The CAA can only issue EASA licences.
The CAA can issue EASA licences in accordance with Part FCL and National Licences in accordance with the ANO(2016) Schedule 8. If you hold a Medical Declaration you may exercise the privileges of a UK PPL as per Schedule 8:
(5) The holder of a licence who does not have a medical certificate and relies on satisfying the requirements of paragraph (3) may only exercise the privileges of the licence—
(a) in an aircraft with a maximum take-off mass of 5,700kg or less;
(b) with not more than three passengers on board;
(c) by day or when exercising the privileges of a night rating;
(d) in visual meteorological conditions or when exercising the privileges of an instrument meteorological conditions rating; and
(e) within the United Kingdom unless the holder has the permission of the competent authority for the airspace in which the aircraft is being flown.
There do not appear to be any "National" Forms!