Workforce, training and education
East of England

The EoE Foundation contacts can be found here:

What is a Foundation Programme doctor?

- The Foundation Programme is an integrated two-year training programme that is followed by all UK medical graduates and which bridges the gap between medical school and specialty/GP training. It has replaced the pre-registration (house job) year since 2005.

- The majority of doctors will move automatically from Foundation Year 1 (F1) through to Foundation Year 2 (F2), if performance and development is deemed satisfactory.

- Both years typically consist of three four-month placements.  During F1 they will have 12 months’ clinical experience in the secondary care setting, which may include mental health.

- Learning objectives for each stage are specific and focused on demonstration of clinical competences.

- The F2 doctor will have full registration with the GMC.

- They are expected to undertake a clinical workload under supervision. 

How is an F2 doctor different from a GP registrar?

- The F2 doctor is not learning to be a GP.

- The aim of the GP placement is to give the F2 doctor a meaningful experience in general practice with exposure to the acutely ill patient and those with chronic health problems in the community.

- This will enable them to achieve the competencies required for the Foundation Programme Curriculum.

- F2 doctors will attend Foundation training organised by the Foundation Training Programme Director (based at the local Trust).

- They are not independent practitioners and therefore have to be closely supervised.

Who decides which doctor will come to my practice?

- When each medical student applies through the national process, they apply for their whole two-year rotational programme. They are allocated by algorithm based on their ranking and their preferred options.

- The School of Primary Care identifies practices that are able to host the F2 placements. Foundation Training Programme Directors (FTPDs) in Trusts are given the list of GPs who have agreed to be clinical supervisors and they link them to F2 programmes with a GP component.

- Any gaps due to either unfilled posts or loss to the programme will be filled by the local FTPD.  However, they may choose not to fill supernumerary community placements, so it is possible to have a gap.

Does the FY2 need to be on the Performers List?

No. They remain an employee of the host Trust who will have carried out all checks.

What about their Contract of Employment?

- The Contract of Employment is held by one of the Acute Trusts within HEEoE.

- They are responsible for paying salaries and other HR related issues.

- However, in addition to this legal contract it is suggested that each practice has an Educational Contract with each of its Foundation Doctors (an example is attached at the end of this guide). 

What about medical defence cover?

- The F2 doctor is an employee of the Trust and will be not require further indemnity.

- It has been agreed that, unlike GPSTs, F2 trainees will be covered by Crown indemnity as the Acute Trust employs them. It is however recommended that they need to belong to a recognised defence organisation at their own expense - (this expense is tax deductible). This ‘minimum’ cover, with all the defence organisations, provides indemnity for ‘good Samaritan acts’ and is advisable for all doctors.

- It is good practice to check they have the appropriate level of medical defence cover.

How closely should an F2 trainee be supervised?

- There should always be a practice GP on the premises when an F2 trainee is consulting. If the supervising GP is in surgery they should have supervision slots to give them time to support the F2 trainee.

- If the supervising GP does not see the patient during the consultation they should review all patients seen with the F2 trainee at the end of the surgery.

Can an F2 doctor sign prescriptions?

- Yes. An F2 doctor is post registration and is therefore able to sign a prescription.  This should be supervised.

- The F2 should use their supervising GP’s FP10.

- It is not appropriate for them to be regularly signing repeat prescriptions.

- It is good practice to advise your CCG Medicines Management of the names of F2 doctors in the practice and dates of employment.

Can the F2 do home visits?

- Yes, though this is not compulsory and not needed for F2 trainees to achieve Foundation competencies.

- All visits should be carefully selected and supervised and F2 trainees should not be doing acute home visits alone.  The competency of the F2 trainee to carry out home visits should be carefully considered.

- Travel costs should be kept to minimum 

- Not all F2 can drive, and therefore this should be carefully considered at the induction interview.

Should an F2 doctor do out of hours shifts?

- They are not expected to work out of hours shifts during their general practice rotation.

- However, some F2 doctors have asked to experience out of hours as a means of exposure to a different type of acute illness. This can be a useful learning opportunity but must be properly supervised.

- If the trainee has requested this, then this will need to be discussed with trainee and then further with the local FTPD and should be considered as a unique ‘taster of out of hours work’ rather than a regular commitment’.

- Any out of hours work will count towards the working week

- It will not attract any extra salary payment  

Are travel costs reimbursed?

- F2 doctors will be able to claim travel to the practice from the base hospital.

- They can also claim for any travel associated with work, including home visits. Please keep this to a minimum.

- Travel claims are made through the host Trust. The rate used for mileage claims is that of the Public Transport Rate.

- If they are using their own car for travel as part of their work, it is advised that they inform their motor insurance company (there is normally no extra charge for this cover).

- Practices may ask for a copy of motor insurance.

What about study leave?

- F2 doctors are entitled to 30 days study leave during the year. However, several of these days will be used as part of the teaching programme organised by the Programme Director.

- Normally no more than a third of the study leave should be taken in each four-month placement.

- Study leave beyond the Trust programme will require approval from the Programme Director and may not be funded.

- F2 trainees are allowed to use study leave for ‘specialty taster sessions’ organised locally.

- Attendance at interviews is usually agreed as professional leave on a local trust basis and is not study leave or annual leave. 

What about holidays and sickness?

- Unless there are very specific circumstances not more than one third of the holiday allowance should normally be in the 4 months in General Practice.

- It is expected that the F2 trainee will give good notice of holiday plans. This needs to be discussed with the supervising practice.

- The F2 trainee should be able to take holiday at any point and should not be restricted by service needs of the practice as long as they give good notice.

- Any sickness should be recorded and reported to the Foundation Programme Administrator and the employing Acute Trust HR department. Foundation doctors are allowed a maximum of 20 days per year time out of training – this includes sickness absence, strike absence and compassionate leave. Therefore the leave should also be recorded on the ePortfolio.

What hours should an F2 trainee work?

- There is no banding pay for the Foundation posts in General Practice.

- They must not work over 40 hours a week in the practice. If shown by hours monitoring to be working over 40 hours the doctor could be entitled to financial remuneration (their rota would be pushed up to a banded rota) and the practice would be liable to pay for this.

- The maximum of 40 hours (advised to aim for a maximum of 39 per week to give a buffer) must also all fall between the times of 7am-7pm Monday to Friday.  No seven-day working here!

- Foundation teaching is included in these hours (including travel to the teaching).

- The actual timetable is able to be practice-specific within these guidelines.

- Best practice would be to inform medical staffing at the Acute trust for monitoring purposes of the hours the F2 trainee is working at the practice so an individual time template can be built.

- If F2 trainees are concerned that they are working over their hours then a clear escalation policy to their Clinical Supervisor should be in place.  The F2 trainee should be informed of this at their practice induction in writing.  This is to avoid an issue over the rota only being raised by the F2 trainee in retrospect.

Should an F2 trainee be allowed to do extra work in hospital?

- In a few Trusts’ Foundation Training Programmes, community trainees are placed on the acute medical rota to maintain acute skills. This is locally negotiated between employing Trusts and the GP partnership. The details should be very clear to the GP practice and the trainees including the specific out of hours work expected as part of this, and the effect on the training hours in GP and on banding.

- F2 trainees can also be keen to pick up extra shifts as a locum in acute hospital specialties.  This is partly to do with the unbanded pay being a drop in income compared to other F2 posts.  Some doctors may also want to extend their experience of acute specialties.

- Acute trusts can also be keen to fill rotas and reduce expenditure on locum doctors by providing extra shifts for the F2 trainees while they are working in GP.

- This extra work is allowed only if this additional work does not impact on attendance at the GP post.

- The GP Clinical Supervisor should be made aware of any additional work undertaken by the F2 Trainee.

- Working a rota that means missing any time in GP (either for the work itself or time off following work to meet EWTD (European Working Time Directive)) is not allowed.

- If this then becomes a banded post, the individual F2 trainee’s working template held by HR at the employing trust should be changed to reflect this.

- F2 trainees doing this extra work cannot opt out of the EWTD rest requirements.

- Any rota design or alteration must be signed off through the usual JDAT (Junior Doctor Advisory Team) policy by the employing Trust.

How are these doctors ‘signed up’ and does the time in primary care count towards GP training?

- The time in General Practice as a F2 trainee does not count towards a GP specialist training rotation.

- The trainers cannot approve any of the experience in Foundation Year 2 for specialist training.

- The trainers should complete the relevant sections of the HORUS or NES Foundation portfolio including all the work place based assessments.

- At the end of the year the evidence from the GP four month placement and the clinical supervisor report will contribute to the annual review of competence progression (ARCP) sign off process.

Who are the people that I need to know locally?

- The Foundation Training Programme Director (FTPD) will usually work at the employing acute trust and is responsible locally for organisation of the Foundation Programme. The FTPD could be a General Practitioner.

- In each area there will be an Administrator for the Foundation Programme.

- The local GP Associate Dean would be available to give advice about educational issues in General Practice.

- Details of Foundation Programme Directors and Foundation Programme administrators can be found on the Foundation pages of the HEE-EoE website:  

Can I get a login to the F2 trainee portfolio?

- Yes, as a clinical supervisor you should have a login to the portfolio in advance of them coming to the practice. The local Foundation Programme Administrator will arrange a login and should be able to give you basic advice about using the portfolio.

- The local Foundation Programme Administrator should also be able to give you training either face to face or via a training guide for using the ePortfolio/HORUS system, as well as the mandatory supervised learning events (SLE – see below) expected during each post.

Who can supervise and teach F2 doctors?

- The practice and supervisor have to be approved by HEE-EoE; they must seek formal approval from the GMC, which must be confirmed before trainees can start a placement.

- GP clinical supervisors should have at least Associate Trainer status.  Information for GP Educators, including gaining approval can be found at:

How does the supervision payment work?

The supervision payment, equivalent to the GPR basic training grant (pro rata) is paid for each F2 doctor.

- If you have sufficient capacity in terms of space and resources you can have more than one F2 at any one time.

- If you share the rotation with another practice then payment will be split appropriately.

- Contact the Foundation Programme Administrators as above