This page outlines the data that have been collected from London and KSS Local Offices and validated at a workshop (17th of October 2023) to map their as-is business processes for Less Than Full Time Training.

Application Windows 2022 - 2024 for London and KSS

In London and KSS, Trainees applying for LTFT under child care / health / disability /caring responsibilities can make an application at any point throughout the training year. All other criteria applications must be submitted during the windows below, which are set according to rotation months below. All applications are submitted online via PGMDE Support Portal.

Rotation Month	LTFT Window	Head of School Sign off	HET Confirmation to Trainee Deadline	TPD Grid Deadline
February	22/09/2023 - 06/10/2023	17/10/2023	18/10/2023	24/10/2023
March	23/10/2023 - 06/11/2023	10/11/2023	17/11/2023	17/11/2023
April	20/11/2023 - 04/12/2023	21/11/2023	19/12/2023	28/11/2023
May	19/12/2023 - 02/01/2024	09/01/2024	18/01/2024	16/01/2024
June	22/01/2024 - 05/02/2024	13/02/2024	16/02/2024	20/02/2024
July	19/02/2024 - 04/03/2024	12/03/2024	18/03/2024	19/03/2024
August	11/03/2024-25/03/2024	03/04/2024	17/04/2024	10/04/2024
September	19/04/2024 - 03/05/2024	17/05/2024	20/05/2024	24/05/2024
October	20/05/2024 - 03/06/2024	14/06/2024	17/06/2024	18/06/2024
November	21/06/2024 - 05/07/2024	17/07/2024	18/07/2024	23/07/2024
December	22/07/2024 - 05/08/2024	16/08/2024	19/08/2024	20/08/2024

LTFT Categories

Category	Circumstance	Supporting documentation
Category 1	Disability/ill health	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.
	Responsibility for caring for children	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
	Responsibility for caring for ill/disabled partner, relative or other dependent	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.
Category 2	All circumstances (Other)	Free text boxes on the online application form detailing the nature of request. They can attach letters of support and job descriptions to the application form should they wish to.
	Non-medical professional development
	Unique Opportunities for own personal/professional development
	Religious commitment
Category 3	Welfare and wellbeing	Free text boxes on the online application form detailing the nature of request.

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:

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.
LTFT Application Stage: With at least 16 weeks notice given and application submitted to HEE

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

Trainee Commencing their training on LTFT basis

As-Is end-to-end LTFT process for London and KSS

As-Is Approval Process for LTFT applications under Category 1

As-Is Approval Process for LTFT applications under Category 2 & 3

Application Numbers Feb 2022 to Aug 2023

Pain Points in the process

No.	Pain Point / Area to improve	Comment
1	Trainees have difficulty understanding Deanery and HEE (NHSE) being the same entity.
2	TPD / FTPD / GP Scheme manager are not normally discussing the impacts of LTFT on their training. E.g. impact on their CCT date and pay changes when having their initial discussion
3	A significant proportion of rejections due to trainees submitting applications outside published window. (See above table.)
4	Trainees having to reapply for LTFT following rejections, where they have applied outside HET window.
5	Trainees having to reapply for LTFT where rejection was due to insufficient supporting evidence despite being chased.
6	Approval emails are automatically sent to trainees except for Childcare reason where this is sent manually.
7	There is no SLA published to trainees currently in managing their expectations, but only internal to the HEE team on processing applications timeline.
8	The only determining factors and national guidelines available are for rejections where either there were insufficient supporting evidence/s for the LTFT category applied under. The HET window is a Local Office arrangement and decision to reject applications under respective categories. (See approval processes)
9	The negotiation of work pattern not taking place until an approval received from HEE(NHSE).
10	There is currently no specific ETA/SLA by Head of Schools / Deputy Deans in providing a decision for an appeal where the application was rejected.

LTFT Email templates

These are the email templates maintained on the London & KSS PGMDE Portal and sent to trainees in the relevant events.

Email Template	Body / Content
Approval	Dear Dr XXXX, I’m pleased to inform you that your application has been approved to train at (Percentage) from (start date). Your trust will be notified of your request to train LTFT via the trust portal. This will inform them of your placement and the number of sessions you are working at. You no longer need to submit a LTFT form upon each rotation, only if you wish to inform us of a change. The workforce team will also notify your Training Programme Director that you have been approved to train LTFT. Your tentative CCT date is XXXX and this will be ratified at your next ARCP. Ensure that you have read the LTFT applicant guide and the frequently asked questions as these should address the majority of LTFT queries. If you wish to submit an enquiry, please do so by clicking into any of the LTFT FAQs and submitting an enquiry. We aim to respond to all enquiries within 5 working days. Please note that Heath Education London and the South East is not an employer. Any issues you have with how your pay is calculated as a LTFT trainee should be submitted to the medical staffing department of your employing trust.
Rejection (insufficient evidence)	Dear Dr XXXX, Thank you for submitting your application to train at Less Than Full Time. Unfortunately you have not provided the supporting evidence with your request, and without this we are unable to proceed with your application. Therefore on this occasion we have had to close your application down. A reminder that if you apply under caring responsibilities, health or disability you must supply a letter of support, dated within the last 3 months, from your GP or Occupational Medicine at your current Trust, recommending that you train at LTFT. Please submit a new application with the evidence requested and we will proceed with your request. If we do not receive a new LTFT application from you with the evidence required, we will assume you no longer wish to train LTFT. Kind regards,
Rejection – application not made within window	Dear Dr XXXX, Thank you for submitting your application to train at Less Than Full Time. All applications made under the criteria listed below, must be made within the LTFT Application Windows so your application has been rejected at this time. A reminder that these windows are according to the month/s you rotate. Welfare and wellbeing Unique opportunities Religious commitment Non-medical development Flexibility for training and career development If you wish to reapply please resubmit your application during the appropriate date range above.
Rejection- include appeal procedure	Dear Dr NAME, Thank you for submitting your application to train at Less Than Full Time. Unfortunately your application has been rejected for the following reasons XXXXX If you wish to appeal this decision please submit a ticket via the portal outlining your reasons why and this will be revied by your Head of School. Kind regards,

CCT Calculator

These are the CCT calculators used across specialties by the London region.

Documents

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LTFT - London & KSS processes