1

Disability or ill health

This may include ongoing medical procedures such as fertility treatment.

• If you are requesting LTFT for health reasons, we require a copy of an Occupational Health or other medical report supporting the application

The letter should be dated within the past 3 months. - TBC

2

Caring responsibilities

Trainees (men and women) with caring responsibilities (e.g. for children, or for an ill/disabled partner, relative or other dependant)

1. If your reason for this request is responsibility for existing children, you will need to send a copy of their birth certificate(s)

2. If you are still on or about to go on maternity leave, confirmation of your eligibility under this criterion will be subject to receipt of the birth certificate when this is available

3. (No need to continue to re-apply upon each period of maternity leave, eligibility is automatic until their youngest child is 18 years old - TBC

4. If you are applying because you are directly caring for an ill/disabled partner, relative or other dependent we require a copy of a medical report confirming the needs of your dependents and that you are directly responsible for their care

3

Welfare and wellbeing

There may be reasons not directly related to disability or ill health where trainees may benefit from a reduced working pattern. This could have a beneficial effect on their health and wellbeing (e.g. reducing potential burnout).

Applications relating to personal choice and/or individual professional or lifestyle needs will be considered by the TPD. Whilst these applications are not subject to judgement, agreement is dependent upon service considerations.

4

Religious commitment

A trainee has a religious commitment that involves training for a particular role and requires a specific time commitment resulting in the need to work less than full time.

None - reason specified on the form

5

Unique Opportunities

A trainee is offered a unique opportunity for their own personal/professional development, and this will affect their ability to train full time (e.g. training for national/international sporting events, or a short-term extraordinary responsibility such as membership of a national committee or continuing medical research as a bridge to progression in integrated academic training).

None - reason specified on the form

6

Non-medical development

A trainee is offered non-medical professional development (e.g. management courses, law courses or fine arts courses) that requires a specific time commitment resulting in the need to work less than full time

None - reason specified on the form

7

Flexibility for training and career development

Flexibility for training and career development with the option to train less than full time with flexibility that might enable development of a broad career portfolio

None - reason specified on the form

1

Revised CCT end date is asked on the form, however, there are no Local Office resources available to support the trainee apart from the Royal Colleges guidance and calculator. This has to be manually verified before inputting to TIS.

2

Once approved, does it remain for the duration of the programme or until trainee decides to make a change by submitting an application? Until end of prog. Or new request to change. Sometimes it doesn’t get fed down. Which can have implication on their pay if the % is not reflected without paperwork.

3

There is no SLA published to trainee on expectation of dates on outcomes of applications

4

Applications applied too early are rejected and trainees asked to re-apply within application window. E.g. If a child is not born yet and an application is made on the basis of childcare, they are rejected and asked to apply after child birth.

5

Calculation of CCT for GP is done by the GP team Royal Colleges whereas in Specialty they are done by the admins team at ARCP. The reason GP moved to Royal Colleges was because of the amount of errors in calculating the data.

6

TV uses Local and National spreadsheets in order to support the processing of applications. Currently a Local and a National spreadsheet that have to be completed manually. This is an admin burden and prone-to-error practice.

7

TV has documented process with Trainee, Associate Dean and Postgraduate Dean involved in an appeal process, however, in practice no rejection insofar has reached to this stage following rejection.

8

The form is a WORD Doc and can be filled in manually or by using a Computer. It is an prone to miss filling in required information. It can also be time-consuming having to print, manually fill, scan and send to NHSE TV.

1

Discussion/Pre-approval Stage

What's your involvement in the Less Than Full Time application process?

• Trainees first point of contact for LTFT

• Sending of the plan (extracted from S/S) to tutors and department to inform and ensure it can be accommodated

• Authorisation of the application following greenlight from Tutors and Rota coordinator

13/12:

• Trainee speak to the TPD if they want to go LTFT through email

• TPD not sure of the process.

2

Discussion/Pre-approval Stage

Which specialties do you cover in regard to discussions with trainees on LTFT? (GP, Specialty, Medicine, Foundation, PH) (GP, Specialty, Medicine, Foundation, PH)

• Anaesthetics care & EM

13/12 Jon: TPD for Occupation Medicine. Covers TV&Wessex

3

Discussion/Pre-approval Stage

Do you get contacted by trainees who wish to change their LTFT arrangement, e.g. increasing or decreasing % WTE or returning FT?

• New starters

• Already in a programme

4

Discussion/Pre-approval Stage

Do you have any involvement in slot-sharing arrangements discussion and with who?

• Yes - spreadsheet

5

Discussion/Pre-approval Stage

Do you have any involvement in Supernumerary post arrangements discussion and with who?

• No, slot share mostly

6

Discussion/Pre-approval Stage

Do you have joint conversations with Head of School / Educational Supervisor on LTFT applications?

• Following discussion, plan sent to tutors for their consideration and greenlight to accommodate the plan

7

Discussion/Pre-approval Stage

At what point in the process do you have the discussion with the trust?

• Rota coordinator copied into email from TPD to obtain their greenlight to accommodate

8

Discussion/Pre-approval Stage

How do you receive the application form to complete and sign? Is it from the trainee by email? Or brought to the face-to-face meeting and completed by hand?

• Following discussion, trainee directed to the website to download form, fill in, sign, send to ES to complete their part and sign, then sent to TPD to have their part completed and signed/approved to be submitted to HEE to the Associate Dean.

9

Discussion/Pre-approval Stage

How do you come to a decision that the programme the trainee is on can be accommodated on an LTFT basis and the percentage WTE required to fulfil the requirements of the programme?

• Use spreadsheet to plan out what their trainees are doing

• Emailing info from S/S to tutors and the plan and getting their approval on whether they are happy with the arrangement

  • Training %, specialty, trainee name, Rota coordinators, summary of the slot sharing arrangement on the post - sent to tutors, rota managers

• Anaesthetics School website may have the spreadsheet in use in the background to interact with

• TPD approves it at the stage they get the greenlight back from the tutors, rota coordinators

• Health reasons applications are reviewed annually, although unsure how it is tracked

  • ES sign, TPD sign following review

  • TIS gets updated, trainee made aware via email

10

Processing/Approval

Once application has been approved by HEE / AD and trainee made aware, are you notified?

• Yes, notified of approval by AD

• TPD sometimes not knowing that the trainees have accepted their post

11

Processing/Approval

Once approved, do you get involved in the implementation of the LTFT, e.g. negotiation of Rota?

• Yes

• Discussion with the departments and rota coordinators

• Rota coord. then have to write the schedule for the LTFT

12

Processing/Rejection/Appeal

What's your involvement if an application is rejected by the AD? (re-classification of reason/criteria discussion with the trainee and meeting with HOS. e.g. Health and Disability)

• Not rejected any application from Anaesthetics/EM for wellbeing reasons at TPD pre-approval stage

• ACCS programme is difficult to accommodate LTFT, due to nature of programme

• If can’t make it work from a trainee perspective, more likely to push back on Cat 3 over category 1/2, for the only reason of not meeting programme requirements

• Try an offer a solution to the trainee mutually.

13

Processing/Rejection/Appeal

According to GMC Gold Guide we understand that "3.124 All well-founded reasons will be considered. However, support to progress the application may be dependent on the capacity of the programme and available resources as well as compliance with relevant legislation relating to CCT requirements (paragraphs 3.118 and 3.119)."

• How do you see this being implemented in practice to avoid any potential rejections?

• What factors contribute to rejection following initial discussion with yourself (TPD) with the trainee?

May not need to ask - See UR Question

• No involvement in the appeal

• Normally try and come to a solution