Guidance for completing the Individual Circumstances form:

The School recognises that some individuals may have serious personal circumstances that have affected/continue to affect their performance, whether by reduction in the volume or range of activities that they were/are able to undertake, or in other ways.

Circumstances that may be taken into account include:

a)Absences on maternity, paternity or adoption leave

b)Periods of part time or other flexible working

c)Breaks in employment due to non-consecutive fixed-term contracts

d)Disability, injury or ill health (permanent or temporarylasting more than six months)

e)Absence from the workforce whilst acting as carer or undertaking domestic responsibilities

f)Career breaks unconnected with academic responsibilities

g)Time spent working in own professional discipline outside academia

h)Substantive absences that the School is legally obliged to permit (including involvement as a representative of the workforce or for religious observance)

i)Agreed special leave of absence on secondment to other organisations

j)Other personal circumstances having comparable impact on an individual’s achievements to those listed above.

Individuals who feel that such information needs to be taken into account in assessing their performance should declare it using this form and submit this to Human Resources as part of their application for promotion.

Any information declared will remain confidential and will only be seen by the Individual Circumstances Panel.

The Panel will consider how much time has effectively been lost from normal work activities as a result of the circumstances involved.

An assessment of this time will be provided to the Promotions Panel by Human Resources.

No details of the circumstances involved will be released.

The time assessment may be given as time lost in months in any one or more of the three areas that form part of the Academic Performance Framework or as an estimate of a percentage of time lost in one or more of the three areas assessed. The period of time over which the loss occurred must also be provided for the Promotions Panel. No loss of fewer than 6 months in total will normally be reported to the Promotions Panel.

Application Type / ☐ Senior Lecturer / ☐ Reader / ☐ Professor
Forename / Surname
Title / Title of current post
Department / Faculty
Contact telephone / Contact email

I wish to make the School aware of the following individual circumstances, which have had had impact on my normal work activities between

Start date:

End date (leave blank if on-going):

Circumstances
Please describe the nature of your circumstances. It may be necessary to contact you for additional evidence if details are not already held in HR. Therefore, you may wish to attach relevant documentation/correspondence to this form.

Impact on ability to fulfil/undertake:

Research and Enterprise
Teaching and Learning
Administration, Management and Outreach

For completion by the Individual Circumstances Panel

Circumstance / Dates / No of months and calculation / Evidence
TOTAL MONTHS ABSENT/LOST

Signed:______Date: ______

Chair of Individual Circumstances Panel