INTRO

We recognise that there are challenges in managing the current Less than fulltime process manually. Below are some of the High-level issues identified: 

• There are variations in the process between regional offices. 

• The current process is susceptible to errors and imposes additional work on internal HEE staff to manage.  

LTFT applications are submitted when full-time training is not practical for well-founded individual reasons. Trainees are required to complete an LTFT application form provided they have discussed with their Training Programme Director / Foundation School Manager / GP Scheme Director.  

The process should be initiated no later than 3 months before the post’s commencement to ensure that all the necessary approvals and funding arrangements are in place before the placement begins. The doctor in training should fill-out the relevant LTFT application form and specify under which category they are applying. This should typically be submitted with any 4 relevant supporting documents (as required) to the Postgraduate Dean or nominated deputy. This ensures that the local office receives the application within at least 16 weeks’ notice. This timeline allows for the processing of the application and providing Trust with at least 12 weeks' notice before the proposed changes to working pattern commence. As part of strategic objective we are set to digitalise forms and standardise LO process, hence we are carrying out this discovery. 

Problem Statement

• How do we improve the management of LTFT across HEE/NHSE LO and ensure quicker and efficient way to process each application

• How do we get all local offices to follow the same process for LTFT so that there is national/unified approach which helps PGDiT especially that IDT

• How do we improve the user experience for all PGDiT that interact with the LTFT process so they can access application, are informed of process/guidelines and can submit application without any issues

• How do we improve communication between HEE/NHSE LO and PGDiT during and after the application process so there is less chance of errors on forms and PGDiT feel supported

• How do we ensure when PGDiT WTE % changes, the trusts get enough notice to factor in pay run and contract changes.

• How do we share/verify with PGDiT impact the change to CCT date has on training so they are aware of the effect. i.e. on pay and on their training plan

• How can we speed up the approval process so there is less delays in submitting LTFT application and its done within the 3 months timeframe

• How do we share with PGDiT the status/stages of their applications so they are informed and don't feel the need to keep chasing HEE/NHE LO for update.

OBJECTIVE

By the end of the research,  

• There is currently no unified process, and we need to establish an agreed standard process across all local offices.   - This is also linked to the Business goal - Achieve national uniformity in managing programs and rotations, creating a seamless experience for every doctor, irrespective of region.

• We should have understood the current process (as is) from all users that interact with the current LTFT process.  

• We also want to pinpoint all the pain points that user (Internal HEE staff, PGDiT and TPD) experience.  

• We should have understood their user needs for the (to be) process. 

• We should have determined whether different specialties require distinct forms and processes.   

Assumptions

1. It is assume that there is a problem with the current LTFT application process, hence the problem statement and objectives lined up for research.

2. It is assume that achieving a standardised LTFT process across all regions and specialities might not be feasible due to varying local requirements, resource constraint and needs.

RESEARCH QUESTIONS (LO)

Before receiving application, what is the role of Support from LO 

What dept and roles of individual manage the LTFT process?

Who/How do they interact with trainees?

Who/How do they provide support to trainees who wish to apply for LTFT?

What are the channels to apply for LTFT?

Can you describe the relationship between NHSE and LTFT team?

Start of the Journey when LO receives Submission of LTFT

Can you tell me how you receive the LTFT submission?

What format do you receive it?

Do you receive complete application forms?

What happens if you receive incomplete form?

What do you do with the form when you receive? Where do you store it?

Have you experienced any challenges or frustrations when receiving submitted forms?

What has worked well for you during the stage of receiving submitted forms?

Experience when reviewing the LTFT application.

How do you verify completeness of the information received?

Do you require any supporting info/evidence to be submitted together with their application?

How do you contact the trainees if information/evidence is not received?

Where applications have been submitted outside an application window or not enough notice given, how do you organise and prioritise applications submitted?

Experience when processing the LTFT application.

Who/What is involved in getting approval for the LTFT application?

How long does it take from application to receiving an outcome?

Do you interact and inform the employing trust of the reduced hours?

How do you contact them? And what do you share with employing trust?

Experience when approving the LTFT application.

Who is involved to approve the LTFT application?

How do you interact with individuals/dept for approval?

Have you experienced any challenges or frustrations during this stage?

Do any applications get rejected? If so, why do they get rejected? And how do you manage that?

Experience when communicating to trainee regarding LTFT application.

What happens after the LTFT application is approved?

How do you communicate the approval to trainees?

What email do they use to contact trainee?

What’s your experience in communicating with trainees?

What do you communicate to the trainees? Do you include the change of CCT?

Do trainees ever chase you for outcome of the applications? If yes, why do you think they chase you?

What are the challenges and frustrations you have encountered when you inform trainees of application status?

Experience how/where does the process/journey end?

(we need to determine end of process and cover anything we missed) 

PGDiT (Primary Users) Questions

Section 1: Start of the LTFT Journey 

1. Can you tell me what you remember about the LTFT process? ​

2. How did you receive the LTFT form?​

3. What stage of your training were you at? ​

4. How effective was the communication throughout the LTFT application process?​

5. Did you feel like you were given all the information need to complete the form?​

6. Were you given a deadline to complete the form? Did you feel the deadline was realistic?​

Section 2: Experience During The LTFT Journey

1. Did you find the language clear and easy to complete the application?​

2. Did you require any support completing the application form?​

3. How long did you complete the application?​

4. Were there any areas in the process that you found unclear or confusing?​

5. Did you experience any challenges submitting the form? ​

6. What has worked well for you (PGDiT) during the LTFT application journey?​

Section 3: Experience After The Journey​

1. What happened after you submitted the application?​

2. What communication did you have after submitting the document? And how was it communicated?​

3. Did you feel the communication you receive met your needs?​

Section 4: Pain Points And Frustrations

1. What were the most significant frustrations you encountered while applying for LTFT?​

2. Were there any delay or bottlenecks in the process that affected your application?​

3. What are the barriers identified when completing the LTFT form?​

4. Did you feel adequately supported during the application process? If not, what additional support would have been helpful?​

Needs And Support

1. What needs or accommodations do you believe would have made the LTFT application process smoother for you?​

2. What is import to you (PGDiT) when it comes to communication?​

3. If we were to digitalize the process, how would you most likely access it?​

4. If we were to digitalize the process would there be any challenges?​

5. How can the application process be adapted to better cater to your professional and personal needs? ​

6. Are there any specific resources or information you wish were available during the process?​

7. What improvement could be made to the current LTFT application process?​

TIS Self-Service And Broader Needs

1. How would you describe your experience or frustration when signing up on TIS Self Service? ​

2. Were you asked to complete Form-R?​

3. Did you experience any challenges or frustration completing or submitting the form?​

4. Is there anything else beyond forms that you would like to find on TIS Self Service? ​

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RESEARCH METHODS

Secondary users (LO)

• To be confirmed

Primary Users (PGDiT)

• We will conduct 15 one hour semi structured interview in person or remotely depending on trainees’ preference.

Demographics

• Age range 30-50 years old

• Current trainees that have completed an LTFT form

• UK graduates

• EU graduates

• non-EU graduates

Geographic spreads

o   Broad spread from the 4 different regions ( London, North, South, Midlands and East)

Accessibility needs

o   Identified primary users with sensory impairments

ANALYSIS

All feedback will be put onto mural. A series of sessions will take place to review all feedback. The user researchers will begin to synthesis the data into actionable insights.

According to the analysis, if we find that the data captured is not suffice then we will plan to recruit using different methods and tease the insights we are looking for.

Due to planned PGDiT strikes and other work commitments there is a risk we may not get good coverage (regional and specialty) of PGDiT as planned. The most obvious and best way to do this is to speak to users directly. But if this is not possible then we may need to take into consideration speaking to proxy users.

TIMINGS

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COMMUNICATION
We would record sessions and take notes and synthesize raw data into actionable insights.

Review session

DELIVERABLES

• Current LTFT user journey process (Primary and secondary user journey)

• Pain points and needs of users of LTFT

• Standardize the LTFT application process - linked to - Business goals - Achieve national uniformity in managing programs and rotations, creating a seamless experience for every doctor, irrespective of region.

Eligibility Criteria (SOP for LTFT signed off by the Deans and Business Managers)

Appendix A – National Data Set

The eligibility application process should include the following data set:

Personal Details

• Surname (used in training)

• First Name

• Other Surname (if different from surname used in training)

• GMC/GDC Number

• Email Address

• Phone Number

• Are you a Tier 2 / Skilled Worker Visa Holder?

LTFT Eligibility

1. Trainees with a disability or ill

2. Trainees (men and women) with caring responsibilities

3. Welfare and wellbeing

4. Unique opportunities

5. Religious commitment

6. Non-medical development

7. Flexibility for training and career development

• Proposed LTFT Placement and Training Plan

• Level you will be working at

• Name of Training Programme

• LTFT Start date

• LTFT End date (if known)

• Proposed Percentage

• Applicant Declaration