This page outlines the data that have been collected from Wessex t Local Offices and validated at a workshop (21st November 2023) to map their as-is business processes for Less Than Full Time Training.

1 Eligibility
2 Application Window for Wessex
3 Application Form for Wessex
4 LTFT Categories
5 Period of Grace
6 As-Is Processes
- 6.1 As-Is end-to-end LTFT process for Wessex
- 6.2 CCT date Calculation
- 6.3 Actors
7 Application Numbers Feb 2022 to Aug 2023; STATS – (From online form used since March 2023)
8 Rotation and application deadlines
- 8.1 Pain Points in the process
9 LTFT Email templates
10 GROUNDS FOR REFUSING A REQUES
11 Documents

Eligibility

All doctors in training can apply for LTFT training, the only requirement being a well-founded individual reason. A list of illustrative examples of reasons for requesting LTFT training is detailed below.

We may need to prioritise requests - if so, this will be in accordance with the provisions of the Equality Act related to protected characteristics, favouring applications related to Health and Disability, Caring responsibilities and roles relating to religious convictions.

Reasons for requesting LTFT training – illustrative list:

· Trainees with a disability or ill health – This may include ongoing medical procedures such as fertility treatment.
· Trainees with caring responsibilities (e.g. for children, or for an ill/disabled partner, relative or other dependant)
· 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).
· 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 train for more information.

Should a trainee wish to train at a percentage other than 50% up to 80% this will require written support from the TPD and the authorisation of the Associate Dean (AD) for LTFT training. Such applications must be for well-founded reasons. The GMC has produced a position statement on LTFT which states that trainees should be required to train at no less than 50%. In the exceptional cases where less time is requested, 20% is the absolute minimum. It is expected that trainees would only work less than 50% for a maximum of 12 months. Please refer to the GMC position statemen https://www.gmc-uk.org/education/standards-guidance-and-curricula/position-statements/less-than-full-time-training for full details

Application Window for Wessex

Doctors in training who wish to be considered for LTFT training should firstly read the guidance document. You are not permitted to commence LTFT training until you have had your application approved by NHSE (Wessex Local Office)

The application window for the February - August 2024 rotation has now closed. We will still accept applications from new starters who have not received placement/Trust information in time. Urgent applications on grounds of health, caring roles or religious convictions will be considered at any time but supporting evidence will be required.

Prior to completing the application form, doctors in training should ensure they have read the relevant information sheets and the BMA guidance on pay. Further guidance can be found on our website: https://wessex.hee.nhs.uk/trainee-information-journey/less-than-full-time-training

Applications need to be submitted no less than 16 weeks before the start date of the rotation during which you wish to go LTFT (rather than the date you wish to start your LTFT training). Applications may be considered outside of this time period for exceptional circumstances but evidence of Medical HR approval will be required as a supplement to your application.

Application Form for Wessex

The same form is completed for doctors applying for LTFT, returning to Full time and for doctors changing their LTFT Training Percentage

Link to application form: LTFT Application Form (office.com)

Applications are being considered for the following rotations:

February – August 2024 rotation – Application window closes 18th October 2023.

March – September 2024 rotation – Application window closes 15th November 2023.

April – October 2024 rotation – Application window closes 13th December 2023.

Urgent applications on grounds of health, caring roles or religious convictions will be accepted at any time but supporting evidence and HR agreement will be required.

LTFT Categories

Period of Grace

LTFT is available to trainees who are undertaking an agreed period of grace (up to 6 months), with the same principles in the policy adhered to. Supernumerary funding would not be available however to any trainee in their period of grace. Ideally trainees in their period of grace should be accommodated into a full time slot, although this is at the discretion of the TPD and employing Local Education Provider (LEP).

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/Discussion and Notifying: 12 weeks or earlier, where a trainee discusses with their TPD / Educational Supervisor and agree “in principle” a post .
LTFT Application Stage: With at least 12 weeks notice given and application submitted to HEE.
3.1 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

Trainee Commencing their training on LTFT basis

As-Is end-to-end LTFT process for Wessex

CCT date Calculation

The programme team, then share/confirm with trainee. An indicative CCT date can be given which will be confirmed at ARCP. Trainee can ask for their CCT date to be brought forward because they have met curriculum requirements. Royal college tools is used (there might be one for GP)

Actors

Actor

Actor
Postgraduate Doctor in Training	The applicant for LTFT
Training Programme Director (TPD)/Delegated Programme Team	Part of application approvers: check if trainee can be accommodated into programme programme For GP Application Verify application with AD Produce list and go through with Head of School (HOS) Check if trainee can be accommodated Check reasons and evidence provided
Educational Supervisor	Recommended trainee discuss their intention to go LTFT with ES
Trust LTFT Team	If application is submitted late; They issue letter of support to trainee as part of approval process.
Head of School	Provided approval for GP
Rota Coordinator	Plan Rota with trainee and work schedule
LTFT Admin (Part of role for Business Support and Education Programme Support Officers)	Look at the category the trainee applied for Check application to ensure everything is completed in the Form is application submitted on time? Check information around confidentially e.g. Child under 16 for AD for Childcare Ensure necessary support evidence is received. Request for more information or supporting evidence from trainee with a deadline to provide the necessary information. If not provided within the deadline the application will not be progressed further Note: Application will be paused until necessary evidence and information is received If late application, they ensure Letter of support from trust is received and additional supporting evidence Check trainee Visa status and sponsorship Check percentage against the legal requirements
Associate Dean	Look at the category the trainee applied for Check application to ensure everything is completed in the Form is application submitted on time? Check information around confidentially e.g. Child under 16 for AD for Childcare Ensure necessary support evidence is received. Request for more information or supporting evidence from trainee with a deadline to provide the necessary information. If not provided within the deadline the application will not be progressed further Note: Application will be paused until necessary evidence and information is received If late application, they ensure Letter of support from trust is received and additional supporting evidence Check trainee Visa status and sponsorship Check percentage against the legal requirements Update Master spreadsheet with Eligibility- Associate Dean Role

Application Numbers Feb 2022 to Aug 2023; STATS – (From online form used since March 2023)

umbers of applications showing highest number in a single day of 8.

Rotation and application deadlines

For rotations with a duration of 12 months we will accept an application in time for the 6 month point.

Pain Points in the process

No.	Pain Point / Area to improve	Comment

No.	Pain Point / Area to improve	Comment
1	They can still put their application through without discussing with the TPD and the trainee tick the box in the form that they have spoken to the TPD
2	Please note at this time it is not possible to save a form in progress and return to it at a later time.
3
4
5
6
7

LTFT Email templates

To be sent by LO

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

Email Template	Body / Content

Email Template	Body / Content
CONFIRMATION OF LTFT – NEW APPLICATION (Once all approved)	Dear Dr XXX,    Less Than Full Time Training Programme    Thank you for completing the application form for less than full time training.  I am pleased to inform you that you meet the criteria for eligibility under disability or ill health / caring responsibilities / welfare and wellbeing / unique opportunities / religious commitment / non-medical development / flexibility for training and career development to continue your training as a LTFT trainee. You are required to fully comply with the LTFT Guidance.    Approval of your LTFT training is subject to the following:    Effective date from: XX To: XX (include for welfare and wellbeing or flexibility for training applications)  Percentage: XX    (Include for welfare and wellbeing or flexibility for training)   Your LTFT status will be in place for a 12-month period only. Should you wish to remain LTFT after this time you will need to re-apply for LTFT training 16 weeks before the rotation during which your LTFT period ends.     This email is your certificate of eligibility which must be provided as evidence of your LTFT training percentage to your employers.  Please contact your Medical HR team immediately so that any rota changes can be discussed and agreed to ensure they meet both educational and service needs. These will vary between Trusts and departments and will need to be reviewed with each rotation.  Any request to change your LTFT training percentage from that stated above must be approved by NHS England, Wessex 16 weeks prior to the rotation during which you want to change percentage. To change percentage please complete a new application form via our website. Please note that it is normal practice to only approve one change of percentage in a twelve-month period. Additional evidence will be required for any further change in that period.  I would like to wish you all the best in your training and if you have any further queries, please can these be directed to your education programme manager or officer in the first instance.   Yours sincerely  Dr Phil Rushton  Associate Dean
CONFIRMATION OF LTFT – CHANGE OF PERCENTAGE (Once all approved)	Dear Dr XX Less Than Full Time Training Programme Thank you for requesting a change to your less than full time training (LTFT) percentage. I am pleased to inform you that the Associate Dean and Programme Manager have approved this change. Approval of your LTFT training is subject to the following: Effective date from: XX Change in Percentage from XX to XX Type of Change: Permanent/Temporary (If temporary, date to revert to original percentage) IF TEMP – Should you wish to remain at your new working percentage after the end date above you will need to re-apply for LTFT training 16 weeks before the rotation during which your LTFT period ends.  If no application is received, you will automatically revert to your previous percentage. This email is your certificate of eligibility which must be provided as evidence of your LTFT training percentage to your employers. Please contact your Medical HR team immediately so that any rota changes can be discussed and agreed to ensure they meet both educational and service needs. These will vary between Trusts and departments and will need to be reviewed with each rotation. Any request to change your LTFT training percentage from that stated above must be approved by NHS England, Wessex 16 weeks prior to the change date. The change form can be found on our website. Please note that it is normal practice to only approve one change of percentage in a twelve-month period. Additional evidence will be required for any further change in that period. I would like to wish you all the best in your training and if you have any further queries, please can these be directed to your education programme manager or officer in the first instance. Yours sincerely Dr Phil Rushton  Associate Dean
CONFIRMATION OF LTFT – RETURN TO FULL TIME TRAINING (Once all approved)	Dear Dr XXX Less Than Full Time Training Programme Thank you for completing the change of percentage form to return to full time training. I am pleased to inform you that the Associate Dean and Programme Manager have approved this change as detailed below: Effective date from: XXX This email is your certificate of eligibility which must be provided as evidence of your training percentage to your employers. Please contact your Medical HR team immediately so that any rota changes can be discussed and agreed to ensure they meet both educational and service needs. These will vary between Trusts and departments and will need to be reviewed with each rotation. Please note that on returning to full time training your LTFT status has been removed and if you wish to train at LTFT in the future you will need to reapply. Please note that it is normal practice to only approve one change of percentage in a twelve-month period. Additional evidence will be required for any further change in that period. I would like to wish you all the best in your training and if you have any further queries, please can these be directed to your education programme manager or officer in the first instance. Yours sincerely Dr Phil Rushton  Associate Dean
EXAMPLE OF A REJECTION EMAIL – WE DON’T HOLD A TEMPLATE FOR THIS AND IT IS COMPLETED MANUALLY	Dear Dr XXX Thank you for your application to increase your training percentage. The Programme Team have discussed this with your TPD and advised that unfortunately your application cannot be supported at this time, due to lack of capacity on the current rotation. Applications will be considered for the October 2024 rotation. The Associate Dean, Medical HR and Programme Team/TPD must be unanimous in their support for a LTFT application. Without all three approvals unfortunately we are not able to progress your application. I have copied your Programme Team and TPD into this email if you wish to discuss this further. I have also copied in Medical HR for their information. If you would like to appeal the LTFT decision you can also respond directly to this email and we will pass that on to the Associate Dean for LTFT for discussion.
Rejection – application not made within window
Rejection- include appeal procedure
LTFT/Change of Percentage Application for Test Programme
LTFT/Change of Percentage Application for Test - Gwil Test - Williams 1234567
REQUEST FOR HR AGREEMENT AND/OR REASON FOR LATE APPLICATION (We delete paragraphs as necessary)	Dear Dr XXX Thank you for your application to train LTFT / change your working percentage / return to full time training. I am sorry to hear this is a difficult time for you. As your application has been received less than 16 weeks before your programme rotation date (MMMM YYYY) supporting evidence from the Trust Medical HR department that you are rotating to is required in order to progress your application please. I have copied in your Education Programme Manager/Officer for their awareness and the Trust Medical HR department for your next rotation, so you will easily be able to make contact. Please include what you have applied to change your percentage from and to, and the start date that you have requested these changes from, so they know if they are able to support it. This evidence will need to be sent back to england.ltft.wx@nhs.net please. In addition, the window for non-urgent LTFT applications for your rotation period is closed. We do accept late applications but the Associate Dean will require a reason for the late application and why your request should be prioritised (for example a change of circumstances not known at the 16 week deadline). Please could you supply a short statement which we can attach to your application. Please do not hesitate to contact me should you have any questions.
REQUEST FOR HR AGREEMENT (When an application is for the current rotation/very late notice)	Dear Dr XXX Thank you for your application to train LTFT. train LTFT / change your working percentage / return to full time training. I am sorry to hear this is a difficult time for you. As your application has been received with an immediate requested start date supporting evidence from the Trust Medical HR department that you are rotating to is required in order to progress your application please. I note you have stated on your application form that you have acquired that confirmation so please do forward that to us as soon as possible. I have copied in your Education Programme Team for their awareness and the relevant Trust Medical HR. For speed I can confirm you have requested XXX with a requested start date for that of XXX. Please do not hesitate to contact me should you have any questions.
REQUEST FOR SUPPORTING MEDICAL EVIDENCE – (HEALTH/DISABILITY APPLICATION)	Dear Dr XXX Thank you for your application for LTFT training. I am sorry to hear this is a difficult time for you. As you have applied for LTFT under the health and disability category we will need supporting evidence from a GP/OH practitioner please in order to progress your application. This evidence should specifically recommend reducing your working percentage to aid your situation. Please could you obtain relevant evidence and email it to us at england.ltft.wx@nhs.net I have copied your TPD into this email for their reference.

GROUNDS FOR REFUSING A REQUES

TIS21 Confluence Space

LTFT -Wessex processes