The London School of Paediatrics is keen to develop and support LTFT training. This page aims to signpost trainees and trainers on various aspects of LTFT training.

Categories of LTFT training

Trainees may consider less than full-time training for various reasons that range from caring responsibilities, health and wellbeing concerns, professional development, or to ensure a healthy work-life balance. Based on the reasons, there are three categories of application with slightly varying processes:
Category 1: Health or caring reasons
Category 2: To avail unique opportunities for personal or professional development
Category 3: Any other reason

Please discuss with your program management TPD before you apply. Detailed resource on LTFT training, mainly focussing on the new Cat 3 LTFT, is available at the link below: this link.

Video resources:

LTFT Training – Applying
LTFT Training – Pay
LTFT Training - Rota patterns

Benefits and Challenges

Although working LTFT has many benefits, there can also be a few challenges. Hence it is vital to plan working arrangements and patterns very carefully.

Comprehensive information on LTFT eligibility for trainees, application, tips and resources is available here.

Application and Process

Trainees who want to apply, change the LTFT category, or the percentage of whole-time equivalent (wte) must communicate with their programme management TPD at least six months before the change. Applications for category 3 have specific application windows and have different minimum notice requirements to category 1 or 2 applications.  Key links are below:

Find your TPD
HEE LTFT application webpage

Rota issues, slot share, reduced hours in an FT slot and related FAQ’s

This is an area that can cause potential conflict and provoke significant anxiety both for trainees and trainers. Most issues can be resolved by communication and understanding the perspectives of both the trainee and rota manager or department.

LTFT trainees work a minimum of 50%, but up to 80% of the whole time equivalent (WTE). They are allocated to either work as:

part of a slot-share - where the two trainees together may add up to more than 1.0 WTE providing extra cover for the specialty
a single trainee working reduced sessions in a full-time post

HEE guidance states that “Day-time working, on-call and out-of-hours duties should generally be undertaken on a pro-rata basis to that worked by full-time trainees in the same grade and specialty unless the circumstances which justify flexible training make this impossible and provided that legal as well as educational requirements are met”.

The majority of trainees prefer working on fixed days each week with the same days off each week. This can be particularly important when organising child care, as most nurseries, childminders, and nannies cannot offer varying days each week.

Trainees must be given adequate notice of rotas, and working commitments as the organisation of child care and medical appointments often require substantial notice. This relies on trainees playing their part by contacting new teams and rota coordinators to discuss their rota well in advance of starting.

When working with a slot share partner replacing a full-time post, the expectation is that between the two trainees, they will cover, as a minimum, all days/shifts of the full-time rota. In all cases, the trainees need to negotiate working patterns so that educational and personal needs can be appropriately balanced with service needs. This requires flexibility and professionalism on the part of the trainees to reach a workable compromise that suits all relevant parties, particularly where specific working days are needed by both partners, e.g. to accommodate child care needs or to attend medical appointments related to health concerns or disability. The School of Paediatrics cannot mediate between two trainees, both requesting the same days to work.

Trainees must be given adequate notice of rotas (6 weeks before starting), and working commitments as the organisation of child care and medical appointments often require substantial notice. This relies on trainees playing their part by proactively contacting new teams and rota coordinators before the rota is out to discuss their rota well in advance of starting.

FAQ’s related to this topic

Please check out these pages:
https://lasepgmdesupport.hee.nhs.uk/support/solutions/folders/7000009155
https://lasepgmdesupport.hee.nhs.uk/support/solutions/7000006974

Guidance for organising an LTFT rota is provided by HEE and can be accessed here.

Pay arrangements

Pay is complicated anyway. It is more complex for LTFT and further complicated in slot sharing. Essentially, FT trainees are paid 50% of their non-banded hours by HEE via the Medical and Dental Education Levy. The trust bears the other 50% and banding costs. Each trust will have a budget for their 50% and the banding.

With LTFT, say at 70% wte, not in a slot share, it is relatively simple. 50% of the base salary comes from HEE, and the remaining 20% comes from the trust’s budget. The trainee works 70% of their non-banded hours and 70% of their banded hours. The trust only gets 70% of the work done, but it has 30% of its budget free to pay for, say, a locum. The trust is entitled to expect the LTFT trainee to work at least 70% of their non-banded hours. The downside of this relationship is that there is a 30% gap in the rota, which may cause problems for service delivery and may have a knock-on effect for others in the rota.

For LTFT trainees in slot sharing positions, it is more complicated. Both trainees cover a single slot in the rota as an advantage, and there are no gaps. But if the wte of both trainees together goes over 100%, it gets difficult for the trust, creating a ‘cost pressure’ – potential expense for the trust that it hadn’t anticipated. It’s a particular problem for out of hours activity, as the trust has only planned one slot on the rota and one salary for this time, but if both trainees are 70%, they would hope for 140% of a rota slot between them, with commensurate pay. The trust does not have this money. As a compromise, we ask that trusts provide a minimum of 50% of out of hours work for each trainee in a slot share.

Further details on pay arrangements can be accessed at:
https://www.bma.org.uk/pay-and-contracts/pay#payslips
https://questionnaires.bma.org.uk/news/lessthanfulltimetrainees/index.html
https://www.nhsemployers.org/articles/pay-and-conditions-circulars-medical-and-dental-staff

Useful links for further information:

Gold guide LTFT training (From page 30 of Gold Guide 7th Edition Jan 2018)
https://www.copmed.org.uk/images/docs/gold_guide_7th_edition/The_Gold_Guide_7th_Edition_January__2018.pdf

RCPCH
https://www.rcpch.ac.uk/resources/less-full-time-training-guidance

GMC
https://www.gmc-uk.org/education/standards-guidance-and-curricula/position-statements/less-than-full-time-training

NHS Employers
https://www.nhsemployers.org/articles/pay-and-conditions-circulars-medical-and-dental-staff

PGMDE

Returning to Practice for LTFT – video from the LSP

e-learning for health – for Educational Supervisors of LTFT trainees.
https://portal.e-lfh.org.uk/Component/Details/473676

LSP Facebook Group

.

Contact

You may wish to know more – so please get in touch. The LSP LTFT is the newest group of the trainee committee, formed in 2020. The TPD lead is Syed Mohinuddin, contactable at syed.mohinuddin@nhs.net.