Less than Full Time Working Policy
|Less than full time training (LTFT) is the means by which doctors in training undertake their training when they are unable to work and train full time for “well-founded” reasons or to increase flexibility within Postgraduate Medical Education by allowing LTFT training for personal choice.
|The purpose of this policy is to clarify how the LTFT training scheme works, who is eligible to apply and the arrangements necessary to secure approval.
This policy applies to all doctors in training taking up appointments in Specialty Training or Foundation posts that are both educationally approved by Health Education England working across the South West and the General Medical Council (GMC) and applies to the following grades: -
|This policy is written to complement ‘A Reference Guide for Postgraduate Specialty Training in the UK’. It is recommended that doctors in training review the Gold Guide in addition to this policy.
All employees have a legal right to request flexible working – not just parents and carers. Therefore, all doctors in training can apply for LTFT training and section 3.123 of the Gold Guide provides a list of illustrative examples for requesting LTFT training:
Those applying due to a disability / ill health or caring responsibilities (1 and 2 above) will be accommodated.
Requests to train LTFT for other well-founded reasons will be dependant on the capacity of the programme and the effect the request may have on the training of other doctors on the training programme. It will therefore be subject to the agreement of the employer / host training organisation before the placement can commence.
Requests to work LTFT can either be made at point of application for entry into training or at any time they have been accepted into training.
Where a doctor in training no longer wishes or is no longer eligible to work on a LTFT basis, they will return to full time training when an appropriate placement becomes available. Until that time the doctor in training will continue to work on a less than full time basis.
Any doctor in training wishing to work LTFT must have obtained a post in open competition. All competitively appointed posts are offered on a full-time basis.
|The national medical postgraduate tariff is not applicable to LTFT doctors in training.
HEE will provide funding from the LTFT budget for:
*Note – supernumerary placements will be exceptional and subject to the agreement of the Postgraduate Dean.
|Statutory leave costs and out of hours enhancements are an employer funding responsibility.
|Less than full time training may be undertaken in one of three ways listed below.
|Slot-sharing works on the basis that two doctors in training occupy one full time post and manage the out of hours work between them.
|Whilst each doctor in training may work up to 80% WTE consideration must be given to the educational capacity within the department and the financial impact. The TPD or HoS should discuss with the Deputy Postgraduate Dean proposals to slot-share doctors in training at greater than 60% WTE.
|Flexibility will be required where specific working days are required by either or both parties. Typically, slot-sharers will work separate days of the week with overlap on one day or more.
|Opportunities for slot-sharing should be explored before any alternative arrangements are considered.
|Part Time in a Full Time Slot
|A doctor in training occupies an established full-time post but works reduced hours.
|As an established post no additional funding will be provided, however the employer may utilise any surplus funds to backfill any service gap.
|Supernumerary posts are those that are in addition to the usual complement of training posts in an employing Trust.
|This option may only be considered provided there is no detrimental effect on other doctors within the training programme.
|Supernumerary placements will only be considered in exceptional cases and with the agreement of the Postgraduate Dean.
|Doctors in training will normally be expected to move between posts within rotations on the same basis as a full-time doctor in training in the same specialty, to ensure they receive a coherent programme of training that is educationally comparable with full time doctors in training.
|Doctors in training on a programme that rotate through different specialties, such as the Foundation Training Programme, Internal Medicine Training, General Practice and Core Surgical Training may find their previously-planned rotations change to enable opportunities to slot-share within the programme.
|Doctors in training working LTFT may also find that their completion date for training may not correspond with August.
Less than full time training is counted exactly the same as full time work in all respects. The table below will assist in calculating the less than full time training required to meet the full-time equivalent quota for training where one applies.
For example, a doctor in training on a three-year full-time training programme working 60% whole time equivalent may take 60 months (five years) to complete, subject to satisfactory progression.
The table above should be used as a guide only. The duration of training for less than full time doctors will be determined in consultation with the Training Programme Director / Head of Foundation School.
|In line with the GMC position statement (2017) on less than full time training, doctors in training will be required to undertake no less than 50% full time training.
|Only where a doctor in training experiences exceptional difficulties may the Postgraduate Dean reduce the time requirement further. The absolute minimum is 20% of full-time training with the expectation that doctors in training should not take a placement at this level for more than 12 months.
|OUT OF HOURS WORK
|Day time working, on-call and out of hours duties will be undertaken on a pro-rata basis to that worked by full time doctors in training in the same grade and specialty.
|The only exceptions to this are circumstances for LTFT training which make this impossible, provided that legal and educational requirements are met.
|UNDERTAKING ‘OTHER WORK’ WHILST TRAINING LESS THAN FULL TIME
|Doctors in training on LTFT placements are not precluded from undertaking other work although they should ensure that in undertaking this work they practice according to the GMC’s good medical practice and that this does not impact negatively on their training.
|Where undertaking additional work within the remit of holding a licence to practice the doctor in training must utilise the annual submission of the Form R to ensure the Postgraduate Dean as their designated Responsible Officer is aware.
|The basic pay for doctors training less than full time is calculated in line with the Doctors and dentists in training terms and conditions (England) 2016 or 2002.
|Basic pay and pay enhancement queries should be directed to the employing Trust, usually via the Medical Staffing department.
|Less than full time doctors in training are expected to make appropriate personal arrangements to access fixed training days when they are not rostered to work. This will require flexibility on part of the doctor to ensure they have access to all of the educational components of the training programme equivalent to their full-time counterparts.
|Less than full time doctors in training should refer to the Study Leave guidelines for information on the allocation and application process.
|FREQUENCY OF ARCP
|Less than full time doctors will have an ARCP at points where decisions relating to progression in training are required and should be assessed not less than annually. There should be no more than a 15-month interval to facilitate Revalidation. Consequently, LTFT doctors in training will have more ARCPs than a full-time doctor in training.
|PERIOD OF GRACE
|The purpose of the period of grace is to provide Doctors in Training (excluding those in General Practice) time to secure a Consultant or other post following attainment of their CCT. Please refer to the POG policy for more information.
|The maximum duration of the period of grace is six months whether the doctor in training is full time or LTFT.
|Doctors in training may apply to act up as a consultant and credit that time towards a CCT. This will normally be for a period of three months or pro-rata for LTFT doctors in training. Please refer to the Acting Up as a Consultant Policy.
|INTER DEANERY TRANSFER
|Doctors in training accepted into the South West via an inter-deanery transfer who are already working LTFT will not have to re-establish eligibility.
|APPLICATION PROCESS AND NOTICE PERIOD
|For applications made for reasons other than disability, ill health or caring responsibilities, doctors in training must discuss any plans for LTFT training with their department lead and employing trust medical staffing department prior to submitting an application. Applications without support from a suitable signatory within the trust will not be approved. A list of trust signatories can be found on the LTFT Policy page of the deanery website. Applications must also have the support of the doctor's Training Programme Director.
|Doctors in training must give at least 16 weeks’ notice of their wish to train LTFT to allow sufficient time for the employing Trust to be notified and to discuss with the Training Programme Director for the purposes of rotation planning. If less notice is received the application will still be considered but the start date may be delayed.
|Requests to train LTFT received at short notice on health grounds will be agreed on a case-by-case basis.
|Where a doctor in training wishes to increase or decrease their whole time equivalent (WTE), they must make an application providing at least 16 weeks’ notice.
|An appeal is an opportunity to question a decision or complain about treatment which a doctor in training considers to be unfair. An appeal will allow all parties to have the case heard before an independent panel, and a decision to be reached on the facts that have been presented.
|Eligibility for Appeal
|Doctors in training refused access to the LTFT training scheme are eligible to appeal.
The appeals process should not be used for:
|Registering an Appeal
|Appeals should be submitted using the ‘Notification of Appeal’ available from the website.
|The Notification of Appeal form must be sent to email@example.com within 15 working days of the decision about which you are appealing being made.
|Process Following an Appeal Being Registered
|The doctor in training will be invited to attend an appeal hearing to be held within 15 working days of the submission of the appeal where possible.
|The doctor in training will be required to provide a Statement of Case which will need to be provided at least 5 working days before the hearing.
|The relevant Associate Dean / Head of School who refused access to less than full time training will also be required to provide a statement of case at least 5 working days before the hearing.
|Both parties will be given copies of each other’s statement of case.
The statement of case will allow the Postgraduate Dean (or nominated deputy) to study all written material and should include the following:
|The Appeal Panel
|The appeal will be heard by an independent appeals panel.
The appeals panel will comprise as follows: -
|The panel members will not have been involved in the original decision that gave rise to the appeal.
|How the Appeal is Carried Out
|The appeal will be a meeting between the panel, the relevant Associate Dean / Head of School and the doctor in training.
|The doctor in training, or representative, will be given the opportunity to put forward the reason for appeal.
|The relevant Associate Dean / Head of School will be given the opportunity to explain why the decision was made.
|Each side will have the opportunity to question the other on issues of fact.
|Decision of Appeal
|The decision of the panel, and the reasons for making that decision, will normally be announced at the end of the appeal; this decision will be confirmed in writing within 5 working days. If, for any reason, a decision cannot be made at that time, a further date may be arranged to hear any further evidence pertaining to the appeal.
|The decision of the panel is final.
Email address for trust approval of LTFT applications
Avon and Wiltshire Mental Health Partnership
Gloucestershire Health and Care
Non-GP requests must be discussed with the clinical or specialty tutor to gain support before forwarding to the DME for approval via firstname.lastname@example.org.
GP requests: email@example.com
Great Western Hospitals
North Bristol Trust
Northern Devon Healthcare NHS Trust
Public Health Trainees
Royal Cornwall Hospital
Royal Devon and Exeter
Royal United Hospitals Bath
Somerset NHS FT
Torbay and South Devon
University Hospitals Bristol and Weston
University Hospitals Plymouth
Yeovil District Hospital