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We recognise that there are challenges in managing the current Less than fulltime process manually. Below are some of the High-level issues identified: 

• There are some variations in the process between regional offices. 

• The current process is prone susceptible to error errors and creates extra imposes additional work for on internal HEE staff to manage.  

LTFT application is made where applications are submitted when full-time training is not practical for well-founded individual reasons. Trainees are required to submit complete an LTFT application form provided they have discussed with their Training Programme Director / Foundation School Manager / GP Scheme Director.  

To begin the process The process should be initiated no later than 3 months before the post’s commencement of the post to ensure that all the necessary approvals and funding arrangements are in place before they begin their the placement begins. The  The doctor in training should complete fill-out the relevant LTFT relevant application form and specify under which category they are applying under. This should normally typically be submitted along with any 4 relevant supporting documents (as required) to the Postgraduate Dean or nominated deputy, to ensure . This ensures that the local office receives the application with within at least 16 weeks’ notice. This timeline allows time for the processing of the application to be processed and providing Trust with at least 12 weeks’ notice to be given to the Trust weeks' notice before the commencement of the proposed changes to working pattern commence. As part of strategic objective we are set to digitalise forms and standardise LO process, hence we are carrying out this discovery. 

Problem Statement In order to improve access to LTFT opportunities as part of work giving doctors in training greater flexibility working lives. The current process across all HEE local offices are perceived inefficient processes and practices for

• How do we improve the management of LTFT across HEE

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• /NHSE LO and ensure quicker and efficient way to process each application

• How do we get all local offices to follow the same process for LTFT so that there is national/unified approach which helps PGDiT especially that IDT

• How do we improve the user experience for all PGDiT that interact with the LTFT process so they can access application, are informed of process/guidelines and can submit application without any issues

• How do we improve communication between HEE/NHSE LO and PGDiT during and after the application process so there is less chance of errors on forms and PGDiT feel supported

• How do we ensure when PGDiT WTE % changes, the trusts get enough notice to factor in pay run and contract changes.

• How do we share/verify with PGDiT impact the change to CCT date has on training so they are aware of the effect. i.e. on pay and on their training plan

• How can we speed up the approval process so there is less delays in submitting LTFT application and its done within the 3 months timeframe

• How do we share with PGDiT the status/stages of their applications so they are informed and don't feel the need to keep chasing HEE/NHE LO for update.

OBJECTIVE

By the end of the research,  

• There is currently no unified process, and we need to establish an agreed standard process across all local offices.   - This is also linked to the Business goal - Achieve national uniformity in managing programs and rotations, creating a seamless experience for every doctor, irrespective of region.

• We should have understood the current process (as is) from all users that interact with the current LTFT process.  

• We also want to pinpoint all the pain points that user (Internal HEE staff, PGDiT and TPD) experience.  

• We should have understood their user needs for the (to be) process. 

• We should have determined whether different specialties require distinct forms and processes.   

Assumptions

1. It is assume that there is a problem with the current LTFT application process, hence the problem statement and objectives lined up for research.

2. It is assume that achieving a standardised LTFT process across all regions and specialities might not be feasible due to varying local requirements, resource constraint and needs.

RESEARCH QUESTIONS (LoE)

NHSE Local Offices (Secondary) questions:-

1. What are key interactions between HEE staff and PGDiT?

2. What are the problems and challenges they are facing?

3. What is the tool they use to carry out the process?

4. Who is involved in the process end to end?

5. What are key phases/stages of the process?

6. What are the communication your are sending out and when? (see the templates)

7. How long do the current process take start to end?

NHSE local Admin, TPD questions (Secondary Users)(For review)

Section 1: Understanding the Current Process

1. What are the current steps involved in the LTFT application process in your regional office?

2. How are PGDiT’s informed about the LTFT opportunity, and what channels are used for the communication?

3. How are eligibility criteria and guidelines for LTFT application conveyed to the applicants?

4. What documentation is required from applicants, and how is it collected and processed?

5. What are the typical timelines for processing LTFT applications?

Section 2: Identifying Pain Points in the Current Process

1. Have there been any common issues or complaints raised by PGDiT’s in different region regarding LTFT application process?

2. Are there any bottlenecks or delay that frequently occur during the application process?

3. Are there any discrepancies in the application of LTFT guidelines among different offices?

4. What is the level of applicants satisfaction with the current process, and how is it measured?

Section 3: Addressing PGDiT Needs

1. What are primary needs and concerns expressed by PGDiT during LTFT application process?

2. Are there any specific support required for applicants with disabilities or specific circumstances?

3. Are there any additional resources or information that applicants commonly request during the process?

Section 4: Exploring Opportunities for Standardization

1. What aspects of the LTFT application process should be standardised across all regional offices?

2. Are there any best practices from all regional offices that could be adopted as part of a unified approach?

3. What are the potential challenges in achieving standardisation, how can they be addressed?

PGDiT (Primary Users) Questions (For review)

Section 1: Background and Motivation

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Could you please share your reasons for considering or applying for LTFT training? (e.g work-life balance, health reasons, caring for responsibilities)

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How did you gather information about LTFT opportunities and guidelines?

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How familiar were you with the LTFT application process before starting the application?

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LO)

Before receiving application, what is the role of Support from LO 

• Which department/s and roles of individual manage the LTFT process?

• Who/How do they interact with trainees?

• Who/How do they provide support to trainees who wish to apply for LTFT?

• What are the channels to apply for LTFT?

• Can you describe the relationship between NHSE and LTFT team?

Start of the Journey when LO receives Submission of LTFT

• Can you tell me how you receive the LTFT submission?

• What format do you receive it?

• Do you receive complete application forms?

• What happens if you receive incomplete form?

• What do you do with the form when you receive? Where do you store it?

• Have you experienced any challenges or frustrations when receiving submitted forms?

• What has worked well for you during the stage of receiving submitted forms?

Experience when reviewing the LTFT application.

• How do you verify completeness of the information received?

• Do you require any supporting info/evidence to be submitted together with their application?

• How do you contact the trainees if information/evidence is not received?

• Where applications have been submitted outside an application window or not enough notice given, how do you organise and prioritise applications submitted?

Experience when processing the LTFT application.

• Who/What is involved in getting approval for the LTFT application?

• How long does it take from application to receiving an outcome?

• Do you interact and inform the employing trust of the reduced hours?

• How do you contact them? And what do you share with employing trust?

Experience when approving the LTFT application.

• Who is involved to approve the LTFT application?

• How do you interact with individuals/dept for approval?

• Have you experienced any challenges or frustrations during this stage?

• Do any applications get rejected? If so, why do they get rejected? And how do you manage that?

Experience when communicating to trainee regarding LTFT application.

• What happens after the LTFT application is approved?

• How do you communicate the approval to trainees?

• What email do they use to contact trainee?

• What’s your experience in communicating with trainees?

• What do you communicate to the trainees? Do you include the change of CCT?

• Do trainees ever chase you for outcome of the applications? If yes, why do you think they chase you?

• What are the challenges and frustrations you have encountered when you inform trainees of application status?

LTFT processes and the link to posts and placement management

• What has to be done when a application is approved?

Experience how/where does the process/journey end?

(we need to determine end of process and cover anything we missed) 

Pre application  & Assessment stage 

• Describe how you would want the trainee to manage the pre-application stage

Prompt

1. If a trainee want to apply for LTFT is there a dedicated email address to contact before making any application?

3. Has any trainees contacted you about assessing the form and guidelines?

4. . If you are to improve this stage what would you want to improve about the pre-application.
   

5. Dedicated person managing the LTFT process within your Local Office?

6. Accessing LTFT Information by trainees

7. What Information about LTFT that is available to trainees before making application?

8. How is the information about LTFT communicated to trainees? Do your trainees and ES know where the information about LTFT are?

9. What are the channels to apply for LTFT in your region?

Submission Application Stage

What happens when a trainee submits an LTFT application?

Prompt
1. Has there any issues of a trainee submitting an application and you did not receive it?

1. When you receive the forms you do eligibility checks do you experience any issues carrying out the eligibility for LTFT?
   2. Quality Checks - what are the important checks for the form to pass trough the pre-application face

2. What format/channel LO receives the application?

3. What happens if you receive incomplete form? When chasing for further evidence for incomplete evidence, are you making the training aware of the time frame of the application window

4. What is categorised as a complete application?

5. Where do you store it?

6. Any challenges/frustrations when receiving submitted forms?

Processing of Application Stage/ Approval

Describe the steps involved in processing LTFT application for LTFT approval

Prompts

1. Who are the approvers for each speciality ? Do you email the relevant people to approve
   How do you communicate with those who approves.

2. Notifications- incomplete application, confirmation of approval

3. Communication : when you are communicating with the trainees about the outcome who do you copy in the mail or important to be aware of the outcome.

4. Status of application

6. CCT end date

7. CCT Calculator/calculation

8. Challenges and Frustrations

9. Where applications have been submitted outside an application window or not enough notice given, how do you organise and prioritise applications submitted?

Rejection and Appeal Stage

1. Do you track any application on pulse

2. On what ground can an LTFT application be rejected.

3. What is the appeal process of an LTFT application?
   
   Post Application Stage

4. Describe the process of post application.

5. Who need to be informed and how?
   
   Needs

6. What are your reporting requirements of LTFT and how would you like to access it

7. As a team what are your reporting requirements

PGDiT (Primary Users) Questions

Section 1: Start of the LTFT Journey 

1. Can you tell me what you remember about the LTFT process? ​

2. How did you receive the LTFT form?​

3. What stage of your training were you at? ​

4. How effective was the communication throughout the LTFT application process?What are your expectations and hopes regarding LTFT?​

5. Did you feel like you were given all the information need to complete the form?​

6. Were you given a deadline to complete the form? Did you feel the deadline was realistic?​

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Section 2: Current LTFT Application Process

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Could you describe the LTFT application process from beginning to the end?

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What challenges and frustrations (PGDiT) did you face during the LTFT application journey?

Experience During The LTFT Journey

1. Did you find the language clear and easy to complete the application?​

2. Did you require any support completing the application form?​

3. How long did you complete the application?​

4. Were there any areas in the process that you found unclear or confusing?​

5. Did you experience any challenges submitting the form? ​

6. What has worked well for you (PGDiT) during the LTFT application journey?​

Section 3: Experience After The Journey​

1. What happened after you submitted the application?

2. Were there any areas in the process that you found unclear or confusing?

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2. What communication did you have after submitting the document? And how was it communicated?​

3. Did you feel the communication you receive met your needs?​

Section 4: Pain Points And Frustrations

1. What were the most significant frustrations you encountered while applying for LTFT?​

2. Were there any delay or bottlenecks in the process that affected your application?​

3. What are the barriers identified when completing the LTFT form?​

4. Did you feel adequately supported during the application process? If not, what additional support would have been helpful?​

Section 4: Needs and And Support

1. What needs or accommodations do you believe would have made the LTFT application process smoother for you?​

2. What is import to you (PGDiT) when it comes to communication?​

3. If we were to digitalize the process, how would you most likely access it?​

4. If we were to digitalize the process would there be any challenges?​

5. How can the application process be adapted to better cater to your professional and personal needs? ​

6. Are there any specific resources or information you wish were available during the process?​

7. What improvement could be made to the current LTFT application process?​

TIS Self-Service And Broader Needs

1. How would you describe your experience or frustration when signing up on TIS Self Service? ​

2. Were you asked to complete Form-R?​

3. Did you experience any challenges or frustration completing or submitting the form?​

4. Is there anything else beyond forms that you would like to find on TIS Self Service? ​

https://healtheducationengland-my.sharepoint.com/:p:/r/personal/tosin_oyekunle_hee_nhs_uk/Documents/Microsoft%20Teams%20Chat%20Files/Discussion%20Guide1.pptx?d=wb8b1f4d7a8e74a11944227cd3ed895c7&csf=1&web=1&e=wXZB5C

RESEARCH METHODS

Secondary users (LO)

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o   Identified primary users with sensory impairments

ANALYSIS TBC

All feedback will be put onto mural. A series of sessions will take place to review all feedback. The user researchers will begin to synthesis the data into actionable insights.

According to the analysis, if we find that the data captured is not suffice then we will plan to recruit using different methods and tease the insights we are looking for.

Due to planned PGDiT strikes and other work commitments there is a risk we may not get good coverage (regional and specialty) of PGDiT as planned. The most obvious and best way to do this is to speak to users directly. But if this is not possible then we may need to take into consideration speaking to proxy users.

TIMINGS

https://healtheducationengland.sharepoint.com/:x:/r/sites/TISys/_layouts/15/Doc.aspx?sourcedoc=%7B80DCB79C-75FA-450D-9F23-6884736C2FAF%7D&file=LTFT%20Discovery%20Plan.xlsx&action=default&mobileredirect=true

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• Current LTFT user journey process (Primary and secondary user journey)

• Pain points and needs of users of LTFT

• Standardize the LTFT application process - linked to - Business goals - Achieve national uniformity in managing programs and rotations, creating a seamless experience for every doctor, irrespective of region.

Eligibility Criteria (SOP for LTFT signed off by the Deans and Business Managers)

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