If you have a query that is not covered in the below FAQs, please get in touch with our team at ltft.eoe@hee.nhs.uk


LTFT and “Slot Shares”: Notes for TPD’s and Educators- January 2022

Background information:

HEE will pay an uplift of 20% for the basic working hours if trainees slot share.

The trust will be asked to pay any more than a 20% uplift

For the purposes of numbers in your training program, HEE is managed on posts. Two trainees sharing a line on a rota are occupying one post. Three trainees sharing two lines on a rota are occupying two posts.

Slot sharing is therefore advantageous as fewer posts are used (so you as TPD can recruit more trainees). It also means that the rota can be filled more easily.  Many trainees prefer to be in a well organised slot share post than LTFT in a FT post.


LTFT scenarios

  1. Two trainees work LTFT at 60% FTE (=120% in total) and share a line on the rota.  HEE pays the 20% uplift for the basic hours, the OOH is split 50:50 and paid by the trust
  2. Two trainees work LTFT, one at 60% FTE, one at 80% FTE (=140% in total) and share a line on the rota. HEE pays a 20% uplift for the basic hours, the trust is asked to pay the additional 20%. They split the OOH 50:50
  3. Three trainees work LTFT, one at 60% FTE and two at 80% FTE (= 220% in total). They share two lines on the rota. HEE pays the 20% uplift. They split 2 OOH rotas approximately 55%/72.5%/72.5%
Am I eligible to train less than full time?

Any trainee in a substantive HEE approved post can apply for less than full time training. If your eligibility is approved, this will be accommodated as soon as practically possible.  Anyone can apply for less than full time training, but they must have well founded reasons why full time training is impractical. Reasons for wishing to train less than full time have been nationally agreed upon, and are divided into three categories (outlined below).

The needs of trainees in category 1 will always take priority. Applications in category 2 may be considered but permission will depend on the capacity of the specific training programme and availability of resources. The Category 3 LTFT model is designed to improve wellbeing, reduce attrition and improve the working lives of trainees by offering an opportunity for improved work-life balance over a specific period of time to support trainees post COVID. 


Category 1 – Those doctors in training with:

- Disability

- Ill health

- Responsibility for caring for children (men and women)

- Primary carer for ill/disabled partner, relative or other dependent


Category 2 - Those doctors in training with:

- Unique opportunities for their own personal/professional development (example training for national/international sporting events)

- Short term extraordinary responsibility (for example a national committee)

- Religious commitment – involving training for a particular religious role which requires a specific amount of time commitment

- Non-medical professional development such as management courses, law courses, fine arts courses or diploma in complementary therapies.


HEE recognises that occasionally trainees have opportunities to run other businesses and would like to train LTFT. These requests will be considered with these cavets:

  1. The impact on service, and other trainees.
  2. Prioritisation within Category 2 – perhaps there are other opportunities that in the context of finite capacity, may trump these.
  3. The need for all external professional work to meet the GMC requirements around appraisal in relation to their full scope of practice. All this work must be declared on the form R


Category 3:

It was only available to trainees in Emergency Medicine, Obstetrics & Gynaecology and Paediatrics. From August 2021 it will be available to all trainees after full implementation as detailed in table 1 below. 


Lead in period go live  

Full model implementation go live  

Higher Physicianly Specialties  

August 2021 

August 2022  

Intensive Care Medicine 

August 2021 

August 2022  


August 2021 

August 2022  


August 2021 

August 2022  


August 2022 

August 2023  

General Practice  

August 2022 

August 2023  


August 2022 

August 2023  

Foundation and Core Training  

August 2022 

August 2023  

Remaining specialties  

August 2022 

August 2023  


Trainees on these programmes are able to apply for LTFT as a personal choice and are not required to meet either category 1 or category 2 criteria as stated above. 

Other well-founded reasons may be considered but it would be dependent on the particular situation and the needs of the specialty in which the individual was training

A ‘lead-in’ 12 months which allows trainees to undertake a 4-month period at 0.8 WTE (whole time equivalent). This allows 3 possible periods to undertake a 4-month LTFT period. 

Following the completion of the ‘lead in’ year, all specialties will then transition the following year into the full Category 3 whereby trainees can undertake an unspecified period of time as LTFT Category 3 and at percentages of 60% or greater. 

Trainees accepted to undertake LTFT Category 3 may only do so when there is capacity and agreement by the Training Programme Director or Head of School. Changes should usually align with the rotation date, but this may not be immediately available. Changes should respect Code of Practice requirements. 

Please Note: Category 1 applicants have priority and HEE will support all category 1 applicants on the grounds of their health, disability or caring responsibilities, subject to available funds and training capacity.  Access to Category 2 and 3 are dependent on individual circumstances and the availability of suitable training placements. Where an application is refused by HEE the applicant has a right of appeal, but, the overall training capacity of a training programme and service commitment will have to be taken into consideration.


When do I need to submit a change in plan form?

Trainees are required to submit a Change in plan form only if they wish to change their percentage of full time work or if their slot share partner changes. The Change in Plan form is located on the same form as the stage but it appears after selecting the change in plan dropdown on page 2.

A Change in Plan form should be submitted 3 months before the planned start date.

Trainees are no longer required to complete a renewal form whenever they rotate trust or practice as they will be notified of the trainees' LTFT status prior to joining the trust.


How far in advance should I apply?

Applicants should apply to HEE with no less than 12 weeks (3 months) notice of their proposed LTFT start date and it will take up to four weeks process the forms. You must receive written confirmation of your Form 1: Eligibility Assessment & Training Plan (or From 2: Renewal Training Plan if you are renewing) before you begin to train LTFT. Please note that it may not be possible to accommodate your proposed LTFT training plan straight away.

At what percentage of full time can I work?

The GMC Postgraduate Board have issued a position statement determining that trainees will be required to undertake no less than 50% of full-time training.

For the small number of trainees who experience exceptional difficulties, it has been agreed that postgraduate deans should have flexibility to reduce the time requirement further. This needs individual discussion with the trainees TPD and then with Dr Rowan Burnstein, AD for LTFT

What is the maximum age my children can be to meet the priority criteria?

You will be awarded priority for LTFT Training if you have a child up to and including the age of 16 years old, or a disabled child who is under 18 years and receives disability living allowance.

I want to revert back to full time, what do I need to do?

In the first instance you really need to discuss this with your TPD and Medical Staffing / Practice, as they will need to ensure you can be accommodated. If this is agreed with your TPD and Medical Staffing / Practice, we need a confirmation email from yourself and your TPD stating whom this has been agreed with and what date you will be commencing 100% from. We will then let the necessary people know of these changes in order for any financial adjustments to be made.

If I train at less than full time, how much longer will I have to extend my training by?

Training is becoming more competency, rather than time based and your progress should be reviewed at each ARCP. As a rule of thumb, your training will be extended so that you are training for the same sort of time as your full-time colleagues. For example, a year at 60% full time equivalent is 7.2 months. This is the minimum time that will count towards your CCT.

Foundation trainees- please discuss with the Foundation School AS Foundation Training is time based and, generally, full placements need to be completed.

If I am in an academic training programme, can I work LTFT?

Yes, this is supported both by CATO and NATO and NIHR. Please discuss with your TPD. Academic lead and the relevant lead in CATO or NATO before submitting your application to HEE.

How much will I be paid in relation to my FT colleagues

Please discuss pay with your employer (trust HR or Lead Employer for GP/PH trainees). The BMA webpage is also helpful:


Can I have other paid employment whilst working LTFT?

Yes, but this must be declared on your form R if the work requires your license to practice.

If you are doing locums, please discuss this with your ES/TPD before agreeing the shift (unless a true emergency). Trainees who are LTFT and do an excessive number of locum shifts may be asked to reconsider their LTFT status.

Locum shifts will not count towards training.

How much annual leave am I entitled to?

Annual leave for LTFT trainees is calculated on a pro-rata basis, so if you work 60%, your annual leave entitlement will be 60% of that of a full-time trainee. You should contact your employing Trust or lead employer for exact calculations.

Do I need to inform HEE if I go on maternity leave?

Yes, you should inform you employer, TPD and HEE of your planned maternity leave dates as soon as possible. Please email the Programme and Information Team: edit.eoe@hee.nhs.uk and they will ensure your records are updated at HEE accordingly.

Trainees do not need to tell HEE if their LTFT plan expires before their mat leave finishes and submit a new plan when they return. They only need to submit change in plan LTFT application form if their percentage and slot share partner is going to change.

Please note: you are not required to submit an LTFT application to cover your maternity leave period.

Can I appeal against HEE’s decision not to allow me access to apply for LTFT Training?

Yes, though it is recommended that you first attempt to resolve any issues informally via discussion with your TPD and the AD for LTFT (rowan.burnstein@hee.nhs.uk)

If a doctor in training has had their application to train LTFT declined, they may appeal in writing to the relevant Postgraduate Dean sending the email to ltft.eoe@hee.nhs.uk. The Postgraduate Dean’s decision will be final.

Can my POG be extended beyond six months as I am LTFT?

No. Period of Grace for full time and LTFT trainees is on a fixed term basis for 6 months only and not pro-rata.

How do I find out who my Training Programme Director (TPD) is?

For Foundation TPDs (FTPD) please click here: https://heeoe.hee.nhs.uk/node/2686 and select your Trust from the options on the left hand side.

For GP TPDs, please click here: https://heeoe.hee.nhs.uk/gp_programme_directors and identify your programme area.  

For all other specialty TPDs, please click Medical Training. Once on the Medical Training page please locate your School from the blue menu options on the right hand side of the page. Once located please select your specialty, then click on the 'Contact Us' menu option on the right hand side of your specialty page which will include contact details of the TPD(s) for the specialty.  

I will be LTFT as a GP trainee and working in a practice, do I need to provide further details on my application?

Yes, we need a timetable of what you will be doing each day. This is so that we can ensure that you are in line with your FT colleagues and meet your clinical and educational time. FT GP trainees work 28 clinical hours and 12 educational hours. Please discuss this with your TPD and practice and submit this information with your application or it may be returned to you.

What are the minimum requirements for my visa status?

All sponsored trainees, regardless of whether they hold a Tier 2 visa or Skilled Worker visa, will need to meet the minimum salary requirements of £20,480 per annum when calculated as a percentage of the going rate. To do this the ‘going rate’ is based on the basic salary as outlined in the NHS Medical and Dental (M&D) pay scales.

A helpful guide, based on current pay scales, the minimum hours are set out in the table below:


Going rate/Basic salary (M&D pay scale) 

Minimum hours to meet salary requirement of £20,480 per annum

Salary per annum 



70% or 28 hours 




61% or 24.4 hours 


CT/ST 1/2 


51% or 20.4 hours 


CT3 and ST 3/4/5 


41% or 16.4 hours 


ST 6/7/8 


36% or 14.4 hours 



Getting Approval

We have informed trainees that while they may be able to reduce their hours to meet sponsorship requirements, LTFT hours will need to be approved by their local HEE Office and/or Trust. 

For further information please contact sponsorship@hee.nhs.uk 

Who needs to sign the LTFT form?

The form will need to be signed the trainees' Training Programme Director or Head of School and their Educational Supervisor or College Tutor. For GP trainees, the form will also need to be signed by their Practice Manager.

For category three (other than paeds/O&G and higher EM trainees), medical staffing also need to sign.


How does slot sharing work?

Slot sharing means that two (occasionally three) trainees share one slot (two slots if three trainees) on the rota. The OOH is split equally between the trainees.

Most trainees slot sharing work at 60% FTE each (and do 50% of the OOH each). Other arrangements will need additional funding via the trust, so please check with your TPD that this is in place before submitting a slot share of more than 60% FTE for each trainee.

If you are slot sharing please try to submit your form at the same time as your slot share partner.

Can Foundation trainees work LTFT?

Yes. The only time limitation is that provisional registration (i.e. F1) can only be held for 3 years and 30 days but most trainees can complete their Foundation programme within that time working at e.g. 60% LTFT.

Can I choose which days I work?

This needs to be negotiated with your employer as soon as possible. They will try to honour your chosen working pattern, but this is not always possible both for LTFT in a Full Time slot and LTFT trainees who are slot sharing. This should also be discussed with your TPD and Educational Supervisor.

Can you be an LTFT Trainee and take an OOP simultaneously?


Thursday, 31 January, 2019
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Thursday, 31 January, 2019