This page outlines the data that have been collected from Thames Valley Local Office and validated at a workshop (28th of November 2023) to map their as-is business processes for Less Than Full Time Training.
Application Windows 2022 - 2024 for TV
Some schools (for example General Practice and Acute Medicine) receive large numbers of applications from trainees wishing to work LTFT. This may mean that you must apply within a specific window, usually at least three months ahead. Application form is in Word format with the same form completed for all Dental, Medical, Public Health and Foundation.
Medicine requires 4 months/16 weeks notice. Windows are 11th of April for 1st of August Rotation, 12th of October for 1st of February Rotation.
Although more notice required in Medicine, 3 months is the strict minimum notice required to apply for LTFT.
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.
All well-founded reasons will be considered. Support to progress the application will be dependent on the capacity of the programme and the effect the request may have on the training available to other doctors in training on the programme.
It is expected that all those applying due to disability or ill health and caring responsibilities (1/2 below) will be accommodated.
No. | Reason selection | Circumstance | Supporting documentation |
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1 | Disability or ill health | This may include ongoing medical procedures such as fertility treatment. |
The letter should be dated within the past 3 months. - TBC |
2 | Caring responsibilities | Trainees (men and women) with caring responsibilities (e.g. for children, or for an ill/disabled partner, relative or other dependant) |
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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. | None - reason specified on the form |
5 | Unique Opportunities | 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). | None - reason specified on the form |
6 | Non-medical development | 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 | None - reason specified on the form |
7 | Flexibility for training and career development | 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 | None - reason specified on the form |
As-Is Processes for Thames Valley
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: 3-4 month before Rotation starts, where a trainee discusses with Trust LTFT champions and with their TPD / Foundation TPD / ES / HOS. The outcome at this stage is “in principle” a post is agreed in order for them to apply to train as LTFT. Trainee obtains signature on the Word Document form from TPD with relevant section filled in.
LTFT Application Submission Stage: With at least 12 weeks notice, application submitted to Y&H to the NHSE Thames Valley Inbox England.ltft.tv@nhs.net.
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
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 | Once approved, does it remain for the duration of the programme or until trainee decides to make a change by submitting an application? Until end of prog. Or new request to change. Sometimes it doesn’t get fed down. Which can have implication on their pay if the % is not reflected without paperwork. | |
3 | There is no SLA published to trainee on expectation of dates on outcomes of applications | |
4 | Applications applied too early are rejected and trainees asked to re-apply within application window. E.g. If a child is not born yet and an application is made on the basis of childcare, they are rejected and asked to apply after child birth. | |
5 | Calculation of CCT for GP is done by the GP team whereas in Specialty they are done by the admins team. The reason GP moved to Royal Colleges was because of the amount of errors in calculating the data. | |
6 | TV uses Local and National 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. | |
7 | TV has documented process with Trainee, Associate Dean and Postgraduate Dean involved in an appeal process, however, in practice no rejection insofar has reached to this stage following rejection. | |
8 | The form is a WORD Doc and can be filled in manually or by using a Computer. It is an prone to miss filling in required information. It can also be time-consuming having to print, manually fill, scan and send to NHSE TV. |
Application Numbers in TV
May to October 2022 and 2023 comparisons by specialty and reasons
Speciality School | May - Oct 2022 | May - Oct 2023 |
---|---|---|
Foundation | 3 | 6 |
GP | 21 | 30 |
Anaesthetics | 7 | 8 |
Emergency Medicine | 3 | 9 |
Medicine | 24 | 21 |
Ophthalmology | 0 | 0 |
Paediatrics | 11 | 9 |
Histopathology | 2 | 1 |
Public Health | 2 | 2 |
Obs & Gynae | 2 | 6 |
Psychiatry | 1 | 8 |
Radiology | 0 | 2 |
Surgery | 6 | 4 |
Dual Emergency Medicine / Medicine | 2 | 0 |
TOTAL | 84 | 106 |
No. | Category | May - Oct 2022 | May - Oct 2023 |
---|---|---|---|
1 | Health/Childcare | 59 | 12 (Health), 53 (Childcare) |
2 | Unique Opportunities | 4 | 5 |
3 | Welfare / Wellbeing | 21 | 26 |
4 | Flexibility for training and career development (new) | n/a | 10 |
LTFT Email templates
These are the email templates managed by specialty teams and LTFT Admins that are sent to trainees in the relevant events
No | Email Template | Body / Content | Sent to |
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1 | Approval | Dear Dr <TPD> Dr Anne Edwards has confirmed DR <Trainee> is eligible to be considered for LTFT under category <NUMBER> . <Dr TRAINEE> is an <ST ?> in <SPECIALITY> Training. The relevant school and the employer will determine whether this can be accommodated, the start date and the % of WTE time to be worked. A start date of <DATE> has been requested. The options for providing LTFTT are: · A slot share and working at 60%, sharing the responsibilities and salary of the post. We pay an extra 10% for each trainee so that they can handover and attend regional teaching etc. Training at 50% is also possible, though this is not recommended long-term. · The second option is to work LTFT in the full time post, this being an option if there are vacancies in the scheme. · The third option is Exceptional funding, which may be available occasionally for a limited period at the discretion of the LTFTT Dean. The ARCP remains an annual process. Annual leave and study leave are on a pro rata basis. If they should wish to return to full time training at any point then <Dr TRAINEE> would need to let you know so that they can move in to a vacant full time post when one arises. Please advise <EPM> whether <Dr TRAINEE> will be in a full-time post or a slot-share, the date and location of the anticipated starting placement, and agreed percentage of training. Kind regards |
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2 | Enquiry | Dear Trainee Thank you for your email. You will find all the information relating to LTFT on our website copied below. Please ensure yourself and your TPD complete the application form on our website prior to returning it to me for approval of eligibility. Please also include evidence per category you wish to apply under with your application. If you have any other queries please do not hesitate to get in touch. Thanks Debbie |
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3 | Rejection | N/A - due to no rejection | |
4 | Appeal procedure | N/A - due to no rejection |
CCT Calculator
For GP, the Royal Colleges is responsible for calculating and inputting of the the CCT date on TIS following LTFT application processing. For Specialty, the HEE admins are responsible to input them and would only happen around ARCP time.
TPD LTFT Process Questions
No | Stage of Process | Question | Responses / Comment |
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1 | Discussion/Pre-approval Stage | What's your involvement in the Less Than Full Time application process? |
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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) |
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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? |
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4 | Discussion/Pre-approval Stage | Do you have any involvement in slot-sharing arrangements discussion and with who? |
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5 | Discussion/Pre-approval Stage | Do you have any involvement in Supernumerary post arrangements discussion and with who? |
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6 | Discussion/Pre-approval Stage | Do you have joint conversations with Head of School / Educational Supervisor on LTFT applications? |
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7 | Discussion/Pre-approval Stage | At what point in the process do you have the discussion with the trust? |
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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? |
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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? |
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10 | Processing/Approval | Once application has been approved by HEE / AD and trainee made aware, are you notified? |
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11 | Processing/Approval | Once approved, do you get involved in the implementation of the LTFT, e.g. negotiation of Rota? |
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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) |
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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)."
| May not need to ask - See UR Question
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