This page outlines the data that have been collected from North East Local Offices LTFT Policy version 3 of February 2024.

LTFT Eligibility (See 4.0 of the version 3 policy)

Applications must be made a minimum of 16 weeks prior to start of LTFT arrangement

All employees have a legal right to request flexible working – not just parents and carers. Therefore, all doctors and dentists 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 (see policy for the examples).

During the Foundation Programme F1 doctors must successfully complete 12 months WTE training to be eligible to apply for GMC Full Registration with a licence to practice which must be in place to facilitate progression into F2 training

The doctor or dentist in training must inform their college of their arrangements for LTFT training as per Gold Guide section 3.126iii..

Doctors or dentists in training on a Tier 2 or Skilled Worker visa must comply with the UK Visas and Immigration requirements for minimum salary. NHS England cannot approve any LTFT requests where they do not meet these requirements regardless of the reason for the LTFT request

LTFT Application (see section 4.1 of the policy)

Requests to work LTFT can either be made at the point of application for entry into training or at any time once a doctor or dentist has been accepted into training.

All doctors and dentists in training must contact their Training Programme Director (TPD), Foundation Programme Tutor (FPT) or equivalent prior to submitting a LTFT application to advise them of their intent to apply for LTFT training

LTFT doctor or dentist in training may be allocated to a post in a slot share with another LTFT doctor or dentist or as a LTFT doctor or dentist in a full time slot (appendix A) or supernumerary post (in exceptional circumstances

To apply for LTFT training, a doctor or dentist in training must complete a LTFT application form (appendix B) online and submit the form via email to their named People Services Officer (PSO) in the Lead Employer Trust (LET) following discussion with their Training Programme Director (TPD), Foundation Programme Tutor (FPT) or equivalent and their Educational Supervisor.

The LTFT application form must be submitted along with any supporting documentation as required (appendix B / Part 2) to the LET with at least 16 weeks’ notice before the proposed start date for a change in working hours. This is to allow at least 12 weeks’ notice to the employer of the proposed changes in line with the code of practice

Where a doctor or dentist in training wishes to make a further increase or decrease to their whole time equivalent (WTE), they must make an additional application to their LET providing at least 16 weeks’ notice before the proposed start date for a change in working hours. Any decrease in working hours will be subject to the minimum requirements for recognition of training set by the GMC’s 2017 position statement on LTFT training. For those doctors in training on a Tier 2 or Skilled Worker visa please refer to section 4.2.

LTFT Application Approval (see section 4.4 of the policy)

Approval to work LTFT will normally be given for the duration of the training placement / programme or dependent on the illustrative list under which they have applied but may be subject to annual review around renewal. This is likely where the reasons for requesting LTFT working are no longer applicable, i.e., a request to undertake professional development such as a management course is completed or where the demand for LTFT working exceeds the capacity of the programme to provide it.

On behalf of NHSE NE the Training Programme Director, Foundation Programme Tutor or equivalent will assess the application for LTFT training and where necessary prioritise according to the provisions of the Equality Act relating to protected characteristics.

Once reviewed the doctor or dentist in training will receive an email from the LET informing them that their LTFT application has either been approved or refused with reasons given.

If approved, the doctor or dentist in training must engage with their placement (or next placement) department (rota co-ordinator) to agree their working days and working pattern. Once agreement is reached the department will complete a personalised work schedule and submit this via email to their named People Services Officer (PSO) in the LET for review and approval prior to any change of working hours/pattern being implemented.

The working days and pattern must be mutually agreed between the doctor or dentist in training and the LEP. It must also be ensured that any working pattern or none working day agreed does not detrimentally impact on the doctor or dentist in training receiving full training. For example, if regional teaching is held every Tuesday the doctor or dentist in training would not have a Tuesday agreed as a none working day.

LTFT Application Refusal and appeal (see section 4.5 of the policy)

Where a request to work LTFT via application is refused a member of the NHSE NE Faculty (HoS, TPD, FPT, Postgraduate Dean or nominated deputy) should meet with the doctor or dentist in training to explain the reasons for the decision. The reason should align to the business reasons set out in the current legislation.

If following discussion, there is new information or an omission it may be possible for the Training Programme Director, Foundation Programme Tutor or equivalent to accept the LTFT request with modifications. This may include working a different WTE or a change to the proposed start date.

Where a request to work LTFT has been declined the doctor or dentist in training has the right to appeal that decision and must follow the appeal process for the NHSE NE local office

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:

1. Pre-application Stage/Discussion and Notifying: 12 weeks or earlier, where a trainee discusses with their TPD / Educational Supervisor and agree “in principle” a post .

2. LTFT Application Stage: With at least 12 weeks notice given and application submitted to HEE. And Negotiation of Working pattern and agreeing start date /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

4. Trainee Commencing their training on LTFT basis

As-Is end-to-end LTFT process for North East

CCT date Calculation

The CCT date initially remains the same as a whole-time doctor or dentist in training because the date entered is only changed via the ARCP process as detailed in the Gold Guide (section 4.87iv). Once the revised CCT date is determined by the ARCP panel, the LET will write to confirm the extension of contract

Actors

Application Numbers Feb 2022 to Aug 2023

Pain Points in the process

LTFT Email templates

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

GROUNDS FOR REFUSING A REQUEST

The service ground(s) must be from one of those listed below:

• Burden of additional costs • Detrimental effect on ability to meet customer/patient demand • Inability to re-organise work among existing staff • Inability to recruit additional staff • Detrimental impact on quality • Detrimental impact on performance • Insufficiency of work during the periods the employee proposes to work • Planned structural changes • Training requirements (including GMC, NIHR and Gold Guide

Documents

Feb. 2024 Updated document from NE