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Book now at www.afpp.org.uk/events or complete the Delegate Booking Form
The Association for Perioperative Practice
Residential Event
Join us for another AfPP Residential full of education and networking.
Thursday 30 July - Sunday 2 August 2015University of York
We are o� ering a number of ALL INCLUSIVE packages for you to choose from depending on how many nights you wish to attend. There are two full days of education on the Friday and Saturday with di� erent lecture streams available for you to choose from in the afternoon.
Prices for this fantastic event are subsidised by the AfPP Charity and start from:
Members £125 (Friday/Saturday package)
Non-Members £175 (Friday/Saturday package) All packages include your education, accommodation, meals and beverages as speci� ed overleaf.
PLUS Limited number of £50 travel bursaries* (Sponsored by MeCoBo) available on a � rst come � rst served basis.
Gala Dinner
11 hrs CPD
Inspirational Speakers
All InclusivePrice
The Programme includes:
A Patient StoryAccountability & LiabilityAdvanced RolesCommunicationDay Surgery
Human FactorsLeadershipPerformance under PressureTeam BuildingSurgical Innovation
Networking
AfPP Residential Event
Thursday 30 July (13.00 - 17.00)
Afternoon: AfPP Meetings, Delegate registration
Evening: Informal Dinner on University Campus
Friday 31 July Delegate registration opens 07.30 (09.00 - 17.45)Morning sessions: Opening session: Resilience: Performance under pressure Aims and objectives for the day, Re-validation - what this means to you
Afternoon sessions: Personal Impact Streams - to be chosen by delegates upon registration
Stream 1 - Students and newly quali� ed, Advanced Roles, Innovation in Surgery and the impact on Human Factors on Robotic Surgery
Stream 2 - Delegation, Accountability and Liability for all levels of perioperative sta� , Day Case Surgery: Research project which includes the role of SCP and improving day case laparoscopic cholecystectomy � gures
Evening: Informal Dinner on University Campus
Saturday 1 August (09.00 - 17.30)Morning sessions: Aims and objectives for the day, A Patient Story: Using route cause analysis to improve outcomes, AGM and engagement session
Afternoon sessions: Personal Impact Streams - to be chosen by delegates upon registration
Stream 1 - Never Events - The human element and personal impact
Stream 2 - Human Factors - Communication and Situational Awareness: Reinforcing a positive safety culture through a structured approach that engages sta� in learning and delivers a transparent culture
Closing session: ‘The Formula Guy’ Innovation and disruption - how to be disruptive in a positive way to improve standards and choose your attitude to help achieve your goals
Evening: Gala Dinner
Sunday 2 August Breakfast and depart (07.30 - 10.00)
For full details visit: www.afpp.org.uk/eventsor call 01423 881300
Book now at www.afpp.org.uk/events or complete the enclosed form
The Association for Perioperative Practice, 42 Freemans Way, HARROGATE, HG3 1DH
PACKAGE 1Thursday 30 July - Sunday 2 August
3 nights’ accommodation (Thu/Fri/Sat)2 days’ educationMeals & beverages including:2 Informal evening meals (Thu/Fri)and Gala Dinner on Saturday
MEMBERS NON-MEMBERS £200 £250
PACKAGE 2Friday 31 July - Sunday 2 August
2 nights’ accommodation (Fri/Sat)2 day’s educationMeals & beverages including: 1 Informal evening meal (Fri)and Gala Dinner on Saturday
MEMBERS NON-MEMBERS £170 £220
PACKAGE 3Friday 31July - Saturday 1 August
1 nights’ accommodation (Fri)2 days’ educationMeals & beverages including:1 Informal Evening Meal (Fri)
MEMBERS NON-MEMBERS £125 £175
Please complete all sections of the registration form in BLOCK CAPITALS and return to:Events Department, AfPP, Daisy Ayris House, 42 Freemans Way, HARROGATE, HG3 1DHIf you have any queries about the event please contact the AfPP events team on 01423 881300 or email [email protected]
Sections marked* are compulsory
Your details
Title* ____________ First name* _______________________________ Surname* _____________________________________
Home address* ____________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Town/City* _________________________________________________ Postcode* ______________________________________
Email address* _____________________________________________________________________________________________
Telephone number* __________________________________________ Mobile ________________________________________
Job title* __________________________________________________________________________________________________
Department _______________________________________________________________________________________________
Employer/University* ________________________________________________________________________________________
Employer/University address* _________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
Town/City* _________________________________________________ Postcode* ______________________________________
Questions about you
Are you a
Day Surgery Manager Director of Nursing HCA/HCW ODP SCP SFA
Senior/Theatre Sister SSD/Decontamination sta� Student Theatre Nurse
Other, please specify ________________________________________________________________________________________
Which of the following best describes the practice area in which you work? (select as many as relevant)
Anaesthetics Education (Clinical) Education (HEI) Midwifery Military Pre-assessment
Recovery Scrub Theatre management
Which of the following best describes your area of specialism? (select as many as relevant)
Anaesthetic Bariatric Breast Cardiac/Thoracic Day Surgery
Decontamination Endoscopy ENT General Surgery Gynaecology
Neurosurgery Obstetrics Oncology Ophthalmic Orthopadics
Paediatrics Plastics/Cosmetic Primary Care Recovery Urology/Renal
Vascular
Other Other description ____________________________________________________________________
Residential Event Registration Form
Delegate Ticket Package Details
Residential booking - please complete the section below
I understand that to qualify for AfPP Residential membership rates, I must be a current member of AfPP. Full terms and conditions are outlined on AfPP’s website.Please state any special requirements that AfPP sta� may be able to help you with (e.g. mobility or diet)
_____________________________________________________________________________________________________
Cancellation: Notice of cancellation should be made in writing to AfPP. Only written cancellations will be accepted. Cancellations received more than 20 days prior to the event, (ie before 10 July 2015) will be eligible for a full refund less a 25% handling fee. Cancellations after this date will not be eligible for a refund. Funds paid are non transferable between events. AfPP reserves the right to add or remove elements from the residential programme depending on availability of speakers and in the light of new events that may be of interest to delegates etc.
Your details will be added to the AfPP database in order to process your request and so that you can be kept up to date with relevant details of our future events and membership services. Once a place has been booked at one of the residential events this place cannot be transferred to another individual. From time to time we may provide you with information from AfPP’s partner companies that may be appropriate. If you do not wish to receive further information from partner companies, whether by post, telephone or e-mail tick this box . Data protection: AfPP does not sell or rent your personal information to others.
Payment: I would like to pay by
Cheque: I enclose a cheque payable to The Association for Perioperative Practice for £ ____________________________
Invoice: (pre-registration only) Payment (in full) must be received by 10 July 2015
Please send an invoice for £ ___________ to: __________________________________________________________________
____________________________________________________Purchase order number (compulsory): ___________________
BACS
Please make BACS payments to:
AfPP Sort code: 53 - 50 - 21 Account number: 51130491
Please quote delegate name and organisation name with all BACS payments.
Credit Card/Debit Card - Please debit my Visa / Mastercard / Switch / Maestro
Cardholders Name: _______________________________________________________________________________________
Card no.
Valid from To Issue no. (Switch) 3 digit security no.
Signature: ______________________________________
Card billing address: (if di� erent from reverse): ________________________________________________________________
_______________________________________________________________________________________________________
The Association for Perioperative PracticeDaisy Ayris House, 42 Freemans Way, HARROGATE, HG3 1DHTel: 01423 881300 Fax: 01423 880997Email: [email protected] www.afpp.org.uk
Package 1 Thursday 30 July - Sunday 2 August 2015 Member £200 Non-member £250
Member Membership number __________________ Non-member
Package 3 Friday 31 July - Saturday 1 August 2015 Member £125 Non-member £175
Package 2 Friday 31 July - Sunday 2 August 2015 Member £170 Non-member £220
I would like to apply for the £50 MeCoBo travel bursary**Full details available on the AfPP website
