Health Service Executive - Approval to Hire Form A – New Posts (revised May 2017)

This form is to be competed in all cases where the post to be filled is either; a new service development post,approved and funded in theNational Service Plan or,a new post arising from the reform programme. In the latter case, full funding must be identified and re-allocated from suppressed approved and funded post(s). A form has to be completed for each individual post.

Please note the recruitment/filling process CANNOT commence until this form is duly authorised and forwarded to appropriate recruitment function. Please complete form in Block Capitals/Tick or complete appropriate boxes
Division / Acute Hospitals//Primary Care //Social Care //Mental Health // Health & Wellbeing //Corporate
//Health Business Services // National Ambulance Service
HospitalGroup/CHO/Function
Title of Post / Cost Centre
Purpose of Post
Details of Post to be filled
Grade Code Position Number (new)
Primary Notification Required: Yes/No* If yes please provide Reference Number: PN / / / 20
Salary Scale: ______to ______New Service Development: Yes/No Newfunded Post: Yes/No
Suppression of another post required:Yes/No Date and value of suppressed Post last filled: ______/€______
Financial Implications: Neutral/Cost increasing. Projected date post to be filled by: Date:______
Funding Code and approval funding letter attached in case of new service developments: ______Yes/No
Signed Line Manager: ______Title: ______Date: ______
Print Name ( )
Details of post to be suppressed to fund a new post if not funded through National Service Plan funding / Location: ______Cost Centre: ______Grade Code: 
Position Number Date Last Filled: ______
WTE Value: ______Name of person last in post: ______

I confirm and certify that the cost of the filling of the post is within the allocated funded workforce plan and sustainable into next financial year. I also certify that the terms and conditions for the post are fully compliant with public sector pay policy and pay scales.

Signed: ______Title: ______Date: ______

Print name ()

Requesting CEO/CO/Hospital Group/CHO/Head of Service; HSE/Voluntary Hospital/Voluntary Agency*

Approval to initiate recruitment process: Granted/Not Granted

Counter-Signed: ______Title: ______Date: ______

Print name ( )

Assistant National Director Operations & Service Improvement (or equivalent) ______Division/Function

Completed form to accompany order form/recruitment request to National Recruitment Services (NRS) or other authorised recruitment function.

Received in WFPA&I:Date:______WFPA&I Log No: ______