Additional Application Form Questions

This document lists the questions and possible answers for the additional application form questions provided by default to all organisations.

Question category / Question text / Answer type / Possible answers
General / Do you possess XXXX qualification or an equivalent? / Single select / Yes
No
General / Do you have relevant teaching or training experience (as required by the Person Specification)? / Single select / Yes
No
Not applicable
Nursing / Do you possess XXXX registration? / Single select / Yes
No
Nursing / Does the NMC require you to have a period of supervised practise or to undergo the Overseas Nurses Programme (ONP)? / Single select / No
Yes. 3 months supervised practise
Yes. 6 months supervised practise
Yes. ONP
Yes. ONP + 3 months supervised practise
Yes. ONP + 6 months supervised practise
I don't have NMC registration
Nursing / If you have a decision letter for NMC registration, please enter its date / Short free text / (Not applicable)
Nursing / When is your revalidation due? / Date picker / Date format: dd/mm/yyyy
Nursing / If applicable, please provide any additional comments regarding your revalidation. / Long free text / (Not applicable)
Medical / Please state your GMC registration status. / Single select / I have full registration with a licence to practise
I have full registration with a licence to practise and an approved practise setting (APS) restriction
I have provisional registration with a licence to practise
I am fully registered with a licence to practise and on the Specialist Register
I am fully registered with a licence to practise and on the GP Register
I have passed PLAB2
I need to pass PLAB2 before applying for registration
I have applied for registration
I have not yet applied for registration
I have (provisional/full/full and GP/full and specialist) registration only (I do not have a licence to practise)
Medical / Please state your specialty. / Short free text / (Not applicable)
Medical / Have you completed research work relevant to this post? / Single select / Yes
No
Not relevant
Medical / Please state who is your current responsible officer / Short free text / (Not applicable)
Medical / Please state the date of your last revalidation / Short free text / (Not applicable)
Medical / Please state the date of your last appraisal / Short free text / (Not applicable)
Medical / Are you currently on the General Medical Council’s Specialist Register, or an SpR due to obtain a relevant CCT/CESR(CP) within 6 months of interview? / Single select / Yes
No
Medical / Please confirm your anticipated CCT/CESR(CP) date / Short free text / (Not applicable)
Medical / Are you currently on the General Medical Council’s GP Register, or a GP Registrar within 3 months of anticipated CCT/CEGPR (or equivalent) at the time of interview? / Single select / Yes
No
Medical / Are you included on this employer’s Regional Performers List, or do you have an expectation for inclusion within 3 months of the date of interview? / Single select / Yes
No
Medical / Please confirm where your Performers List is currently held / Short free text / (Not applicable)
Medical / Do you have current Section 12 (Mental Health Act England and Wales) Approval for working in this NHS region? / Single select / Yes
No
Medical / Are you currently registered in this employer’s region as a ‘Responsible Clinician’? / Single select / Yes
No
Medical / Have your Foundation Programme 1 competencies been formally signed off? / Single select / Yes
No
Medical / Have your Foundation Programme 2 competencies been formally signed off? / Single select / Yes
No
Medical / If you have not completed Foundation Training, please provide an explanation below, e.g. “Equivalent competency formally recognised by Deanery” (evidence of this will be required). / Short free text / (Not applicable)
Psychologists / What grade of Psychology degree do you hold? / Single select / First
Upper Second
Lower Second
Other
Allied Health Professionals / Healthcare Scientists / Are you registered with the HCPC? / Single select / Yes
No
No - I need up to 3 months adaption
No - I need 3-6 months adaption
No - I need 6-12 months adaption
No - I need more than 12 months adaption
Allied Health Professionals / Healthcare Scientists / Do you hold a relevant degree or graduate diploma as required by the Person Specification? / Single select / Yes
No
Not applicable
Dental / Please state your GDC registration status. / Single select / I have full registration
I have temporary registration
I am not registered but have passed ORE parts 1 and 2
I am not registered but have passed ORE part 1
I need to pass all parts of ORE before I can register
I am not registered but I am an EEA dental graduate
Dental / Please select your Royal College. / Single select / The Royal College of Anaesthetists
The Royal College of General Practitioners
The Royal College of Obstetricians and Gynaecologists
The Royal College of Ophthalmologists
The Royal College of Paediatrics and Child Health
The Royal College of Pathologists
The Royal College of Physicians and Surgeons of Glasgow
The Royal College of Physicians of Edinburgh
The Royal College of Physicians of London
The Royal College of Psychiatrists
The Royal College of Radiologists
The Royal College of Surgeons of Edinburgh
The Royal College of Surgeons of England
Faculty of Public Health
Faculty of Pharmaceutical Medicine
Faculty of Occupational Medicine
College of Emergency Medicine
Royal College of Physicians of Ireland
Faculty of Dental Surgery
Royal College of Surgeons in Ireland
Dental / Please select your Royal College membership status. / Single select / Fellow
Member
Associate
Affiliate
Junior
Full
Other
Dental / Are you currently on the General Dental Council’s Specialist Register, or an SpR due to obtain a relevant CCT/CESR(CP) within 6 months of interview? / Single select / Yes
No
Dental / Please confirm your anticipated CCT/CESR(CP) date / Short free text / (Not applicable)
Dental / Have you had an IMER update in the past 5 years?
/ Single select / Yes
No
Fitness to Practise / Are you currently subject to a fitness to practise investigation and/or proceedings by a regulatory or licensing body in the United Kingdom, or in any other country? / Single select / Yes
No
Fitness to Practise / IfYES, please include the reasons given for the investigation and, where applicable, the details of any proceedings, limitations or restrictions that currently apply to your professional registration, and the name and address of the licensing or regulatory body concerned.
Please include any additional information, or other supplementary comments that you believe to be relevant. / Long free text / (Not applicable)
Fitness to Practise / Have you ever been removed from the register, or have conditions or sanctions been placed on your registration, or have you been issued with a warning by a regulatory or licensing body in the UK or in any other country?
You should selectNO where any right to appeal has been upheld and where that appeal has resulted in your case being fully exonerated. / Single select / Yes
No
Fitness to Practise / If YES, please provide details of any conditions or sanctions (including limitations, suspension or any other restrictions) that apply to your registration and/or any warnings issued, where relevant, and the name and address of the regulatory or licensing body concerned.
Please include any additional information or evidence that you believe to be relevant. / Long free text / (Not applicable)
Fitness to Practise / In your current or any previous employment, have you had restrictions placed on your clinical practise as part of the revalidation process? / Single select / Yes
No
Fitness to Practise / If applicable, please provide details of any restrictions you may have. / Long free text / (Not applicable)
Driving / Do you have access to a vehicle which can be used for work purposes? / Single select / Yes
No
Driving / Do you have a valid driving licence for the UK? / Single select / Yes
No
Driving / Please specify the vehicle categories for which you hold a licence: / Multiple select / Motorbike (A)
Car (B)
Car with Trailer (B+E)
Medium Sized Vehicle (C1)
Medium Sized Vehicle (C1+E)
Minibus (D1)
Minibus with Trailer (D1+E)
Large Goods Vehicle (C)
Large Goods Vehicle with Trailer (C+E)
Passenger Carrying Vehicle (D)
Passenger Carrying Vehicle (D+E)
C1 Provisional Licence
Driving / How many penalty points do you currently have on your driving licence? / Single select / 0
1-3
4-6
7-9
10-12
Driving / If you have penalty points, please state the Endorsement Offence Codes and the date of issue / Short free text / (Not applicable)
Welsh Language / Can you speak and understand spoken Welsh? / Single select / Yes
No
Welsh Language / Please select the level that best fits your ability to speak and understand spoken Welsh (see appendix for explanation of levels): / Single select although uses radio buttons / Level 0
Level 1
Level 2
Level 3
Level 4
Level 5
Welsh Language / Can you read Welsh? / Single select / Yes
No
Welsh Language / Please select the level that best fits your ability to read Welsh (see appendix for explanation of levels): / Single select although uses radio buttons / Level 0
Level 1
Level 2
Level 3
Level 4
Level 5
Welsh Language / Can you write in Welsh? / Single select / Yes
No
Welsh Language / Please select the level that best fits your ability to write in Welsh (see appendix for explanation of levels): / Single select although uses radio buttons / Level 0
Level 1
Level 2
Level 3
Level 4
Level 5
Internal Vacancies / Are you currently employed by the Employer advertising this vacancy? / Single select / Yes/No
Internal Vacancies / Which organisation are you currently employed by? / Short Free text / (Not applicable)
Internal Vacancies / What is your current position title? / Short Free text / (Not applicable)
Internal Vacancies / Which is your current department? / Short Free text / (Not applicable)
Internal Vacancies / Who is your current manager? / Short Free text / (Not applicable)
Safeguarding / Are you currently bound over, or have you ever been convicted of any offence by a Court or Court-Martial in the United Kingdom or in any other country?
You should selectNO if any convictions are protected (or filtered out) by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) 2013.
Please refer to further information about protected and spent convictions and cautions in the ‘Application form Help - criminal background’ section. / Single select / Yes
No
Safeguarding / If YES, please provide details of the order binding you over and/or the nature of the offence, penalty, sentence or order of the Court, the date and place of the Court hearing.
You are not required to tell us about parking offences.
Please include any additional information or evidence that you believe to be relevant. / Long free text / (Not applicable)
Safeguarding / Are you currently bound by any barring decision made by the Disclosure Barring Service (DBS) from working with children? / Single select / Yes
No
Safeguarding / Are you currently bound by any barring decision made by the Disclosure Barring Service (DBS) from working with adults? / Single select / Yes
No
Safeguarding / Have you ever received a police caution, reprimand or final warning in the United Kingdom or in any other country?
You should selectNO if any cautions, reprimands or final warnings are protected (or filtered out) by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) 2013.
Please refer to further information about protected and spent convictions and cautions in the ‘Application form Help - criminal background’ section. / Single select / Yes
No
Safeguarding / If YES, please provide details of the caution, reprimand or final warning, including the date and reason administered.
You are not required to tell us about parking offences.
Please include any additional information or evidence that you believe to be relevant. / Long free text / (Not applicable)

Appendix: Explanation of Welsh Language Levels

LISTENING / SPEAKING

For the question “Please select the level that best fits your ability to speak and understand spoken Welsh”, the levels are as follows:

Level
0 /
  • I cannot understand or speak any Welsh

1 / I can:
  • Pronounce Welsh words, people’s names, place names etc.
  • Greet and understand a greeting
  • Understand and use basic everyday words and phrases e.g. thank you, please, excuse me, may I speak to… etc.

2 / I can:
  • Understand the gist of Welsh conversations in work
  • Understand, ask and respond to simple job related requests, questions and instructions
  • Express opinions in a limited way as long as the topic is familiar

3 / I can:
  • Understand much of what is said in the workplace
  • Keep up a simple conversation or answer simple questions on a work related topic but may need to revert to English to discuss complex or technical issues
  • Offer advice on simple job-related matters

4 / I can:
  • Keep up an extended casual work related conversation
  • Give a presentation with a good degree of fluency but may need to revert to English to answer unpredictable questions or explain complex points.

5 / I can:
  • Advise on/talk about routine, non-routine, complex, contentious or sensitive issues related to own experiences
  • Give a presentation/demonstration and deal confidently with hostile or unpredictable questions

READING

For the question “Please select the level that best fits your ability to read Welsh”, the levels are as follows:

Level
0 /
  • I cannot read or understand Welsh

1 / I can:
  • Understand simple key words and sentences on familiar/predictable matters relating to my own job area, e.g. on signs, in letters

2 / I can:
  • Understand factual, routine information and the gist of non-routine information on familiar matters related to my own job area, e.g. in standard letters, leaflets etc.

3 /
  • Scan texts for relevant information
  • Understand a fair range of job-related routine and non-routine correspondence, factual literature, etc. when standard language is used

4 / I can:
  • Read and understand information fairly quickly as long as no unusual vocabulary is used and no particular complex or technical information is involved

5 / I can:
  • Understand complex ideas and information expressed in complex or specialist language in documents, reports, correspondence and articles etc.

WRITING

For the question “Please select the level that best fits your ability to write in Welsh”, the levels are as follows:

Level
0 /
  • I cannot write in Welsh

1 / I can:
  • Fill in simple forms, note down simple information, e.g. Welsh name, address, date etc.

2 / I can:
  • Write short simple notes/letters/messages on a limited range of predictable topics related to my personal experiences or my own job area

3 / I can:
  • Write a detailed/descriptive letter relating to my own job area, but will need to have it checked by a Welsh speaker
  • Make reasonably accurate notes while someone is talking

4 / I can:
  • Prepare formal letters of many familiar types such as an enquiry, complaint, request and application
  • Take reasonably accurate notes in meetings or straightforward dictation
  • Write a report/document relating to my own job area but will need to have it checked by a Welsh speaker

5 / I can:
  • Write letters on any subject
  • Write full/accurate notes of meetings while continuing to follow discussions and participate in them
  • Write reports/documents with confidence but they may need to be checked for minor errors in terms of spelling and grammar.

September 20171 Version 2