Wessex Deanery GP Recruitment - Candidate Geographical Limitations form
Candidate NameOriel PIN number
- Please use this form if you are only able to consider employment in a restricted geographical area within the Wessex Deanery and indicate below which category applies to you.
- Examples of evidence you need to provide to substantiate your selection are given under each category.
- Please bring this form and the supporting evidence to the Stage 3 Selection Centre and hand it in at Registration or post it to GP School, Southern House, Otterbourne, Winchester. SO21 2RU to reach us no later than Monday 9 February 2015. Please provide one set of photocopies if you do not wish us to retain original documents.
We cannot consider requests received after 9 February 2015.
CATEGORY 1 - Personal Health Care.Description: tied to an area for critical health needs; for instance ongoing illness requiring tertiary specialist treatment
Evidence: A letter from your doctor, confirming that you are receiving ongoing treatment in the locality, and giving reasons why your treatment cannot be provided elsewhere. You probably will not need to make an appointment to see your doctor. Depending on your doctor’s practice you may be able to request a letter by phone via the practice manager or secretary. Such a letter will be outside your doctor’s NHS contract and you may be asked for a fee, which will be your responsibility to pay.
CATEGORY 2 - Dependent Children
Description: tied to a specific location for some reason relating to dependent children;
a) Health reasons are most important, for example attendance at a special school for health reasons, or access to tertiary health care.
b) Children of secondary school age are the next most important, especially if approaching major examinations such as GCSE or A levels.
Other reasons may be given such as infant childcare or junior school placement but if these facilities are likely to be portable, no priority will be given.
Evidence: A letter from your child’s doctor confirming that they are receiving ongoing treatment in the locality. You probably will not need to make an appointment to see your child’s doctor. Depending on your doctor’s practice you may be able to request a letter by phone via the practice manager or secretary. Such a letter will be outside your doctor’s NHS contract and you may be asked for a fee, which will be your responsibility to pay.
OR
A letter from your child’s school, confirming their attendance in the locality and giving reasons why it is essential that they remain in the area.
CATEGORY 3 - Adult Connections
Description: a) Partner tied to an area by job or education and unable to relocate.
b) Dependent family members for whom you are a primary carer tied to an area and unable to relocate.
c) Head of household - Some candidates may see themselves as being head of a large extended family and feel they must be in a specific location in order to carry out their family duties.
Evidence: A letter from your partner confirming they live with you on a permanent basis, and a letter from your partner’s employer confirming that their job ties them to that locality.
OR
Evidence that you have a relative for whom you are the primary carer and who isdependent upon your support and evidence that they are tied to that locality. This evidence could be a letter from your relative’s doctor (which you may be required to pay for), social services, or carers’ organisation.
OR
Evidence from an external source that you are regarded as head of a large household and giving reasons why you are tied to a particular area.
The following section must be completed fully:
- I wish to be located in the following area for my GP training:
......
- I am restricted to this area because of (please tick):
Category 1 – Personal Health Care
Category 2 – Dependent Children
Category 3 – Adult Connections
- I have provided documentary evidence to support my request
- I understand that the decision of the Associate Dean for GP Recruitment regarding my request will be final.
Signed ...... Date ......