the nurse’s nursing qualifications were obtained outside the United Kingdom.
9. Documentary evidence of any relevant qualifications and training.
10. A full employment history, together with a satisfactory written explanation of any gaps in employment and details of any current employment other than for the purposes of the agency.
11. Record of immunisation status.
12. Confirmation of current registration with the Nursing and Midwifery Council, including details of the Part of the register in which the nurse is registered.
13. Details of any professional indemnity insurance.