The following FAQs have been created with trainee and TPD input to provide information for trainees, educational supervisors and employers. They are for guidance purposes only. If your LTFT question isn't answered below please feel free to get in touch with us (see contacts information) for further support and possibly to inspire a new addition to the FAQs. Enjoy!

APPLYING

  • Can I apply for LTFT just ‘because’?
    • Yes this is a category 3 application, there are specific application windows throughout the year at which point category 3 applications can be made - THIS ONLY APPLIES TO RECENT APPLICATIONS. NEW PROCESS COMING FOR 2023 (SEE BELOW)
    • Update Dec 2022: The above categories will no longer be used for the next application window. Trainees can still submit an application for LTFT working for lifestyle purposes as per criteria 3 (see below). As before, this will need to be done during set application windows. The following two quotes coming directly from HEE:
      • "Criteria 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). "
      • "From August 2022, all doctors in training across England in any specialty have the right to apply to train LTFT for any well-founded reason, including for their wellbeing or through personal choice."
  • My circumstances have changed and I need to go LTFT urgently. What do I do?
    • You are able to apply outside of set application windows to process an 'urgent' application to change to LTFT working if your reason for this is parental care, caring responsibility or disability/ill health. This involves lots of admin. In these situations, we would always recommend speaking with your educational supervisor/college tutor/TPD ASAP. Technically HEE have a 16 week notice period to change to LTFT working, however if they process and approve your application, the start date of your LTFT working depends on agreement with your employers (which you need to provide to HEE in writing), therefore they may be able to accommodate you changing to LTFT sooner than 16 weeks. Lastly, if applying for health grounds you will need to provide a supporting letter from your GP or occupational health department.

 

ROSTERING/WORK SCHEDULES

  • What is the maximum LTFT percentage I can work in London? The maximum is 80%
  • What is the minimum LTFT percentage I can work in London? The minimum is 50%
  • I work 80%, how many hours should I be working per week?
    • The average FTE hours are a maximum of 48 per week. In reality, most full-time rotas are a slightly less than this. LTFT doctors on the same rota should expect to work a pro-rata equivalent of full-time average weekly hours according to their working percentage. The absolute maximum that a LTFT doctor can work if their full-time colleagues were working 48hrs per week would be:
      • 80% = maximum 38hrs per week on average
      • 70% = maximum 34hrs per week on average
      • 60% = maximum 29hrs per week on average
      • 50% = maximum 24hrs per week on average
    • Trainees should expect these hours to be spread across a pro-rata reduced number of all shift types (nights, long days, short days etc.), i.e. if a full-time trainee works 20 night shifts over 6 months, a 50% FTE trainee should expect to work 10 night shifts over 6 months
    • The number of any fixed non-working days may vary based on the local rota. i.e. a 50% trainee may have Monday & Tuesday as non-working days then work their required 50% of all shift types across the remaining days (Wednesday-Sunday). Another example is a 70% trainee with one non-working day who works their required 70% of shifts across the other 6 days. It is very rare for LTFT trainees to be scheduled to work half days.
  • I’m a 60/70/80% LTFT trainee and I’ve been put into a slotshare, is this right?
    • Generally speaking, LTFT trainees should expect to be in a slotshare unless there are rota-gaps.
  • "I'm a 70% LTFT trainee but my new trust have asked me to slotshare with another LTFT trainee. They have told me I will only do 50% of out of hours shifts. Is this OK?"
    • Generally speaking, a LTFT trainee should be prepared to work the same FTE percentage across all shift types. However, funding for slot sharing LTFT trainees is complicated and a trust may only be prepared to pay 100% of out of hours pay for one slot. This may mean that when all slots on a rota are full, a 60/70/80% trainee may be rostered to work 50% of FTE out of hours shifts (so that the OOH is shared equally between slotshare partners). This results in a reduction in the proportion of 'on call' shifts. Often trusts will make up the difference with ‘in-hours’ shifts. Either way this is likely to result in being paid less than an equivalent trainee working the same percentage across all shift types.
  • "I'm an 80% trainee but I only want to work 50% of out of hours shifts - this is what a friend in another trust is doing, can I do the same?"
    • As stated above, a LTFT trainee should be prepared to work the same percentage of all shift types. Any requests to reduce out of hours shifts would have to be agreed locally and then from placement to placement. We have some 50% LTFT trainees saying "I'm happy to go up to 80% in-hours if I can stay 50% out of hours", this is not a typical arrangement and again would need to be agreed locally.
  • My non-working day is Tuesday, am I allowed to work a Tuesday night? How do nights work on LTFT rotas?
    • The way in which LTFT rotas are made varies from trust to trust. Often the trainee is involved early on in building their rota from choosing a ‘pro-rata-reduced’ number of each shift type from a FTE rota slot. However the rota is made, when satisfying the requirement to fulfil the necessary pro-rata-reduced numbers of each shift type (i.e. short days, weekend long days, nights), it may be the case that a LTFT trainee has to work a night shift that runs into or starts on their required non-working day. i.e. this doctor may elect to work night shifts on Tuesday but avoid Monday nights so they can be awake/rested for their non-working day. Therefore, it is critical for trainees with fixed non-working day requirements to be involved very early on with discussing their needs with rota-coordinators.
    • Also see the following from the Junior Doctor Contract: NHS-doctors-and-dentists-in-training-eng-tcs-v9_0.pdf (nhsemployers.org). Page 34, Clauses 18 and 19. "When requested by a doctor, all reasonable attempts should be made to facilitate set working day patterns.... provided that service needs can be met." "Unless agreed, no shift should be rostered on a non-working day in a fixed working pattern"
  • I work 80% and have an agreed work schedule with a non-working day of Thursday. My rota co-ordinator is now asking me to work a Thursday day shift, is this allowed?
    • This depends on your category of LTFT training.
      • For category 1 &2 we defer to the following statement from the junior doctor contract "Unless agreed, no shift should be rostered on a non-working day in a fixed working pattern"
      • For category 3: During the LTFT application process, category 3 applicants are informed that they cannot necessarily expect to have a fixed non-working day. In reality most departments will find it easier to set fixed non-working days however this relies on mutual agreement.
    • Dec 2022 update: with categories of applications now being a thing of the past, we await clarification on the above issue. The answer to the question below also provides some relevant information in this area
    • Non-working day: “I am starting at a new trust, can my employer refuse to agree to my requested non-working day?”
      • This is a tricky area, the junior doctor contract stipulates that “all reasonable attemptsshould be made to facilitate set working day patterns, in line with their statutory right to request flexible working provided that service needs can be met”. In other words, any non-working day arrangements are mutually agreed between an employer and the junior doctor. In practice the majority of trainee non-working day requests are accommodated by employers but we recognise that sometimes this is not the case. This is a local employment issue therefore your TPD/HEE cannot stipulate set working days for trainees to trusts. Therefore we encourage LTFT trainees to make early contact with college tutors and rota coordinators to discuss their individual needs. Furthermore, if you are in a slot share, between you the whole slot will need to be covered and you will not both be able to have the same days off. This needs to be negotiated between slot share partners.
    • Should I get a day-in-lieu if my full-time equivalent rota slot is marked as an off-day but it falls on my non-working day?
      • No, by working pro-rata of each shift type, LTFT trainees will naturally be allocated the correct number of off-days. You do not get a day in lieu in this scenario.

 

LEAVE

  • Annual leave: How much annual leave do I get?
    • Pro-rata reduced amount according to your FTE percentage
      • 5 years of continuous NHS service means 32 days
      • <5 years of continuous NHS service means 27 days
    • Study leave: How much study leave do I get?
      • You are entitled to a pro-rata amount of study leave. Full-time entitlement is 30 days per year
    • Bank holidays, how do they work?
      • The total annual bank holidays number is 8, so for example if you are 60% you should get 5 days per year pro-rata
      • Your trust may allocate you pro-rata additional annual leave days. So that:-
        • If you work an on-call day on a BH, you work and no day off in lieu is given, as it is already in your leave allowance.
        • If you are scheduled to work a non on-call shift on a BH you then take the bank holiday as a full-timer would, or you can chose to work.
        • If you are not due to work the BH (it’s on your non-working day or you are not scheduled to work) then your compensatory leave allowance is untouched

 

PAY

  • How will it affect my pay?
    • Your pay will obviously be reduced overall compared to full-time working in the same post, however for more senior trainees you may pay less tax as a proportion of your overall earnings. This is because the 40% ‘higher rate’ income tax rate applies to annual earning above £50,271 (the rate of income tax below this threshold is 20% rather than 40%). There is also an additional flexible training payment, paid annually in the 2016 contract and monthly in the current contract (the latter appears as ‘flex PT trans 2019’ on your payslip)
  • How will I know if I am being paid correctly?
  • What about my pension?
    • In 2022 the pension T&Cs have changed so that LTFT doctors no longer pay full-time contributions. Success! Your pension payments (the money you get when you retire) on the latest pension scheme is calculated based on career-average earnings so it will be lower if you work LTFT.

MATERNITY

  • What about maternity leave?
    • Your maternity pay is calculated based on average weekly earnings for the 8 weeks up to and including the 15th week before the expected week of childbirth. This will usually be an average of the 2 monthly payslips before week 25 of pregnancy. Therefore, as you would expect, maternity pay will be reduced.

 

LOCUM SHIFTS

  • Can I do locum shifts whilst working LTFT?
    • Yes, but if you are doing an excessive amount of locum shifts, the college advise that you discuss your LTFT status with your ES/TPD. You also need to declare locum work that you do on your ARCP form-R

 

TRAINING

  • Does going LTFT always mean more training time?
FTE Training extension for every 2 yrs
50% 1yr
60% 9 months
70% 6months
80% 3 months
  • Going LTFT will delay your CCT date regardless of your FTE percentage (even if working 80% - the max LTFT % in London). Having said this, training is competency based therefore you may be able to accelerate. This must be discussed prospectively with your educational supervisor and TPD so competency can be properly assessed. Applications to fast-track training need to be made 6 months in advance and submitted for consideration at ARCP. 

 

PROGRESS+

  • I am a current LTFT trainee, I don’t know how progress+ will affect me, help!
    • This is tricky and individualised. Stay posted for some illustrative examples from the progress+ information evening

 

RETURNING TO FULL-TIME

  • What if I want to go back to full-time?
    • You can change back to full-time working but only when this can be accommodated within the programme. This is also very likely to affect your future placements. At the point of wanting to return to full-time, if your current trust can accommodate a change to full-time, great! If they can’t, you will probably need to wait for the next changeover after the minimum notice period (16 weeks) from submitting your change form.

WHAT IF MY QUESTION IS NOT ANSWERED HERE?

    • Firstly please have a look through the information page
    • HEE have also recently published some FAQs which you can view here

here

  • Please get in touch with us with any further queries, perrhaps your AQ will become a FAQ!