Thank you for deciding to apply for this role with LHP. If you require further information please refer to our website www.lincolnshirehp.com/board-recruitment or you can email recruitment@lincolnshirehp.com, or call 0345 604 1472

There are five sections to this application: 1. About you 2. Supporting Statements 3. Key Questions 4. Diversity Monitoring (confidential) 5. Declarations.

You are able to save your application as you complete it - and return to it at a later stage if needed.

Applications at sifting and shortlisting stages are anonymous. Only sections two and three are provided to the Selection Panel. Once the Panel have determined who they wish to invite to interview, candidate identities will be revealed.

We will use the information you provide on this application form to check facts relevant to the role and will conduct these checks in a way that is fair to all candidates.

If you know any LHP Board members or employees personally (i.e. a relative or close friend) or have any other interests (for example you work for a company which works closely with LHP) please let us know in section five of this application form which will help us manage interests. You will not be removed from the selection process based on actual, potential or perceived conflicts of interest. If you have significant interests which may need managing if you become a Committee member you will be given an opportunity to discuss this at interview.

Please complete the diversity monitoring questions below. The information you provide will be treated as confidential and not seen by the selection panel at any stage. If you do not feel comfortable answering a question please use the prefer not to say option.

The data will be held securely and anonymised and aggregated to understand the diversity of applicants and how that compares to the populations of board members, employees and customers. This will enable us to understand and ensure that any future recruitment attracts applicants from under-represented groups. The questions and categories are taken directly from the NHF EDI Data tool to allow wider comparison.

For the question below, definitions are: Married - includes those in opposite and same sex marriages Single - never married or civil partnered Widowed - includes those who are a surviving civil partner Divorced - includes those who have legally dissolved their civil partnerships

For the question below, informal care means caring that is not a paid job. This could be for a friend or family member on a voluntary basis.

For the question below, a disability is as defined by the Equality Act 2010 - a person who is considered to have a disability if they have a self reported long standing illness, condition or impairment, which causes difficulty with day-to-day activities

For the question below, independent school meaning a school that charged a fee to attend rather than funded by the government.

Reputation - The conduct of Non-Executive Directors impacts directly on LHP's public reputation. Non-Executive Directors are expected to abide by the LHP Code of Conduct https://www.lincolnshirehp.com/governance/#board-member-and-code-of-conduct which sets out Board and Committee Members’ responsibilities in respect of acceptable behaviour and accountability.

Thank you for completing this application. Please ensure you submit this form (using the blue button below) by 16 January 2023. We will contact you to acknowledge receipt - If you do not hear from us within 48 hours please email us on recruitment@lincolnshirehp.com to check your application has been received.