STATEMENT OF AGREEMENT FOR VOLUNTEERS

  1. In the course of your voluntary work you may gain knowledge of a confidential nature relating to the private affairs, diagnosis and treatment of patients, information affecting members of the public, matters concerning staff and details of items under consideration by the trust. Under no circumstances should information be divulged or passed to any unauthorised persons. This includes discussions with colleagues concerning patients in situations where the conversation may be overheard. Any breach of confidence or unauthorised disclosure will result in disciplinary action, which may result in your dismissal from voluntary work on Trust premises.
  1. You will be issued with an ID badge and this is for your use only. You are required to wear this at all times whilst volunteering. Under no circumstances do you allow access to any other individual using your ID badge, and please be aware of the importance of preventing ‘tailgating’.
  1. If you have been given access to the Trust’s car parks, you are only permitted to use this access for the purposes of your volunteering.
  1. You have a legal obligation to take reasonable care of your own health and safety and the safety of other people who may be affected by your acts or omissions. All volunteers are given the opportunity to access information, instruction and induction training necessary to enable the safe performance of prescribed safe systems of work practises within the department/unit you enter.
  1. Should you be involved in an accident in your capacity as a volunteer whilst on Trust premises, you or someone acting on your behalf should notify the Department Manager or the Patient Experience and Engagement Manager. An entry must be made in the departments Accident Book.
  1. Fire precaution in Portsmouth Hospitals is everybody’s business. Please ensure you are familiar with the hospitals fire procedures. It is your responsibility and/or your group/unit manager/co-coordinator to ensure you are aware of relevant fire procedures/induction training.
  1. Patient’s rights must be respected at all times. No abuse of patients or users of our services will be tolerated.
  1. Portsmouth Hospitals accepts no responsibility of any items of personal property that are lost or damaged on the premises whether through fire, theft or otherwise.
  1. Under no circumstances must Portsmouth Hospitals’ property be removed from the premises without first obtaining the approval of the Head of Department or the VSC. Any items issued to you i.e. identity pass, site permit, protective clothing etc. remain the property of Portsmouth Hospitals NHS Trust and must be returned to the VSC when you cease to undertake voluntary work at the hospital. You are also asked to conserve energy as appropriate by switching off lights, closing windows, etc.
  1. Portsmouth Hospitals requires you to observe our No Smoking Policy. Any volunteer found to be smoking on one of our sites will be asked to leave.
  1. The Trust reserves the right to ask you to desist/relocate your voluntary activity in respect of complaints, legislative or organisational changes that may occur.

I agree to completely abide by the terms and conditions outlined in the above statement. I understand that should I fail to comply with these terms, Portsmouth Hospitals NHS trust has the right to terminate my voluntary activity on Trust Premises.

Sign and print name:…………………………………………………………………….…….Date: ……………………

Please can you provide us with details of someone whom we would contact on your behalf in the event of an emergency:

Name:
Relationship to You:
Telephone Number Home:
Telephone Number Mobile:
Telephone Number Work:
E-mail address:

PTO