Samir Niranjan PATEL

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

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

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

Glossary V12

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

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. • Assessment • Record keeping • Relationships with patients 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

a To have an educational supervisor approved by my responsible officer (or their nominated deputy) and to inform the GMC of these arrangements. b My educational supervisor must be independent from my place of employment. c 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

a To be supervised in all my posts by a clinical supervisor, as defined in the Glossary for undertakings and conditions. My clinical supervisor must be approved by my responsible officer (or their nominated deputy) and I must inform the GMC of these arrangements.

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

Glossary V12

To get the approval of my responsible officer (or their nominated deputy,)and to inform the GMC of the approved arrangements before working: a as a locum/in a fixed term contract b out-of-hours

Glossary V12

To share my performance assessment report 12 January 2017 with: 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 one working day 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 my workplace reporter and educational supervisor g of the organisation on whose medical performers list I am included or seeking to be included, at the time of application.

Glossary V12

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

To inform the following persons of the undertakings listed at 1 to 12 : 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.

Glossary V12

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

Glossary V12

1. To notify the GMC promptly of any post he accepts for which registration with the GMC is required and provide the GMC with the contact details of his employer and the NHS England Area Team on whose Medical Performers List he is included, or the local Health Board/Health & Social Care Board if employed in Scotland, Wales or Northern Ireland.

Glossary V10

2. At any time that he is providing medical services, which require him to be registered with the GMC, to agree to the appointment of a workplace reporter nominated by his employer, or contracting body, and approved by the GMC.

Glossary V10

3. To allow the GMC to exchange information with his employer, or any contracting body for which he provides medical services.

Glossary V10

4. To inform the GMC of any formal disciplinary proceedings taken against him, from the date of giving these undertakings.

Glossary V10

5. To inform the GMC if he applies for medical employment outside the UK.

Glossary V10

6. To work with a Director of General Practice Postgraduate Education, (or their nominated deputy), to formulate a Personal Development Plan, specifically designed to address the deficiencies in the following areas of his practice:

a. Assessment

b. Clinical Management

c. Record Keeping

Glossary V10

7. To forward a copy of his Personal Development Plan to the GMC within three months of the date on which he gives these undertakings.

Glossary V10

8. To meet with his Director of General Practice Postgraduate Education (or their nominated deputy), on a regular basis to discuss his progress towards achieving the aims set out in his Personal Development Plan. The frequency of the meetings is to be set by his Director of General Practice Postgraduate Education (or their nominated deputy).

Glossary V10

9. To allow the GMC to exchange information about the standard of his professional performance and his progress towards achieving the aims set out in his Personal Development Plan with the Director of General Practice Postgraduate Education, (or their nominated deputy), and any other person involved in his retraining and supervision.

Glossary V10

10. At any time that he is employed, or providing medical services, which require him to be registered with the GMC, to place himself and remain under the supervision of an educational supervisor, as agreed by the GMC. His employer/Director of General Practice Postgraduate Education (or their nominated deputy) will be asked to assist in identifying a possible supervisor.

Glossary V10

11. Not to work as a locum or undertake any out-of-hours work, unless approved by his educational supervisor, and with the prior agreement of the GMC.

Glossary V10

12. To disclose the Assessors’ Report of the assessment of his professional performance to:

a. Any current and prospective employers, (at the time of application)

b. The NHS England Area Team in whose Medical Performers List he is included (or seeking inclusion)

c. Any other individual involved in his retraining and supervision

Glossary V10

13. To undergo an assessment of his professional performance at a date specified by the GMC, unless notified by the GMC that this assessment is not necessary.

Glossary V10

14. To inform the following parties that his registration is subject to the undertakings listed at (1) to (13), above:

a. Any organisation or person employing or contracting with him to undertake medical work

b. Any locum agency or out-of-hours service he is registered with or applies to be registered with (at the time of application)

c. In the case of locum appointments, his immediate line manager at his place of work (at least 24 hours before starting work)

d. Any prospective employer or contracting body (at the time of application)

e. The NHS England Area Team in whose Medical Performers List he is included, or seeking inclusion (at the time of application), or the local Health Board/Health & Social Care Board if employed in Scotland, Wales or Northern Ireland

Glossary V10

15. To permit the GMC to disclose the above undertakings to any person requesting information about his registration status.

Glossary V10