Form

Severance payments at NHS foundation trusts: approval form

Apply for approval for a special severance payment for an NHS foundation trust staff member.

Applies to England

Documents

Template for Monitor and HM Treasury approval for special payment cases

Request an accessible format.
If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email [email protected]. Please tell us what format you need. It will help us if you say what assistive technology you use.

Details

Use this form to apply to HM Treasury for a special severance payment for someone leaving their job at an NHS foundation trust.

It is for payments outside someone’s normal contractual entitlement.

You should read Managing Public Money Annex 4.13 before completing this form.

Completed forms should be submitted by email to [email protected].

Updates to this page

Published 26 April 2013

Sign up for emails or print this page