Programmes | NTNs

Context

There are currently discussions outstanding about the future of NTNs and how they are used and assigned to trainees.

Option 1 entails that NTNs will no longer be used across HEE - legacy NTNs can be ignored and they will no longer be created, or assigned (as a mandatory field) for trainees

Option 2 entails that the format and assignation is amended, which can be supported by auto-generation of NTNs against a trainee record.

The format of NTN is to change and will be auto-created based on the characteristics of the trainee Programme Curriculum Membership (PCM):

NTN number is to be based on new criteria = location of training + speciality + trainee’s GMC number + single letter suffix (for example identifying whether the trainee is on a programme aimed at delivering a CCT or CESR (CP) etc + whether they are academic trainees), details below taken from a draft text going into the Gold Guide:

3.14       Following appointment to a specialty training programme, a National Training Number (NTN) or Dean’s Reference Number (DRN) will be awarded. This includes trainees working in NHS and non-NHS employment but not in LAT posts.
3.15       NTNs will only be awarded to doctors in specialty training programmes that (subject to satisfactory progress) have an end point of the award of a CCT or CESR(CP)/
CEGPR(CP).
3.16       Core trainees will not be awarded NTNs but will be awarded DRNs. These training numbers are for administrative purposes and do not confer any entitlement to entry to further specialty training.
3.17       The NTN or DRN is unique to the trainee for the period the trainee holds the number in that specialty training programme. The NTN or DRN may be changed for a given trainee if that trainee is subsequently appointed competitively to a different specialty or academic programme.
3.18       A trainee should not hold more than one training number (NTN or DRN) at the same time except in circumstances approved by the Postgraduate Dean.
3.19       Where a NTN or DRN has been issued, it will be held so long as the trainee is in specialty training or is out of programme on statutory grounds, or for out of programme activity that has been agreed with the Postgraduate Dean.
3.20       The NTN is a numeric code which identifies the location of training, the speciality, the GMC number of the holder and a single letter suffix (for example identifying whether the trainee is on a programme aimed at delivering a CCT or CESR (CP) etc and whether they are academic trainees). Detail on the configuration of the NTN and a table of permitted specialty and subspecialty combinations can be found in the NTN Appendix available on the COPMeD website.
3.21       The specialty component of an NTN will consist of a concatenation of specialty/subspecialty codes to reflect all the curricula a trainee is undertaking as part of their training programme.

For Discussion

The purpose is to support educational planning and management, enabling postgraduate deans to keep track of location and progress of trainees. NTNs also inform workforce planning

#		Comment	Owner
1	following appointment to a programme, an NTN (national training number) or Deans Reference Number (DRN) will be awarded what’s the difference between the two? which one is used when?	an NTN is given to a trainee who's programme leads to CCT. This includes run through and higher specialty programmes. a DRN is given to trainees following a programme that does not lead to CCT e.g Foundation, CMT, CST, CPT Tom de Salis - NTNs are issued for programmes leading to CCT, DRNs are issued for core/uncouple programmes Lynn Bradley - NTN is for a trainee in a run through or higher programme that leads to a CCT/CESR - the suffix denotes the route and also if the trainee is on an academic programme DRN are used for core trainees as the core training programme does not lead to CCT.
2	for docs in NHS and non-NHS employment, but not for LAT posts what’s a LAT post? does HEE look after non-NHS roles? ie should we be concerned with this?	A LAT is a Locum (cover for a trainee). These are being phased out so not a great concern. All our trainees should be in NHS roles I believe. Tom de Salis - LATs are/were fixed-term training appointments which could be accumulated and used to ‘add up’ to a CCT (through the CESR route). I don’t think we recruit LATs anymore. They used to get a DRN (with an ‘L’ suffix). I think, in this context, it’s talking about things like Occupational Medicine with industry placements, and Palliative Med trainees with hospices Lynn Bradley - LAT stands for Locum Appointment to Training. They are no longer appointed. They were used to fill gaps in rotations and would also be given an ARCP and this evidence/period could be used towards a CCT/CESR I think the non-NHS roles may be for those trainees in palliative medicine who work in hospices, the non-medical Public Health trainees and the occupational medicine trainees that are industry based
3	trainees should only have 1, except in pre-approved circumstances NTN should change to reflect that a trainee is undertaking a dual or sub-specialty programme what should be done about those with multiple NTNs now?	We will need Russell to analyse how prevalent multiple NTNS are. there shouldn't be a huge amount. Tom de Salis - I think the current system of attaching the NTNs to the programme membership works well (and allows for the ‘pre-approved circumstances’). There is no situation where a trainee would have 2 NTNs for one programme membership Lynn Bradley - I have never known anyone with 2 NTNs – for dual trainees it is my understanding that the NTN is allocated for the "parent" programme with the trainee being attached to one programme but 2 curriculums. It is the 2 curriculums that shows that the trainee is dual training This is the same for those who are on e.g. O&G programme but also an academic programme. The NTN will be for O&G but their suffix is an "A" for the duration of their academic programme.
4	where NTN is issued, it will be held so long as trainee is in specialty training trainee is out of programme on statutory grounds or agreed out of programme how do we know this is true for a trainee?	Tom de Salis - I think we are the arbiters of most of this. OOP applications are approved by Royal College/HoS, but we process them all so there shouldn’t be any we don’t know about. Lynn Bradley - If a trainee is off on statutory grounds, in HEENE they notify our LET who will then amend the placement on the trainee record on intrepid to show this e.g. parental leave so people know that the trainee needs to keep the NTN. If it is for an agreed out of programme, the trainee applies for the OOP and when it is approved they are placed in a bucket post with the reason why stated. This also allows people to see that the NTN is still required for this particular trainee.
5	NTN’s only awarded to programmes with CCT or CESR/CESP/CEGPR/CEGCP in order to receive the final award, they must have NTN is a flag needed for those who do not have an NTN at a certain point in their training? What should the single letter suffx be, assuming there needs to be one for each of the following - CCT / CESR / CESP / CEGPR / CEGCP - can they be defined by TIS?	Yes, a flag for trainees on a curriculum leading to CCT but without an NTN would be useful Suffix Codes Suffix A is Academic Suffix C is the standard CCT route Suffix L is CESR/CEGPR (CP and E is old version) We no longer issue training numbers to new starters with a N suffix (but indicates old SpR type) Suffix F is Fixed-Term Training Appointment (FTTA) Been renamed to Post CCST for Dental (no longer used?) Suffix S is Trainees who switched to the new Speciality curriculum from ‘N’ suffix. Suffix I is Industrial Training Number For Occupational Medicine Suffix T is for non-medical Public Health trainees Lynn Bradley - I think a flag would be useful for new starters so that it is easy to see those who have not been allocated an NTN – they need the NTN to be able to register with their relevant Royal College so they can get access to eportfolio The single letter suffix should remain the same as it is now I personally feel. Changing them causes more confusion, trainees get confused as it is with which route they should be on and whether or not their suffix is correct.
6	core trainees will be awarded DRN, not NTN how is a DRN different / made up?	DRN takes the format 11/XXX/Y222/ZZZ 11 – Academic year of issue (e.g. ‘17’ for 2017/18 academic year) XXX – 3 letter or number code to indicate core programme (see table below) Y – Letter to indicate type of contract (C for Core training, F for FTSTA, L for LAT) 222 – Numerical indicator (generally issued sequentially) ZZZ – 2 or 3 letter code to indicate issuing deanery (e.g. WM for West Mids) Lynn Bradley - An example of a DRN in HEENE is 15/CPT/C0003/NR - this denotes that it is for Core Psychiatry Training – Joanne Watson will be able to tell you why it is in the format that it is
7	NTN’s are persisted through the lifetime of a programme even through research or career breaks How is this currently handled?	NTNs can be owned by only one trainee at a time. V10 validates this through programme membership dates (no overlap allowed) Lynn Bradley - An NTN can only be held by one trainee at a time – this is validated by intrepid using the dates of a programme membership. It flags it if you try to allocate an already current trainee's NTN to another. This is very useful and prevents duplication errors
8	where inter-deanery transfer takes place, a new NTN to be issued What should the trigger point be?	At the point of IDT, the old programme membership will end and a new one (with the new deanery) will be issued. Each programme membership will have a different NTN Lynn Bradley - When a transfer date is agreed by both regions – the current region will end their programme membership and remove the NTN from the trainee. The receiving region will then create a new programme membership for the day after the end date of the previous on and will allocate a new NTN linked to their region.
9	NTN is removed where completion of training is assessed as unstable to continue does not comply with requirements for maintaining their registration with Postgraduate Den does not hold GC number resigns is dismissed is erased/suspended from medical register at Dean’s discretion What should be the process be to "remove" an NTN? (New scenario)	The programme end date should be ‘trimmed’ to end early. If an NTN is removed, the trainee exits the training programme, so this should be all that is necessary Lynn Bradley - Our LET works with our Specialty training team depending on reasons why the NTN is being removed. We have local processes that are followed. It is my understanding that the local office should end date the programme membership to match the last working day and the record made inactive.
10	where an NTN has been removed it can be reinstated with the old one?	We would just issue a new one, as the old one would probably have been recycled to a new trainee, unless the period between removal and reinstatement was very short. (NB RE: suspension – we wouldn’t typically remove an NTN until all appeals had been exhausted) Lynn Bradley - This will depend on whether you have already reallocated the NTN to another trainee. If you have you can just create a new one. I do not know of a situation where we have had to reinstate an NTN – removal of an NTN is the last resort and there would have been a lot of avenues exhausted before it would get to this stage. I vaguely remember that during the consolidation project we (all local offices) were asked to see if the local business managers agreed to just creating new NTNs rather than recycling? I think we always recycled because historically you were only allowed a specific number of NTNs per programme per region and you had to apply to that programme's lead dean if you wanted new ones (Joanne Watson will probs be able to shed light on this one) All above is superceded by the intention to auto-generate the NTN.
11	Some specialty training award NTN(I) who specifically should have this? how do we structure the number?	Occupational Medicine trainees who spend their entire training seconded to a single industry placement (i.e. one non-NHS organisation ‘sponsors’ their whole training) Lynn Bradley - The I suffix is for occupational medicine trainees who are in an industrial placment for the duration of their training e.g. Capita The number is structured exactly the same it is just the "I" suffix that is different
12	Defence Medical Services - Successful candidates for specialty training will be selected as required by the DMS. Those appointed as Specialty Registrar (StR) will be awarded a DPMD NTN by the Defence Postgraduate Medical Dean and the prefix of the NTN will remain “TSD” to designate the trainee as a Defence Deanery trainee once this is complete, they need to seek training as a civilian and will be awarded a new NTN relinquish DPMD NTN whats the current process?	DMS issue their own NTNs. Currently we email DMS and ask them. If a trainee resigns from the military and relinquishes their DMS NTN, they generally need to apply in open competition to a ‘normal’ training programme. Occasionally our PGD will waive this process, usually for DMS trainees who are quite close to CCT (because it is hard to be appointed to a programme at ST6/7/8 level) Question from JW - how can we manage this on TIS - are Military trainees appointed via Oriel?
13	Defence issue and should all have prefix that indicates so (DEF, DFD or something along those lines). They also get a DRN in core with similar prefix.	TSD = prefix for NTNs DE = Suffix for DRNs
14	What are the impact for Option 1 legacy NTNs - will these no longer be needed as mandatory fields? should it still be made available to local offices to assign if they so choose? If so see 15	NTNs to continue until we receive formal notice
15	What are the impacts for Option 2 will there still be 1 NTN per programme? if yes to above, trainees could have multiple? at what point shoud NTN number generated? how will they be communicated with trainees? ie via email? when should it be communicated? post Form R (A) submission?
16	Relationships between NTN, Trainee & Programme/Curricula NTN to Person - 1 to 1 per programme, except for dual accredited programmes (2 to 1) if you change programme, the NTN will change if you change local teams, the NTN will change NTNs should not be transferable Is this correct? Does it line up with above specifications?
17	Would it be useful if NTNs had a status? i.e. active / inactive / closed	No status required
18	What are the suffixes for the following? CESP CEGCP
19	How do we meet the requiement to reflect dual or sub-specialty?	Where there is a "." after the main specialty, there will be sub-specialty following Where there is a "-" after the main spcialty, there will be a dual specialty following Nothing where there is neither
20	Should trigger for NTN/DRN creation be Oriel import? If so, what's the flow? If not, what shoud trigger/process be?	Would be good if the NTN could be generated upon import however I don't know if the necessary info will be available in the import function: NTN NTH/018.880-001/7766554/A NTH = Local Office = yes for most but unsure about how military trainees will be dealt with 018 = Main curriculum being followed = yes from Oriel import info 880 = subspecialty (not applicable to all) = unsure how this is shown in Oriel import info 001 = dual curriculum being followed (not applicable to all) = unsure how/if this is recorded in Oriel and how shown on Oriel import info 7766554 = GMC number. Should be in Oriel import info as all trainees entitled to an NTN will have their registration A = suffix to denote training pathway. Not shown on Oriel and so far nowhere to record this in TIS DRN 15/CMT/9012345/NE 15 = year trainee will start in e.g. 2015. CMT = programme trainee appointed into - will be available in Oriel data 9012345 = trainees GMC number - will be available in Oriel data NE = local office = yes for most but unsure about how military trainees will be dealt with	Joanne Watson (Unlicensed) / Ashley Ransoo / Alistair Pringle (Unlicensed)
21	Do we need to display the hisory of NTNs in case the trainee has multiple?	Yes, further informatin required (diagram pending)	Joanne Watson (Unlicensed)

Programmes | NTNs

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