Less Than Full Time (LTFT)

Less Than Full Time Training (LTFT)

Please Note:

Health Education England, East of England (HEE, EoE) LTFT application and renewal processes is now  on one form, the application for LTFT will remain until the trainee completes their training programme within the East of England, once approval has been granted.

The main change is that trainees applying for LTFT arrangements will no longer need to complete a Renewal form whenever they rotate to a new trust or practice. Trainees now only need complete a new form when they wish to change the amount of hours per week they wish to work (percentage) and slot share partner. 


Health Education England working across the east of England has a strong commitment to helping all doctors reach their full potential and to helping those with child-caring or other responsibilities or health problems, to continue training.

HEE fully endorses the principles set out in the Gold Guide.

Any trainee in a substantive HEE approved post can apply for less than full time training (LTFT) if they meet the eligibility criteria outlined in the FAQs below. If deemed eligible, LTFT arrangements will be accommodated as soon as practically possible.

Image I worked as a LTFT Training for 8 years and would have left medicine otherwise. It enabled me to continue my surgical training and take my FRCS exams whilst caring for 2 children and living apart from my husband who was a locum consultant in another city. When I started I was the only trainee working LTFT Ttraining in my speciality, there have since been 6 others and it is now a well established pathway in the region I trained in. I’m keen to encourage trainees who might benefit from working LTFT Training to continue to work whilst maintaining their caring responsibilities. Image Isobel Fitzgerald O'Connor, Consultant Otolaryngologyst


ImageTraining LTFT in the east of England has made a considerable difference to me personally by improving my work / life balance. I love the fact that I can work hard and enjoy my job at the beginning of the week but I can also have days away from work each week to spend precious time with my children. Image

Laura Kessack, ST7 Anaesthetics 



Important note: Please be reminded you are not permitted to commence training less than full time until you are in receipt of your fully approved Form 1 LTFT application.

Our fully electronic LTFT application form is available for you to use at the bottom of this page. Please ensure you save the form locally and open as a PDF with Adobe Acrobat or Adobe Reader before completing. Do not begin completing the form if it has opened as a webpage or in PDF Previewer, as this will disable the electronic signature fields and deem the form invalid.  Instructions for setting up a digital ID and additional assistance for Mac users are also available at the bottom of this page. As an organisation we are moving towards going paperless and appreciate your assistance with this. Please ensure you carefully read the instructions on page 1 of the LTFT application form prior to completion.


Please direct all LTFT enquiries and application forms to The Secondary Care Team LTFT mailbox (ltft.eoe@hee.nhs.uk


ImageApplying for LTFT training was straightforward; the biggest hurdle is getting the training consultant to meet and agree a job plan prior to starting the job. I found the criteria clear, the forms simple and the process quick.Image

Olivia Will, ST8 General Surgery




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.  Trainees of either sex can apply for less than full time training, but 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 two 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.


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.


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.


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 is 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.



How do I apply to train less than full time?
  • Due to a change in a process on 1st August 2018 the LTFT process has become a 1 stage process and the less than full time training application and change in plan is located on the same form which must be electronically completed in full by the applicant and emailed to the LTFT mailbox. All submitted forms must be agreed by HEE in order for you to commence your requested reduced working arrangement.

Please note that LTFT posts cannot always be accommodated straight away


You are not eligible to commence LTFT training until you have received written HEE EoE approval for your Form 1: Eligibility Assessment & Training Plan (or the Change in plan form).


LTFT Form 1           Eligibility Assessment & Training Plan


This is the initial form all applicants must submit for approval. 


Change in plan (Located on the same form)


If you wish to change the percentage of LTFT you are working then you must submit a Change in plan form which is located on the Form 1 document (you will need to use a blank copy).

There is now no requirement to renew if you have put your LTFT end date as the same as your CCT date.

Please ensure the form are submitted electronically to the LTFT mailbox (ltft.eoe@hee.nhs.uk) with all mandatory fields marked with a red asterisk (*) completed. Hand written, scanned or posted application forms will be destroyed. 

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

Under the new process which came into place on 1st August 2018 Trainees are required to submit a Change in plan form only if they wish to change their percentage of full time work. 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.


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 2 months’ notice of their proposed LTFT start date. 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. The absolute minimum would be 20% of full-time training, with an expectation that trainees should not undertake a placement at this level for more than 12 months.

GMC position statement on less than full-time training


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 you stating who it 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?

Flexible training should be counted exactly the same as full-time work in all respects. Use the table below to calculate the length of training completed by a flexible trainee who is undertaking 5, 6, 7 or 8 sessions a week.

For example, a trainee who has been doing 5 sessions a week for three years, accrues 18 months training time, likewise, if you need another 3 years full-time training to complete, it will take another 72 months at 5 sessions a week

Full Time Equivalent Table








5 sessions a week = 6 months per

 12 months

 24 months

 36 months 

 48 months

 60 months

 72 months

6 sessions a week = 7.2 months in each year

 10 months   

 20 months


 40 months

 50 months 

 60 months

7 sessions a week = 8.4 months in a year

 8.5 months   

 17 months 

 25.5 months

 34 months

 42.5 months

 51 months

8 sessions a week = 9.6 months in each year

 7.5 months    

 15 months

 22.5 months

 30 months 

 37.5 months

 45 months

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

Academic training programmes may be appropriate for LTFT trainees, but these should be discussed on an individual basis with the Postgraduate Dean. Under normal circumstances, an academic training placement done at less than full time should be a minimum of 50% of the full-time placement.

GMC additional position statement on academic training in a LTFT setting  

Is less than full time training available to LATs, LAS or Locums?

LAT Foundation doctors may apply for LTFT training, and must complete the process in the usual way however there will be no approval for additional time required. However identification of a placement may not be immediately available.

LAS doctors and locums are not associated with HEE and therefore may not apply to work LTFT through HEE's application channels. We recommend discussing your need to work LTFT with Medical Staffing/HR at your employing Trust.

Is my less than full time post recognised for training?

Since 1 December 2007, in conjunction with Royal Colleges / Faculties, LETBs have responsibility for ensuring that all LTFT training of any kind is undertaken in prospectively approved posts and programmes which meet the statutory requirements of the General and

Specialist Medical Practice (Education, Training and Qualifications) Order 2003 and the requirements of the Foundation Programme Curriculum. 

HEE will therefore usually approve LTFT training (subject to reasoning), unless the introduction of LTFT / supernumerary training increases post numbers above the specialty maximum capacity for HEE.  Trainees should be aware that they may require approval from their Royal College, and should discuss this with their Training Programme Director or Head of School.


I am going to be slot sharing, what percentage of full time can I work?

Where two trainees share one slot, HEE provisionally agree to provide an uplift in funding of up to 20% of basic salary to enable both trainees to work at up to 60% of full time. This is subject to receipt of approved training plans for both trainees. Please note: If you are slot sharing in a post, you and your partner’s stage 1 training plan form must be submitted for approval at the same time.


ImageHaving a job-share partner has been a really positive experience for me enabling exchange of ideas, challenging concepts of working practice and overall ensuring that we both fulfilled our training requirements whilst providing excellent clinical care for the patientsImage - Antonia Wells, ST7 General Surgery trainee.


How will I be paid in relation to my full-time colleagues?

The method for calculating pay for LTFT trainee’s can be found in the following national guidance from NHS Employers; Equitable pay for flexible medical training

Any detailed queries or guidance regarding individual pay should be directed to the employing (or prospective employing) organisation.

Can I work part time in another job whilst training less than full time?

LTFT trainees may now do additional paid work, including locums.  This will not count towards their training time and must comply with the terms of their contract.

  • The trainee should not feel pressurised to do additional work
  • If the trainee chooses to work additional hours, they should be paid for them
  • Additional work will form part of their practice, so they must declare it on their Form R.
  • The trainee has a professional duty to maintain patient safety and a healthy work/life balance
  • If the trainee is noted to be doing an excessive number of shifts, their eligibility for LTFT training may be questioned.
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.

If your LTFT plan will now end sooner than the date originally agreed (due to commencement of your maternity leave), it is important that you inform HEE of this ASAP, as this will impact on funding to your employer.

If your LTFT plan needs to be extended up to the point of your maternity leave start date, you will need to inform the HEE LTFT team ASAP. If you wish to continue training less than full time upon your return from maternity leave, you will need to submit a Form 2: Renewal Training Plan 2 months in advance of your proposed return to work date.

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 in discussion with HEE. If agreement cannot be reached you may then wish to utilise the formal appeals process. The Appeals Process can be downloaded from the Policies & Procedures section of this website.

Does LTFT apply to my Period of Grace?
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.