Martin David JACKSON

01. To notify the GMC within seven calendar days of signing these undertakings:

a of the details of my current post, including my job title, job location and responsible officer (or their nominated deputy) information

b of the contact details for my employer and/or contracting body, including my direct line manager

c of any organisation where I have practising privileges and/or admitting rights

d of any training programmes I am in

e of the organisation on whose medical performers list I am included.

f of the contact details of any locum agency I am registered with

Glossary V12

02. To notify the GMC:

a of any post I accept, before starting it

b if any formal disciplinary proceedings against me are started by my employer and/or contracting body, within seven calendar days of being formally notified of such proceedings

c if I apply for a post outside the UK.

Glossary V12

03. To allow the GMC to exchange information with any person involved in monitoring my compliance with my undertakings.

Glossary V12

04. a To have a workplace reporter approved by my responsible officer (or their nominated deputy) and to inform the GMC of these arrangements.

b Not to start/restart work until my responsible officer (or their nominated deputy) has approved my workplace reporter and this approval has been forwarded to the GMC.

Glossary V12

05. a To design a personal development plan (PDP), approved by my responsible officer (or their nominated deputy), with specific aims to address the deficiencies in the following areas of my practice.

• Obtaining adequate patient history

• Performing adequate examinations

• Making adequate records

• Arranging adequate follow up

• Issuing appropriate prescriptions

• Making appropriate referrals]

b To give the GMC a copy of my approved PDP within three months of the date I agree these undertakings.

c To give the GMC a copy of my approved PDP on request.

d To meet with my responsible officer (or their nominated deputy), as required, to discuss my achievements against the aims of my PDP.

Glossary V12

06. a To have an educational supervisor approved by my responsible officer (or their nominated deputy) and to inform the GMC of these arrangements.

b Not to start/restart work until my responsible officer (or their nominated deputy) has approved my educational supervisor and this approval has been forwarded to the GMC.

Glossary V12

07. To undertake an assessment of my performance, on a date given by the GMC, unless notified by the GMC that this assessment is not necessary.

Glossary V12

08. To inform the following persons of the undertakings listed at 1 to 7:

a my employer and/or contracting body

b my responsible officer (or their nominated deputy)

c my immediate line manager at my place of work, at least 24 hours before starting work (for current and new posts, including locum posts)

d any prospective employer and/or contracting body, at the time of application

e the responsible officer of any organisation where I have, or have applied for, practising privileges and/or admitting rights, at the time of application

f any locum agency or out-of-hours service I am registered with

g the organisation on whose medical performers list I am included or seeking to be included, at the time of application

h my regional section 12 approval panel

Glossary V12

09. To allow the GMC to disclose the above undertakings to any person requesting information about my registration status.

Glossary V12