GUIDANCE FOR APPLICANTS

On the process of applying for pre-allocation to foundation

school on the grounds of

SPECIAL CIRCUMSTANCES

INDEX

Section Content Page

1. General principles 2
2. The criteria 3
3. Educational special circumstances 4
4. Panels 5
5. Process for submission & consideration of applications 5
6. The local panel’s decision 6
7. When special circumstances arise after the closing date 7
Appendix
A. National timeline 8
B. Helping potential applicants be realistic 9
C. Criterion 1: Statement confirming parental responsibility 11
D. Criterion 2: Statement confirming applicant’s role as primary 14
carer
E. Criterion 2: Guidelines for care plan 19
F. Criterion 3: Report by Occupational Health physician or medical 25
specialist
G. Appeal process 29
H. Transfer of Information form 33

Please note:
1. Throughout the document, for the sake of brevity, ”Consideration of applicants for pre-
allocation to Foundation schools on the grounds of Special Circumstances” has
frequently been shortened to “Special Circumstances”.
2. All non-UK medical school students/graduates, and UK medical school graduates that
have a date of qualification prior to 03 August 2009, will make their application via the
UKFPO. For these applicants, all references to “local panels” should be read as “the
UKFPO panel”.
1. General principles

1.1 Medical students who wish to remain in a geographical area for specific family,
caring or health reasons to undertake their F1 training can apply to their medical
school to be considered for pre-allocation to a specific foundation school on the
grounds of special circumstances.

1.2 Medical schools may also nominate students with educational special
circumstances for pre-allocation to their local foundation school.

1.3 Each medical school will convene a local panel to consider applications from its
undergraduate students.

1.4 Approved special circumstances will result in applicants being pre-allocated to a

specific foundation school for their F1 training, provided that their score is
sufficient to meet the national allocation criteria.

1.5 Approval of a special circumstances application does not guarantee a specific

programme within the foundation school.

1.6 All applicants must adhere to the rules of the national recruitment process. This
means that they must still complete and submit an application, which will be
scored. Applicants will have to score highly enough to meet the national
allocation criteria. This score will also be used as part of the process of matching
to programme.

1.7 All applicants must adhere to the rules of the national recruitment process. This
means that they must still complete and submit an application, which will be
scored. Applicants must still achieve the optimum score for their application as
they will have to score highly enough to meet the national allocation criteria. This
score may also be used for pre-placement to programmes. If there is over
subscription to the Foundation Programme then the management of special
circumstances applicants will be in accordance with the contingency plan in place
that year.

1.8 This is a UK-wide process and is linked to the national online recruitment system
for allocation to foundation schools. It is run under the governance of the Medical
Schools Council (MSC) in collaboration with the UK Foundation Programme Office
(UKFPO).

1.9 For those who qualified prior to August 2009, and those who are not graduates
from UK medical schools, the process will be essentially the same, but managed
via the UKFPO.

1.10 MSC will review the process annually, using a review tool, to inform discussions
about any changes for future years.
(Appendix K: Review tool)

1.11 An applicant pre-allocated to a foundation school on the grounds of special

circumstances will not be permitted to link their application to another individual in the
recruitment process.

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1.12 An appropriately completed Transfer of Information (TOI) form is mandatory for
all applicants for special circumstances. The TOI form must be completed and
returned with the special circumstances application form.
(Appendix L: Transfer of Information form)

2. The criteria
In order to be considered for pre-allocation to a foundation school on the grounds of
special circumstances, applicants must meet one or more of the following criteria:

2.1 Criterion 1: The applicant is a parent or legal guardian with significant

caring responsibilities for a child or children under the age of 18. This would
normally mean the child(ren) residing primarily with the applicant.

2.1.1 It is expected that the child(ren) of applicants in this category will remain in their
present residence and application for pre-allocation will be to the foundation
school local to that address.

2.1.2 It is also expected that the postal address of the applicant will be in appropriate
proximity to the foundation training offered by the school.

2.1.3 If the applicant and the child(ren) do not normally reside together, this should be
referred to on the application form, and information supplied as to why the caring
responsibilities remain equally significant.

Supporting evidence required (mandatory for all applicants):

• Copy of birth certificate(s) of child(ren)

• Statement confirming that the applicant has significant caring

responsibilities for the child(ren) . (Appendix C: Criterion 1: Statement
confirming parental responsibility)

Please note: This criterion is based on childcare responsibility current at the time of the
application. Pregnancy is not part of this criterion.
An applicant whose sole criterion is that she - or his partner - is currently pregnant will
not be regarded as eligible for special circumstances.

2.2 Criterion 2: The applicant is the primary carer for someone who is
disabled (as defined by the Disability Discrimination Act 2005) (expected to
be a partner, sibling or parent).

2.2.1 If the person they are caring for is not their partner, sibling or parent, applicants
will be expected to explain clearly and put a strong case why they are taking on
the role of primary carer for this person.

2.2.2 It is also expected that the postal address of the applicant will be in appropriate
proximity to the foundation training offered by the school.

2.2.3 Normally, there will be an expectation that applicants will have acted as the
primary carer for this person during their time at medical school.

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2.2.4 Applicants will be required to complete a care plan to demonstrate how they will
combine the responsibilities of foundation doctor and primary carer and that local
support resources have been fully considered.

Supporting evidence required (mandatory for all applicants):

• Statement from GP/Social Services confirming the applicant’s role as
primary carer for this person (Appendix D: Criterion 2 : Statement confirming
applicant’s role as primary carer)
• Care plan (Appendix E: Criterion 2 : Guidelines for care plan)
Please note: Applicants who provide care for a person as part of a group of carers, e.g. a
family, are not eligible to apply under this criterion
2.3 Criterion 3 : The applicant has a medical condition (physical or
psychological) or disability for which local follow up is an absolute
requirement, as confirmed by a report from an Occupational Health
physician or an appropriate medical specialist.

2.3.1 It is expected that the postal address of the applicant will be in appropriate
proximity to the foundation training offered by the school.

Supporting evidence required (mandatory for all applicants):

• A report by an Occupational Health physician or medical specialist, in
which they will be required to
o describe the current medical condition (be it physical or
psychological) or disability
o describe the nature of the ongoing treatment and frequency of
follow up required
o state why the follow up must be delivered locally, rather than by
other treatment centres in the UK.
(Appendix F : Criterion 3 : Report by Occupational Health physician or medical
specialist)

3. Educational Special Circumstances

3.1 Medical schools will counsel students perceived to have particular educational
needs as to the best environment in which to undertake the F1 year.

3.2 Medical schools will similarly counsel students where there may be concerns
about their ability to adapt to the working environment.

3.3 The medical school may decide, with the student’s written agreement, to nominate
him/her for pre-allocation to the local foundation school.

3.4 A nomination form will be completed for such students by an appropriate member
of the medical school, signed by the student and ratified at the meeting of the
local panel.

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4. Panels
4.1 Local panels

4.1.1 Each medical school will convene a local panel which will consist of a minimum of
three people, at least one of whom must be a clinician, to consider applications
from its medical students.

4.2 National panel

4.2.1 The purpose of the national panel is to be a referral point when a local panel
cannot reach agreement and to adjudicate on appeals by unsuccessful applicants.

4.2.2 No national panel member will be allowed to consider an application s/he has
already considered as a local panel member.

4.2.3 The national panel will consider the appeal and inform both the applicant and the
local panel of it’s decision. The decision of the national panel is final.

5. Process for submission and consideration of applications

5.1 Details of the process, the criteria, and the relevant forms will be published on the
UKFPO website: www.foundationprogramme.nhs.uk.

5.2 Medical students who believe that they meet one of more of the criteria are
strongly advised to discuss their circumstances with their medical school before
completing the national special circumstances form. The purpose of this
discussion would be to help potential applicants be realistic and clarify for them
exactly what the panel would expect to see in the submitted documentation, in
order to be able to make an informed decision.
(Appendix B : Helping potential applicants be realistic)

5.3 Applicants must send their applications by post, rather than email, because of the
nature of the signed supporting documentation. Medical schools will advise its
local students of the address details for applications.

5.4 Applicants must submit their application form with the required supporting
documentation in accordance with the national timeline.

5.5 Medical students who are on elective at the time when applications are to be
submitted may make arrangements with their medical school to send their
application form by email and their supporting documents separately.

5.6 Those who qualified before August 2009 and those who are not graduates from
UK medical schools will be able to access similar support and information from
the UKFPO.

5.7 Applications must be complete and include all the required supporting
documentation. Applicants cannot submit further documentation at a later date
unless they have previously arranged with their medical school to do so. Panels
have been asked to be sympathetic about this with students who are on elective

5
 at the time of the application. It will be the decision of the panel whether late
documentation is accepted.

5.8 The local panel must decide if applicants adequately demonstrate that they meet
one of the criteria, and have provided the necessary supporting documentation.
Some applications may meet more than one of the criteria.

6. The local panel’s decision

6.1 After considering the application, the local panel will reach one of the following
decisions:
• the application is approved for pre-allocation to the specified foundation
school
• the panel refers the application to the national panel because a decision
could not be agreed
• the application is not approved.

6.2 The local panel will notify applicants of the outcome in line with the national
timeline.

6.3 If the local panel approves the application, a copy of the application form and
supporting documentation will be forwarded to the receiving foundation school
where the applicant will be pre-allocated, provided his/her online application
scores sufficiently highly to meet the national allocation criteria.

6.4 If the local panel cannot reach an agreement on an application, the applicant will
be notified that their application is to be referred to the national panel, and told the
reason(s) for this decision. The applicant must be advised of the opportunity to
submit additional information, clarifying the points raised by the local panel. The
panel will advise the applicant of the date by which the additional information must
be submitted. In all cases, any additional information from the applicant is to be
sent to the Administrator of the local panel.

6.5 If the local panel does not approve an application, the applicant will be notified of
the reason(s) why the application was not approved. The panel will advise the
applicant of the appeals process and the date by which an appeal must be
submitted.

6.6 If the panel disagree with the opinion of the medical professional in the supporting
documentation, whilst assessing an application using criterion 3, it is the
responsibility of the panel to discuss and clarify the reasons with that professional
and record the reasons for their decision. This information should be shared with
the applicant and, if there is an appeal, on the appeal documentation be
considered by the Appeals Panel.

6.7 Applicants in 6.5 and 6.6 above will be advised that appeal forms, and/or
additional information, should be sent in the first instance to the local panel, so
that they can be attached to the original application. This will then be forwarded
to the national panel for consideration.

6.8 The national panel will consider the referral/appeal and inform both the applicant
and the local panel of its decision. The decision of the national panel is final.

6
6.9 Approval of an application for pre-allocation on the grounds of special
circumstances is pre-allocation to a foundation school, and does not guarantee a
specific programme within a foundation school. However, pre-matching to a
specific programme or geographical area can be recommended to the receiving
foundation school by the panel considering the request. The final decision on this
will rest with the receiving foundation school.

7. When special circumstances arise after the closing date for

applications

7.1 The above process is geared to the consideration of existing special

circumstances, many of which may have been managed by the applicants through
their time at medical school. However, it is recognised that special
circumstances can arise at any time. Applicants whose circumstances change
after the closing date for submission of applications must contact the director of
the foundation school where they have been allocated, as soon as possible.

7.2 An application at this stage will be treated as an inter-school transfer, for which
there is a separate process. Details are available in the Key Documents section
of the UKFPO website: www.foundationprogramme.nhs.uk

7.3 However, it must be stressed that this is not a process for late applications. The
applicant will be required to clearly demonstrate how the circumstances have
arisen or changed significantly since the closing date for applications.

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 APPENDICES:
APPENDIX A: National timeline

Special Circumstances – August 2011 entry

30 September Deadline for submission of special circumstances applications

to the home medical school.
01 – 14 October Local panels meet to consider applications.
By 15 October Local panels notify applicants and the receiving foundation
school of panel decision and forward relevant documents.
18 – 25 October Appeals and additional docs for referrals are accepted by local
panels.
By 27 October Local panels advise national panel of appeals and referrals and
forward all documentation (including referred applications).
01 – 05 November National panel meets to consider referred applications and
appeals.
By 12 November National panel notifies applicants and local panels of their
decisions on referred applications and appeals.
By 17 November Local panels advise foundation schools of successful
referred/appeal applications and forward all documentation to
them.
By 18 November All approved applicants to have been flagged on the national
system for pre-allocation
08 December All applicants are notified of their allocations to foundation
schools.
From Consideration of any applications for special circumstances
08 December arising after 23 September by the allocated foundation school,
as an inter-school transfer.

APPENDIX B: Helping potential applicants be realistic

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FOR INFORMATION: this document has been sent to medical schools to discuss
with potential applicants

Criterion 1

1. Applicants with children will be familiar with combining the demands of

parenthood with managing a demanding full time course. In most cases they will
therefore have worked through the majority of issues related to child care that
they will face as Foundation 1 doctors.

2. Medical schools should discuss with applicants the differences between

being a student and a doctor. These will include less regular hours, shift patterns
and working nights.

3. Medical schools should discuss with applicants the longer term implications
of their care commitments. It needs to be pointed out that special circumstances
arrangements do not exist for specialty training, and that applicants should be
giving some thought to how they will manage in the longer term. There are many
sources of advice as the majority of doctors balance family and work
responsibilities.

4. Medical schools should discuss with applicants whether flexible training

would be an appropriate option.

5. Medical schools should explain that this criterion is related to childcare and
that pregnancy will not be considered under this criterion.

Criterion 2

1 Many applicants have aging and/or ill relatives to whom they give care,
and the demographics of the population nationally suggest that this is likely to
increase. For the purposes of this exercise, applicants must be counseled to
indicate clearly how they are the primary carer of the person being cared for, and
that all appropriate local resources are being utilised.

2 All applicants are required to indicate the extent/level/type, as well as the

frequency, of the caring role they provide. They are required to include a
structured care plan to indicate how they intend to balance the requirements of
their care commitment with the demands of a busy job, with varying shift patterns.

3 Applicants must demonstrate that they utilise or do not duplicate

alternative care services which are available, hospital based or community based.

9
For example, many people would wish to accompany a sick relative to an
important medical appointment and would expect to take annual leave to do so.
Interpreting or translating for a relative is not a reason for special circumstances.
Translators or interpreters can routinely be available for GP and hospital
appointments.

4 Medical schools should discuss with applicants the longer term

implications of their care commitments. It needs to be pointed out that special
circumstances arrangements do not exist for specialty training, and that applicants
should be considering whether their level of care commitment is realistic in the
longer term.

5 Medical schools should discuss with applicants whether flexible training

would be an appropriate option.

Criterion 3

1. Applicants with a medical condition (physical or psychological) or disability

will be familiar with combining the requirements of their condition with managing a
demanding full time course. However, there are significant differences between
being a student and a doctor. These will include less regular hours, shift patterns
and working nights.

2. Medical schools will no doubt have already discussed with applicants the
longer term implications of their condition in terms of their career. It needs to be
pointed out that special circumstances arrangements do not exist in the same way
for specialty training, and that applicants should be aware of the mechanisms
deaneries have for managing doctors with medical conditions and disabilities.
Early referral to an Occupation Health physician and/or the local deanery may be
advisable.

3. Medical schools should discuss with applicants whether flexible training

would be an appropriate option.

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APPENDIX C: Criterion 1: Statement confirming parental responsibility

Criterion 1 The applicant is a parent or legal guardian with significant caring

responsibilities for a child or children under the age of 18. This would
normally mean the child(ren) is/are residing primarily with the
applicant.

As part of demonstrating that they have a significant caring responsibility for a child or
children under the age of 18, applicants must submit a completed and signed copy of the
accompanying statement.

The signatory must be someone who works in a recognised profession and be in a

position to confirm that the applicant has a significant caring responsibility for a child or
children under 18.

The signatory must:

• be over 18
• have known the applicant for at least two years
• not be related to the applicant by birth or marriage
• not be in a personal relationship with the applicant
• not live at the same address as the applicant

Suggestions about whom to approach

• Lawyer
• Councillor: local or county
• Doctor
• Dentist
• Teacher
• Justice of the Peace
• Nurse / Health Visitor (RGN and RMN)
• Police Officer
• Social worker

The statement should indicate the relationship of the individual supporting application to
the applicant, e.g. headteacher of the child(ren)’s school.

11
Statement Confirming Parental
Responsibility
In support of an application for pre-allocation to a foundation school
on the grounds of special circumstances
CRITERION 1

Please type or word process this form.

............................................................................................................................................

The applicant must include with his/her application this signed statement from someone
who works in a recognised profession. The signatory must have known the applicant for
at least two years, and be in a position to confirm that s/he has a significant caring
responsibility for a child or children under 18.

DETAILS of APPLICANT
First
Surname:
name:

Applicant’s
Address:
Postcode:

Age group: 22 - 25 26 - 30 over 30

Gender:

DETAILS of CHILD(REN)
Name of Child Date of Birth Age

Address of
Child(ren):
Postcode:

12
 DETAILS of SIGNATORY
First
Surname:
name:
Professional
status :

Address:

Postcode:

Phone number
for queries
Relationship to
applicant :
e.g. Headteacher of
school attended by
children
How long you
have known the Years Months
applicant?

DECLARATION

I, the undersigned, confirm that

• I am over 18 years old

• I am not related to the applicant by birth or marriage
• I am not in a personal relationship with the applicant nor live at the same address.

I further confirm that the applicant named above has a significant caring responsibility for
the child(ren) under 18 named above.
I am prepared to be contacted by the Medical School to discuss this information if
necessary.

Signature:

Name:

Date:

Applicants are advised to check that all sections have been completed, and then
attach this supporting evidence to their application form.

13
APPENDIX D: Criterion 2 : Statement confirming applicant’s role as a
primary carer

Criterion 2: The applicant is the primary carer for someone who is disabled (as
defined by the Disability Discrimination Act 2005) (expected to be a
partner, sibling or parent).

If applicants are the primary carer for someone who is disabled (see below for definition)
they are eligible to apply for pre-placement in the area where the person they are caring
for is living. In order to be fair both to those with significant caring responsibilities and all
other applicants, it is very important that such applications are verified as true.

On the accompanying form, applicants are asked to give details of the person they are
caring for and to obtain a signed declaration from the general practitioner or social worker
of the person being cared for, certifying that they are the primary carer of the person they
have named and the type and level of the care provided.

The general practitioner or social worker must:

• not be related to the applicant by birth or marriage

• not be in a personal relationship with the applicant
• not live at the same address as the applicant.

Definition of 'disability' under the Disability Discrimination Act (DDA) 2005

The Disability Discrimination Act (DDA) defines a disabled person as someone who has a
physical or mental impairment that has a substantial and long-term adverse effect on his
or her ability to carry out normal day-to-day activities.

For the purposes of the Act:

* substantial means neither minor nor trivial

* long term means that the effect of the impairment has lasted or is likely to last for
at least 12 months (there are special rules covering recurring or fluctuating
conditions)
* normal day-to-day activities include everyday things like eating, washing, walking
and going shopping
* a normal day-to-day activity must affect one of the 'capacities' listed in the Act
which include mobility, manual dexterity, speech, hearing, seeing and memory

Some conditions, such as a tendency to set fires and hay fever, are specifically excluded.

People who have had a disability in the past that meets this definition are also covered by
the scope of the Act. There are additional provisions relating to people with progressive
conditions.

The DDA 2005 amended the definition of disability. It ensured that people with HIV,
cancer and multiple sclerosis are deemed to be covered by the DDA effectively from the
point of diagnosis, rather than from the point when the condition has some adverse effect
on their ability to carry out normal day-to-day activities.

14
Statement confirming
applicant’s role as a primary
carer
In support of an application for pre-allocation to a foundation school
on the grounds of Special Circumstances
CRITERION 2

Please type or word process this form.

............................................................................................................................................

When a medical student completes his/her training s/he will start work as a Foundation
year 1 doctor (F1). This used to be known as the Pre-registration House Officer year.
Students have to apply to a national system to be considered for F1 jobs and are
allocated to a particular area of the country and a particular programme of posts. If a
student is the primary carer for someone who is disabled (as defined by the Disability
Discrimination Act 2005) s/he is eligible to apply for pre-allocation in the area where the
person they are caring for is living. In order to be fair both to those with significant caring
responsibilities and all other applicants it is very important that applications are verified.

The applicant whose details are below is applying for consideration for pre-allocation to a
foundation school to undertake his/her F1 medical training. S/he has asked for
consideration under Criterion 2:

The applicant is the primary carer for someone who is disabled (as defined by the
Disability Discrimination Act 2005) (expected to be a partner, sibling or parent).

To support his/her application s/he needs a declaration from the general practitioner or
social worker of the person for whom they care, to certify that they are the primary carer
of that person.

Please complete and sign the report in PART 2 of this form; and return it to the applicant.

PART 1 – For completion by applicant

DETAILS of APPLICANT
First
Surname:
name:

Applicant’s
Address:
Postcode:

Age group: 22 - 25 26 - 30 over 30

Gender:

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DETAILS of PERSON BEING CARED FOR
First
Surname:
name:

Address:

Postcode:

70 or
Age group: 0 - 18 19 - 29 30 - 39 40 - 49 50 - 59 60 - 69
over
Gender:
Relationship of
applicant to person
being cared for:

Does the person being cared for meet the

definition of disability as outlined in the Yes No
Disability Discrimination Act (2005)

16
PART 2 – For completion by the general practitioner or social worker of the person
being cared for by the applicant.

The panel does not require details of the disability of the person being cared for. Our
concern is to know that the applicant is the primary carer for that person. By primary
carer we mean the person who provides, or is responsible for the provision of, care, on a
daily basis. Applicants who are part of a group, e.g. a family, which provides care for a
person are not eligible to apply under the Special Circumstances provision.

As will be obvious, in signing to declare this to be true the panel is relying upon your
professional judgment and integrity.

How long you have

Years Months
known the applicant?

Does the person being cared for meet the

definition of disability as outlined in the Yes No
Disability Discrimination Act (2005)

CARE GIVEN
Please provide brief details of the type and level of care the applicant provides:

17
DECLARATION

I, the undersigned, confirm that

• I am over 18 years old

• I am not related to the applicant by birth or marriage
• I am not in a personal relationship with the applicant nor live at the same address.

I further confirm that information about the applicant named above is correct and I certify that
the applicant is the primary carer of the person named above who is my patient/client. As
such, I support the applicant’s request for consideration for pre-allocation to a foundation
school on the grounds of special circumstances, Criterion 2.

I am prepared to be contacted by the medical school to discuss this information if necessary.

Signature:

Name:

Date:

Professional status :
Address:

Postcode:

Phone number
For queries

Applicants are advised to check that all sections have been completed, and then
attach this completed form to their application.

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APPENDIX E: Criterion 2: Guidelines for Care Plan

Criterion 2 The applicant is the primary carer for someone who is disabled (as
defined by the Disability Discrimination Act 2005) (expected to be a
partner, sibling or parent).

As part of the process of applying for pre-allocation on the grounds of special

circumstances under Criterion 2, applicants must provide a care plan in support of their
application.

The purpose of this plan is twofold:

• Part 1: to confirm that the applicant is the primary carer for someone who is
disabled (see below for definition) and to outline the type and level of care
provided
• Part 2: to ensure that the applicant has given due consideration to the issues
which will face him/her in combining a demanding full time job and providing care

In completing this plan, applicants are reminded that panels do not need to know
confidential details of the medical condition of the person being cared for. What is
needed is an indication of the level of care that is being given by the applicant.
Applicants are advised to discuss their care plan with their medical school or UKFPO
before completing the accompanying form.

Definition of 'disability' under the Disability Discrimination Act (DDA) 2005

The Disability Discrimination Act (DDA) defines a disabled person as someone who has a
physical or mental impairment that has a substantial and long-term adverse effect on his
or her ability to carry out normal day-to-day activities.

For the purposes of the Act:

* substantial means neither minor nor trivial

* long term means that the effect of the impairment has lasted or is likely to last for
at least 12 months (there are special rules covering recurring or fluctuating
conditions)
* normal day-to-day activities include everyday things like eating, washing, walking
and going shopping
* a normal day-to-day activity must affect one of the 'capacities' listed in the Act
which include mobility, manual dexterity, speech, hearing, seeing and memory

Some conditions, such as a tendency to set fires and hay fever, are specifically excluded.

People who have had a disability in the past that meets this definition are also covered by
the scope of the Act. There are additional provisions relating to people with progressive
conditions.

The DDA 2005 amended the definition of disability. It ensured that people with HIV,
cancer and multiple sclerosis are deemed to be covered by the DDA effectively from the
point of diagnosis, rather than from the point when the condition has some adverse effect
on their ability to carry out normal day-to-day activities.

19
Care Plan
In support of an application for pre-allocation to a foundation school
on the grounds of special circumstances
Please type or word process this form
............................................................................................................................................

As part of the process of applying for pre-allocation on the grounds of special

circumstances under Criterion 2, applicants must provide a care plan in support of their
application.

The purpose of this plan is twofold:

• Part 1: to confirm that the applicant is the primary carer for someone who is
disabled in the terms of the Disability Discrimination Act (2005)and to outline the
type and level of care provided
• Part 2: to ensure that the applicant has given due consideration to the issues
which will face him/her in combining a demanding full time job and providing care

DETAILS of APPLICANT
First
Surname:
name:

Applicant’s
address:
Postcode:

DETAILS of PERSON CARED FOR

Name of person cared for:

Address:

Postcode:

Relationship of applicant to person being cared for:

Does the person being cared for meet the

definition of disability as outlined in the Yes No
Disability Discrimination Act (2005)

20
Outline the care provided, or what responsibility you take for the care provided. Please
indicate how much of your time this takes each day/week.

Could these responsibilities be taken by anyone else? If not, why not?

21
What other services does the person you care for utilise? e.g. social services, private
carers, translation/interpreter services, primary health care team. Have all local support
resources been fully considered?

What happened (or will happen) to the person you care for while you were (or will be) on
your elective? Who cared (or will care) for them during this time?

22
How do you plan to combine these responsibilities with a full time F1 post, which involves
irregular shifts, nights and weekends? (Foundation doctors cannot necessarily guarantee
to leave exactly at the end of their shift every day.)
Please provide as much detail as possible.
Continue on a maximum of one supplementary A4 sheet, if necessary.

What arrangements will you have in place for unexpected or planned periods when you
will be unavailable? What will happen, for example, if you have to do a week of nights, you
are unwell or you go on holiday?

23
DECLARATION

I confirm that:

• the information I have provided is correct and truthful

• I give my permission for all the information in this application to be shared with relevant
panels and the receiving foundation school
• I give my permission for information in this application to be used in anonymised form for
review and evaluation of the process and outcomes of foundation training.

Signature:

Name:

Date:

IMPORTANT

Applicants are reminded that panels do not need to know confidential details of the
medical condition of the person being cared for. What is needed is an indication of the
level of care that is being given by the applicant.

Applicants are advised to check that all sections have been completed, and then
attach this completed form to their application.

24
APPENDIX F: Criterion 3: Report by Occupational Health physician or
medical specialist

Criterion 3 : The applicant has a medical condition (physical or psychological) or

disability for which local follow up is an absolute requirement, as
confirmed by a report from an Occupational Health physician or an
appropriate medical specialist.

Definition of 'disability' under the Disability Discrimination Act (DDA) 2005

The Disability Discrimination Act (DDA) defines a disabled person as someone who has a
physical or mental impairment that has a substantial and long-term adverse effect on his
or her ability to carry out normal day-to-day activities.

For the purposes of the Act:

* substantial means neither minor nor trivial

* long term means that the effect of the impairment has lasted or is likely to last for
at least 12 months (there are special rules covering recurring or fluctuating
conditions)
* normal day-to-day activities include everyday things like eating, washing, walking
and going shopping
* a normal day-to-day activity must affect one of the 'capacities' listed in the Act
which include mobility, manual dexterity, speech, hearing, seeing and memory

Some conditions, such as a tendency to set fires and hay fever, are specifically excluded.

People who have had a disability in the past that meets this definition are also covered by
the scope of the Act. There are additional provisions relating to people with progressive
conditions.

The DDA 2005 amended the definition of disability. It ensured that people with HIV,
cancer and multiple sclerosis are deemed to be covered by the DDA effectively from the
point of diagnosis, rather than from the point when the condition has some adverse effect
on their ability to carry out normal day-to-day activities.

As part of demonstrating that they have a medical condition or disability requiring local
follow up, applicants must ask their Occupational Health physician or appropriate medical
specialist to complete and signed the relevant sections of the accompanying form.

25
Report by Occupational
Health physician or
medical specialist
In support of an application for pre-allocation to a foundation school
on the grounds of special circumstances
CRITERION 3
............................................................................................................................................

The applicant whose details are below is applying for consideration for pre-allocation to a
local foundation school to undertake his/her F1 medical training.

S/he has asked for consideration under Criterion 3:

The applicant has a medical condition (physical or psychological) or disability for

which local follow up is an absolute requirement, as confirmed by a report from an
Occupational Health physician or an appropriate medical specialist.

To support his/her application s/he needs a report by an Occupational Health physician or

medical specialist, in which they will be required to
o describe the current medical condition (be it physical or psychological) or
disability
o describe the nature of the ongoing treatment and frequency of follow up
required
o state why the follow up must be delivered locally, rather than by other
treatment centres in the UK

Please complete and sign the report in PART 2 of this form and return it to the applicant.

PART 1 – For completion by applicant

DETAILS of APPLICANT
First
Surname:
name:

Applicant’s
Address:
Postcode:

Age group: 22 - 25 26 - 30 over 30

Gender:

26
PART 2 – For completion by Occupational Health physician or medical specialist.

How long you have

known the Years Months
applicant?

MEDICAL CONDITION or DISABILITY

Please describe the current medical condition or disability

ONGOING TREATMENT
Please describe the nature of the ongoing treatment and frequency of follow up
required.

REQUIREMENT for LOCAL FOLLOW UP

Please indicate where the follow up will be delivered and why this must be
delivered locally, rather than by other treatment centres in the UK.

27
 DECLARATION

I, the undersigned, confirm that

• I am over 18 years old

• I am not related to the applicant by birth or marriage
• I am not in a personal relationship with the applicant nor live at the same address.

I further confirm that information about the applicant named above is correct and I
support the applicant in their application for consideration for pre-placement in a local
foundation school on the grounds of special circumstances, Criteria 3.

I am prepared to be contacted by the medical school to discuss this information if

necessary.

Signature:

Name :

Date

Professional status:

Address:

Postcode:

Phone number:
for queries

Applicants are advised to check that all sections have been completed, and then
attach this completed form to their application.

28
APPENDIX G: Appeal process

APPEAL PROCESS

Applicants whose applications for pre-allocation to a foundation school on the grounds of

their special circumstances are not approved by their local panel have the right of appeal.

The following will be recognised by the national panel as grounds for appeal:

a) that the local panel did not follow due process and this resulted in an error in
the assessment of special circumstances;

b) that an applicant had submitted evidence of special circumstances that was

not considered by the local panel.

If an applicant wishes to appeal against the decision by the local panel not to approve
his/her application, the appeal must be made on the accompanying national special
circumstances appeal form, explaining succinctly the grounds for the appeal.

If the local panel are unable to reach a decision on the application, it will be forwarded to
the national panel as an appeal. The applicant will be notified of this and the area(s) on
which the original panel could not agree. The applicant will be recommended to submit
an appeal form, which clarifies the area(s) on which the panel could not agree. The
appeal form will accompany the original documentation.

If any additional supporting evidence is enclosed with the appeal, it must be made clear
that the local panel did not see this evidence, and an explanation given as to why it was
not submitted to the local panel.

The completed form must be signed and submitted to the local panel by the date
indicated in the letter sent to the applicant, advising them that why his/her application had
not been approved, and of their right to appeal. This is for administrative purposes only,
as the local panel will then forward all the original documentation, plus the appeal form, to
the national panel.

The local panel will send the applicant an email within five working days to acknowledge
that they have received the appeal. Late appeals cannot be considered.

The appeals panel will consider the appeal and make its decision on the basis of any
investigations it considers reasonable, having regard to the statement within the appeal
and any supporting evidence provided by the applicant.

The privacy and confidentiality of the appellant will be respected, subject to the need for
an open and fair investigation and for the outcome of the investigation to be reported
appropriately. The intention is both to protect the appellant’s privacy and to protect those
involved with the appeal.

The applicant and local panel will be informed of the outcome of the appeal in line with
the national timeline.

The decision of the national panel is final.

29
Appeal Form
For appeal against local panel decision on application for pre-
allocation to a foundation school on the grounds of special
circumstances
............................................................................................................................................

Please type or word process this form.

APPLICANT DETAILS
First
Surname:
name:

Current address:
for correspondence

Postcode:
Mobile
Telephone number:
telephone:
Email:

Foundation school
requested:
Local panel which
considered but did not
approve original
application:

CRITERIA FOR APPEALS

Please tick below the criterion which you feel is relevant to your appeal.
You may wish to tick more than one:

• that the local panel did not follow due process and this resulted in an error in the
assessment of special circumstances;

• that I have submitted evidence of special circumstances that was not

considered by the local panel;

• that I have submitted clarification of areas indicated by the local panel, which
could not decide whether or not to approve my application.

30
APPLICANT’S EXPLANATION OF GROUNDS FOR APPEAL or SUPPLEMENTARY
INFORMATION ON AREAS INDICATED BY LOCAL PANEL
Please explain succinctly the grounds for your appeal or give any supplementary
information on the areas indicated by your local panel which could not decide whether to
approve your application. Continue on a separate sheet if necessary, but limit additional
sheet to one side of A4 paper.

31
DECLARATION

I confirm that:
• I have stated my grounds for appeal, which I wish the national panel to consider OR I
have given supplementary information on the areas indicated by the local panel.
• the information contained in my appeal and documentation is correct and truthful
• I understand that a copy of my original application and supporting documentation will
be forwarded to the national panel and considered in conjunction with my appeal
• I give my permission for all the information in this application to be shared with
relevant panels and the receiving foundation school
• I give my permission for information in this application to be used in anonymised form
for review and evaluation of the process and outcome of Foundation training.

I hereby formally submit my appeal against the local panel decision for my application for
consideration for pre-placement in the foundation school I have indicated on the grounds of
special circumstances.

Signature:

Name:

Date:

Submitting your APPEAL form

Please mark your envelope: Confidential: Special Circumstances APPEAL

If you are currently a student at a UK medical school:

You should submit the completed appeals form and any additional supporting documentation to
the address advised by your medical school.

If you qualified before August 2009 or if you are an applicant from a non-UK medical
school:

You should submit the completed appeals form and any additional supporting documentation to:
UK Foundation Programme Office, PO Box 478, Cardiff, CF11 1HG

32
 APPENDIX M: Transfer of Information form
Confidential Transfer of Information to Your Local Educator
Please complete the form below, which will be passed to the person responsible for your
foundation training (usually the Clinical Tutor or Foundation Training Programme Director) at
your employing Trust(s) at the start of your F1 training. The information will NOT be passed to
your Clinical Supervisor (usually the consultant you will be working for) or any other person
without your permission. The purpose of passing information to your local educator is to
ensure that he/she is aware of any particular support or help you may need during your F1
year. Forms should be typed or word processed.
Surname:

Other names:

Date of birth:
Where and in which year did you
commence your medical studies?
Additional degrees: give date of award,
course, and class of degree awarded
(if applicable)
Give date of your first entry into finals: Month: Year:
Was your course extended, or any
examinations postponed?
(Please give details and dates of any
periods of absence)
Have you been absent from your medical
course due to illness or other reasons?
(Please provide details of absences of
more than 2 weeks in duration only)

Have you been required to repeat any

medical school examinations or clinical
firms/attachments? (Please give details)
Please provide any further information you
feel will help your Foundation Training
Programme Director to support you in your
F1 year.

I confirm that the information I provided is

accurate. Yes / No *

I will allow this information to be passed to

my local educator, and understand a copy
will be retained by my foundation school.
Yes / No *

I agree that the information in this form

may be used for anonymised statistical
purposes. Yes / No * Signed:

(*please circle as appropriate) Date:

This form must be returned to: (DN: Insert the name of your local medical school office/registry here)

33
34