REF 2014 Individual Staff Circumstances Disclosure Form

REF 2014 Individual staff circumstances disclosure form

Section one:

Name / Click here to enter text. /
Department/Faculty (or college if you are a college-only employee) / Click here to enter text. /
Unit of Assessment (if known) / Click here to enter text. /
Email / Click here to enter text. /
Telephone number / Click here to enter text. /
Preferred method of communication / Click here to enter text. /

How to return this form

First, download a copy of the form and save it before completing it. The boxes will expand if you need more space. Overtype the instructions. Only complete sections which are relevant for you.

Then, there are three ways to return this form:

Email:Please email the form Please note that email is not a secure method of communication.

Weblearn: You can use Weblearn (a University of Oxford web-based storage facility) to return the formsecurely.

1)Please visit

2)You will need to log on to your Oxford account using your Single Sign-On (SSO). If you need help with your SSO please contact your local IT support service.

3)Select ‘yes’ when asked if you would like to join the REF 2014 site.

4)A folder with your name will appear under Drop Box. Hover over the 'Add' button on the right of this folder and select 'Upload files'.

Your folder and its contents will only be accessible by designated members of the Planning & Resource Allocation Section and the Equality and Diversity Unit.

Hard copy:You can return the form by internal/external mailto Caroline Moughton, REF Equality, Equality & Diversity Unit, University Offices, Wellington Square, OX1 2JD. Please seal the envelope and mark it ‘confidential’ if appropriate.

If you do not respond, we will assume that you have no circumstances which you wish to disclose.

If you have any general questions related to disclosing your circumstancesplease contact the University’s Equality and Diversity Unit (EDU): 01865 289821. If you have questions about the disclosure of a disability contact the Staff Disability Adviser in the EDU: 01865 280687.

Please note:

In order to be eligible, circumstances must have had a significant constraint on an individual’s ability to carry out research, usually over a period equivalent to 12 months’ full time equivalent working. The exception is that each discrete period of statutory maternity leave or statutory adoption leave (regardless of length) and each discrete period of additional paternity or adoption leave taken lasting four months or more, automatically qualifies for a reduction of one output.

If you received any ‘reasonable adjustments’related to a disability they will be taken into account in assessing whether you are eligible for a reduction in expected outputs for the relevant period.

We will contact you if further information or evidence is required (for example, confirmation from your GP or department/faculty). You may withdraw your disclosure at any time. If insufficient information is available, the Committee will not be able take the case forward.

Section two

I wish to make the University awareof the following clearly defined circumstances which have had an impact on my ability to produce four outputs or to work productively between 1 January 2008and 31 October 2013.

Please describe therelevant circumstance(s). Any information provided in section two will be seen by the relevant Unit of Assessment Coordinator[1], University REF officers, and other senior academics involved in the preparation of the REF return.

Clearly defined circumstances

1. Early career researcher (started career as an independent researcher on or after 1 August 2009)[2]

Date on which you started your career as an independent researcher (see footnote definition):
Click here to enter text.
Please describe how you met the criteria of independent researcher from that date (e.g. first held award as principal investigator):
Click here to enter text.

1. Part time working

Dates, FTE (full time equivalent), and duration in months:
Click here to enter text.
Any further information?
Click here to enter text.

1. Career break or secondment outside of the higher education sector

Dates and duration in months:
Click here to enter text.
Further information:
Click here to enter text.

1. Maternity leave or statutory adoption leave regardless of the length of leave; or additional paternity or adoption leave (taken by partners of new mothers or co-adopters) if lasting four months or more

For each period of leave state which type of leave was taken and the dates and duration in months:
Click here to enter text.
Any further information?
Click here to enter text.

1. Are you a junior clinical academic staff member who will not have gained a Certificate of Completion of Training by 31 October 2013?[Note, this only applies to specific units of assessment within REF]

Yes / No / Not applicable (please indicate)

Section three

I wish to make the University awareof the following complexcircumstances which have had an impact on my ability to produce four outputs or to work productively between 1 January 2008 and 31 October 2013.

Please describe the relevant circumstance(s). Any information provided in section three will only be seen by the University’s REF Equality Committee. The relevant Unit of Assessment Coordinator[3] and University REF officer will be informed of any agreed reduction in outputs, but not of the circumstances underlying this.

Complex circumstances

1. Disability (a physical and/or mental impairment which has a substantial and long-term adverse effect on your ability to carry-out normal day-to-day activities. Long term impairments include those that last or are likely to last for at least 12 months, including chronic and progressive/degenerative conditions. Cancer, HIV and multiple sclerosis fall within the definition of disability from the point of diagnosis.

Provide information below on the constraints on your ability to produce four outputs, or to work productively, including the duration in months that you were affected:
Click here to enter text.

1. Mental health condition

Provide information below on the constraints on your ability to produce four outputs, or to work productively, including the duration in months that you were affected:
Click here to enter text.

1. Ill health or injury

Provide information below on the constraints on your ability to produce four outputs, or to work productively, including the duration in months that you were affected:
Click here to enter text.

1. Constraints relating to pregnancy, maternity, breastfeeding, paternity, adoption or childcare in addition to the period of maternity, adoption or additional paternity leave taken.

Provide information below on the constraints on your ability to produce four outputs, or to work productively, including the duration in months that you were affected:
Click here to enter text.

1. Other caring responsibilities (including caring for an elderly or disabled relative)

Provide information below on the constraints on your ability to produce four outputs, or to work productively, including the duration in months that you were affected:
Click here to enter text.

1. Gender reassignment

Provide information below on the constraints on your ability to produce four outputs, or to work productively, including the duration in months that you were affected:
Click here to enter text.

1. If you think you have other exceptional and relevant circumstances that may be eligible (not including teaching or administrative work) please contact the University’s Equality and Diversity Unit:

Trudy Coe; 01865 289821.

Please tick the boxes to give permission for the University to use the information provided:

I confirm that the personal data provided above is a true and accurate description of my circumstances.

I agree that the University may collect, process and use the personal data provided above for purposes connected with the REF2014 and that:

• Anyinformation provided in section two will be seen by the relevant Unit of Assessment Coordinator, university REF officers, and other senior academics involved in the preparation of the REF return
• Any information provided in section three will onlybe seen by the University’s REF Equality Committee[4]. The relevant Unit of Assessment Coordinator and university REF officer will be informed of any agreed reduction in outputs, but not of the circumstances underlying this.

I agree that the University may share the personal data provided above with the UK funding bodies’ REF team and that:

• Any information provided in section two will be seen by the relevant REF sub-panel, the REF panel secretariat and the UK funding bodies’ REF team.
• Any information provided in section three will only be seen by the REF Equality and Diversity Advisory Panel, the REF Main Panel Chairs and the UK funding bodies’ REF team. This information will not be seen by the REF sub-panel[5].

Where permission is not provided, the University will not be able to request a reduction in outputs.

Signature: Date:

(Staff member)

Where the form is returned via email or Weblearn Drop Box by the named individual, a signature is not required. For PRAS use only

Following consideration of the personal circumstances described above, PRAS/EDU have determined:

This form contains only clearly described circumstances and has been passed on to the relevant UOA coordinator (via Divisional REF officer) to determine whether they are eligible to be returned with fewer than four outputs.

Further information on the circumstances is required, as follows:

For PRAS use only

The staff member does not meet the criteria outlined within the REF ‘Panel criteria and working methods’ for submitting fewer than four research outputs. The reason(s) for this decision are:

For PRAS use only

This form contains complex circumstances and will be considered by the REF Equality Committee

If considered by the REF Equality Committee:

The staff member does not meet the criteria outlined within the REF ‘Panel criteria and working methods’ for submitting fewer than four research outputs. The reason(s) for this decision are:

For PRAS use only

The staff member does meet the criteria for submitting fewer than four research outputs and their minimum output count has been determined asFor PRAS use only

Signature:For PRAS use onlyDate: For PRAS use only

(For PRAS use onlyon behalf of REF Equality Committee)

[1]A list of UOA coordinators is available from the University’s REF webpages:

[2] For the purposes of REF, an individual is deemed to have started their career as an independent researcher from the point at which they undertook independent research, leading or acting as principal investigator or equivalent on a research grant or significant piece of research work. (A member of staff is not deemed to have undertaken independent research purely on the basis that they are named on one or more research outputs).

[3]A list of UOA coordinators is available from the University’s REF webpages:

[4]Membership and Terms of Reference can be found on the University’s REF webpages

NB. Academic members will not be shown confidential material related to staff from their own department.

[5]All REF panel members, chairs and secretaries are bound by confidentiality requirements, and acceptance of the confidentiality requirements is a condition of their appointment to the role. No information relating to identifiable individuals’ circumstances will be published by the funding bodies REF Team. All data collected, stored and processed by the UK funding bodies REF Team will be handled in accordance with the Data Protection Act 1998.