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This page outlines the data that have been collected from Yorkshire & Humber Local Office and validated at a workshop (7th of November 2023) to map their as-is business processes for Less Than Full Time Training.

Application Windows 2022 - 2024 for Y&H

There are no application windows for Yorkshire and Humber. Application forms are either PDF or Word formats with the same form completed for all Dental, Medical, Public Health and Foundation

LTFT Reasons

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

No.

Reason selection

Circumstance

Supporting documentation

1

Disability or ill health

This may include ongoing medical procedures such as fertility treatment.

A letter from GP/ Occupational Health Consultant/ Medical Specialist which includes:

  • Nature of disability/health requirements for LTFT Training

It must be on letter-header paper or be from an official email address which can be validated. The letter should be dated within the past 3 months.

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. Trainee to confirm the anticipated or actual date of birth of their youngest child on the online application form. (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

  2. A letter from their GP or Medical Specialist involved in the care of their partner / relative / dependent which includes:

  • Level of care anticipated that they will need to provide

It must be on letter-header paper or be from an official email address which can be validated, dated within the last three months. - TBC

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.

How is the nature of request captured?

5

Flexibility for training / career development / opportunity e.g. development of a broad career portfolio

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).

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.

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.

6

Flexibility for non-training career development / opportunity e.g. non-medical activity requiring specific time commitment

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.

Applications relating to unique opportunities should be supplemented with written details of the unique opportunity, together with relevant letters of support.

7

Other

How is the nature of request captured?

How is the nature of request captured?

As-Is Processes

In trying to map the LTFT end-to-end process we came up with 4 main stages in the order in which they would occur namely:

  1. Pre-application Stage: 16 weeks or earlier, where a trainee discusses with their TPD / Foundation TPD / GP Scheme manager and “in principle” a post is agreed in order for them to apply to train as LTFT. Obtaining signature on the form from TPD with relevant section filled in.

  2. LTFT Application Submission Stage: With at least 14 to 12 weeks application submitted to Y&H to the relevant Specialty/School inbox.

3.1 Work Pattern, payroll changes and Start date agreement negotiation with Trust stage, following approval of their application, typically around 8 weeks prior to commencing LTFT

3.2 Appealing the decision stage, where their application was rejected, typically 8 weeks before commencing

  1. Trainee Commencing their training on LTFT basis

As-Is end-to-end LTFT process for Yorkshire & Humber

Actors in the process

No.

Role

Responsibility

1

Postgraduate Doctor in Training

  • Review LTFT guidance on the HEEYH website

  • Make an application with all information completed

  • Provide 16 weeks’ notice of intentions where possible

  • Meet with Training Programme Director, utilising the crib sheet

2

Training Programme Director (TPD)

  • Support the Postgraduate Doctor in Training

  • Meet with the Postgraduate Doctor in Training, utilising the crib sheet

  • Complete the TPD section of the application

  • Facilitate slot-shares where possible

  • Manage the rotation

  • Maintain a good understanding of the LTFT process

3

School Hub administrative team

  • Take oversight of the administrative process

  • Respond to queries from TPDs, Trusts and Postgraduate Doctors in Training

  • Ensure data quality to enable accurate reporting

  • Understand the LTFT process and relevant SOPs

  • Ensure website is kept up to date

  • Maintain all national and local documentation relating to LTFT

  • Save applications and supporting documents to file, adhering to HEE records retention policy

4

Medical Staffing (Trust)

  • Support the Postgraduate Doctor in Training

  • Enable LTFT where possible via the Rota Co-ordinator

  • Provide 8 weeks’ notice of the rota to the Postgraduate Doctor in Training (in line with Code of Practice requirements)

  • Have a basic understanding of the LTFT process

5

Flexible Working Champion/Guardian of Safe Working

  • Support the Postgraduate Doctor in Training at their place of work

  • Champion safe and flexible working within the Trust

  • Have a detailed understanding of the LTFT process

6

HEE Professional Support Associate Dean

  • Meet with the Postgraduate Doctor in Training, where applicable

  • Provide on-going support for Postgraduate Doctors in Training where health and caring responsibilities are impacting on their training

  • Have a detailed understanding of the LTFT process

7

Educational Supervisors

  • Be aware of the support available (HEEYH website, Trust contacts, TPD) to signpost ➢

  • Have a basic understanding of the LTFT process

8

Sponsorship Team in Yorkshire and Humber

  • Our role is to monitor HEE Sponsored Postgraduate Doctors in training and signpost for further/advice guidance

  • Where LTFT is concerned, our role is to ensure HEE sponsored doctors in training meet the minimum salary requirements for Tier 2/Skilled worker visas

  • Have a basic understanding of the LTFT process

9

HEE Deputy Postgraduate Dean

  • Review supernumerary funding requests

Pain Points in the process

No.

Pain Point / Area to improve

Comment

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

Given the new policy to extend flexible training, there has been a large number of applications and it has meant that the categories no longer exist. This in turn has made the triaging of applications almost ad-hoc and unmanageable when it comes to prioritising the processing as and when the applications are received based on the reasons. E.g. there is no Local process to prioritise the processing of Childcare/Disability/Health reasons applications over wellbeing ones.

3

It can take significantly more time where applications are submitted with less than 12 weeks notice to process due to approval required from Trust in Y&H process. This may require chasing the Trust who are also operating within their own constraints.

4

Y&H uses Tracker 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.

5

There isn’t always an opportunity in the Y&H process for trainees to be discussing with the Trust directly regarding their ability to accommodate for LTFT for a rotation, as the trainee may not be at the specific Trust they are going to be rotating yet where they intend to train as LTFT.

6

Y&H has a extensively documented process with Trainee, Associate Dean and Postgraduate Dean involved, preparing cases statements, with timescales made aware to the parties involved. However, in practice, this has not yet happened as there have been no rejections yet.

Application Numbers

As the categories are no longer technically used in Y&H (inline with Gold Guide) they list on a tracker spreadsheet an overview of the application. Since starting new process, Y&H have 210 applications listed against wellbeing and lifestyle.

LTFT Email templates

These are the email templates managed by specialty teams and LTFT Admins that are sent to trainees in the relevant events - (TBC)

No

Email Template

Body / Content

Sent to

1

Approval

Dear Dr <Name> <GMC>

Re: LTFT Placement Confirmation – <SCHOOL> <SPECIALITY>

Further to agreement with your Training Programme Director, I can now confirm that your less than full time post in <SCHOOL, SPECIALITY> at <Trust> has been agreed in principle and you should commence at <PERCENTAGE> WTE, including appropriate on call, on <START DATE>. If you are to be in a slot share, your TPD will confirm the name of your slot share partner.

It is advisable that you keep me informed of any changes to your training, i.e. change in hours, parental leave, long term sickness or out of programme so that the necessary funding for your post can be allocated accordingly.

Please be aware that your less than full time status will have an impact on your CCT date and future ARCP dates.

HEE Yorkshire and the Humber has a dedicated Supported Return to Training (SuppoRTT) team who are available to support the transition of existing trainees who are returning to their training programme following a period of absence. We have lots of resources available, of which details can be found on our website. Alternatively, please contact the SuppoRTT Team via england.suppo-rtt.yh@nhs.net.  

If you are NHSE Sponsored (Tier 2/Skilled Worker visa holder) please ensure to complete the required reporting form within 5 working days to notify the National Overseas Sponsorship team and Yorkshire and Humber Sponsorship team of the change to your circumstances. If you have any questions or queries, please contact the Yorkshire and Humber Sponsorship team at england.sponsorshipsupport.yh@nhs.net.

If you have any queries or need any further information with regards to LTFT training, please do not hesitate to contact me.

Kind regards

<Insert Signature>

  • Trainee

2

Send to Trust for review email (Rotation Contact)

Dear X,

RE: LTFT Application Less Than 12 Weeks’ Notice

I am writing to you regarding <Trainee name and GMC/GDC number>. They have applied to go LTFT from <START DATE>. This is less than 12 weeks’ notice and we understand this may be difficult for you to accommodate, as per our LTFT policy we are writing to you to request you approve or decline this request.

We require a decision by <2 weeks deadline>, otherwise we will assume it can be accommodated.

The application form is attached, if you need any further information, please let me know.

Kind Regards

<Insert Signature>

  • Trust

3

Send to Professional Support email

Dear Team,

RE: LTFT Trainee Requiring Professional Support

The below trainee has applied to go LTFT at <PERCENTAGE> from <START DATE>, their TPD has indicated that they require additional support from yourselves.

If you require additional information regarding this application please review their Trainee File and see their detail within the LTFT Tracker.

Kind Regards

<Insert Signature>

4

Send to Deputy Dean for Supernumerary Approval email

Dear Fiona Bishop,

RE: LTFT Trainee Requiring Supernumerary Approval

Please see attached LTFT application form that requires supernumerary funding. Please can you review this and let us know if it is approved or declined. All the information is on the form but if you need anything else please let me know.

Kind Regards

<Insert Signature>

  • Deputy Dean

Rejection

Appeal procedure

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