Postgraduate Doctor in Training

The applicant for LTFT

Training Programme Director (TPD)

1. First point of contact for trainee on LTFT and agree in principle with trainee. Form 3 months prior to commencement of LTFT

2. Give Trainee ‘Agreement in Principle’

3. Engage with Trust, LTFT Lead around post, capacity and funding

4. In the East Midland, the TPD get involve in the capacity discussion for GP practices and Trust as the rotation might impact the CCT date and Doctor might have to move GP practice

5. Approves application and send approval to the programme team.

6. First person to have an informal discussion with Trainee in the case of appeal of rejection

Educational Supervisor

1. First point of contact for trainee on LTFT and agree in principle with trainee. Form 3 months prior to commencement of LTFT

2. Give Trainee ‘Agreement in Principle’

3. Engage with Trust, LTFT Lead around post, capacity and funding

4. Approves application and send approval to the programme team.

Trust LTFT Team

1. Engage with trainee on Rotation/Placement, Funding etc

2. Engage with TPD and ES on Trainee Rotation planning, capacity planning and Post Funding

Head of School

HoS reviews the appeal request and involves the Deputy Dean (DD) if required

Rota Coordinator

Agree Rota pattern with Trainee

Month - Year

Application in progress or did not complete

Approved

Grand Total

Nov - 2022

3

28

31

Dec - 2022

1

12

13

Jan - 2023

21

21

Feb - 2023

11

11

Mar - 2023

22

22

Apr - 2023

40

40

May - 2023

2

61

63

Jun - 2023

40

40

Jul - 2023

19

19

Aug - 2023

34

34

Sep - 2023

1

28

29

Oct - 2023

20

19

39

Nov - 2023

5

5

Grand Total

32

335

367

1

LTFT can’t be controlled by the LO as Trainee can apply anytime. TPD can only Advise Gold Guide states ‘Well founded reasons’

Pre- application

2

The process of discussion with Trust not very clear

Pre- application

• LTFT Admin are not involve in the initial discussion until application is submitted

• West, Programme don’t need to speak to the trust if > 12 weeks but the east constantly speak to trust around post, capacity and funding

• In the East the TPD get involve in the capacity discussion for GP practices and Trust as the rotation might impact the CCT date and Doctor might have to move GP practice

• In the west, TPD don’t get involve with Trust/Hospital as the HEE Programme does on capacity discussion but TPD get involve with GP practices capacity discussion

3

Some Trainees applies without discussion with TPD/ES

Pre- application

4

The fields are all mandatory but trainee can type in anything to progress the form. So programme still need to check after submission and request more information via email

Application

5

No dedicated team for LTF. Just the programme team.

Application

6

No process for Appeal yet but the TPD should be responsible here not the programme

Application

7

Issue with form around submission on time or late submission; Progressive submission. Still allows submission with missing fields

Application

Approval

Dear  

Application for Change of Percentage (Less Than Full Time Training (LTFT)) – Confirmation of Approval

 I am writing to inform you that NHS England – East Midlands has approved your Change of Percentage application as follows:

GMC/GDC Number

Specialty

New Percentage

Start Date of New Percentage

New Estimated CCT Date

Changes in your percentage training hours may impact on your original completion date. To ensure this is considered appropriately we have supplied an estimate above based on the percentage change and have updated your TIS record accordingly. This will be reviewed and confirmed with your TPD in your ARCPs/RCPs. This change to your percentage may also impact any rotations you were allocated as part of your original offer. We cannot guarantee you will be able to work in those same rotations.

This letter is confirmation of your new training percentage (whole time equivalent) but is not a guarantee of any specific working patterns as NHS England is not your employer. You will, therefore, need to negotiate your specific working patterns and rota with your upcoming employer (or appropriate department) for any affected placements. For late applications these conversations must have been underway, if not finalised, before submitting your application. Please let us know if there are any issues.

If you wish to change your training percentage again in the future, you will need to complete a new application form. Once you have started on your new percentage, it is your responsibility to ensure you check on your payslip that you have been paid correctly. Failure to do this could lead to overpayment, which would need to be repaid to your employer, or underpayment. We recommend you also check you are receiving the correct allowances to support LTFT training. Please also keep us informed regarding any training gaps including prolonged periods of absence.

If any of the information you submitted on your application form has changed, or you wish to rescind your application altogether, you must contact us as a matter of urgency.

Please do not hesitate to contact us if you have any questions.

Yours sincerely,

Name

NHS England - East Midlands Programmes Administrator

On behalf of

Caroline Brown

Associate Postgraduate Dean (East Midlands) /Senior Educator Team, East Midlands

Rejection (insufficient evidence)

Rejection – application not made within window

Rejection- include appeal procedure

LTFT/Change of Percentage Application for Test Programme

Dear Programmes team,

THIS IS A NOTIFICATION THAT AN APPLICATION HAS BEEN SUBMITTED, NOT THAT IT HAS BEEN APPROVED. PLEASE ENSURE THE ACTIONS LISTED ARE COMPLETE BEFORE SENDING APPROVAL LETTER

A new change of percentage application form has been submitted by Test - Gwil Test - Williams (1234567) in East Midlands Test Programme.

You must do the following before sending our approval letter:

Training Programme Director approval - Wait for an email to be recieved from foundationprogrammes.em@hee.nhs.uk confirming they approve this application.

Educational Supervisor approval - Wait for an email to be recieved from gwilym.williams1@nhs.net confirming they approve this application.

Please see below for the relevant sections of this application. The full form can be found on MS Forms and these details will be added to the tracker automatically:

Name: Test - Gwil Test - Williams
GMC: 1234567
Training programme: Test Programme
Proposed start date: 2023-11-01
Grade at time of change: ST2
Proposed working percentage: 60%

This is an automated email generated by Power Automate on completion of our online form.

LTFT/Change of Percentage Application for Test - Gwil Test - Williams 1234567

Dear all,

This is an automated email generated when a doctor or dentist in training completes our online change of percentage form

A new change of percentage application form has been submitted by Test - Gwil Test - Williams (1234567) in East Midlands Test Programme.

They have put your email addresses as Training Programme Director and Educational Supervisor.

If they have indicated that they are a dual specialty doctor then this email will also be copied to the second specialty TPD for their information only.

Please could you review the below application and respond to this email if you approve or have any queries. If you are planning to reject this application please discuss it with the appropriate APD for LTFT so we can ensure all avenues have been explored. You may have already calculated a new estimated CCT date for this doctor. If so, please could you send it through along with your approval
This application will not be processed until we have your approval.

Name: Test - Gwil Test - Williams
GMC: 1234567
Training Programme: Test Programme
Proposed start date: 2023-11-01
Grade at time of change: ST2
Proposed working percentage: 60%
Current CCT: 2024-08-06

Reason for requesting change:
Caring responsibilities

Test reason detail

Many thanks
The Midlands Programmes Team

1

Discussion/Pre-approval Stage

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

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?

4

Discussion/Pre-approval Stage

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

5

Discussion/Pre-approval Stage

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

6

Discussion/Pre-approval Stage

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

7

Discussion/Pre-approval Stage

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

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?

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?

10

Processing/Approval

Once application has been fully approved and trainee made aware, are you notified?

11

Processing/Approval

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

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)

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?