School of Emergency Medicine
General Questions and Answers for LTFT Training
Please also have a look at the NHS England LTFT Page or get in touch with the NHS England LTFT Team at ltft.eoe@hee.nhs.uk
Any trainee in a substantive NHSE approved post can apply for less than full time training. In EM there is no longer a requirement to have a specific reason eg parental or carer responsibility for training at LTFT. The online application forms are available on HEEoE website.
Eligibility Assessment & Training Plan for LTFT Training at NHS England (NHSE), EOE
LTFT trainees most commonly work between 60-80% of full time. However up to a minimum of 50% is permitted.
Applications should be submitted with >12 weeks before the start date.
Step 1 (>16 weeks in advance): Discuss with Training Programme Director (TPD), Educational Supervisor (ES) and medical staffing detailing circumstances including dates/timetables.
Step 2 (>16 weeks in advance): Trainee may complete LTFT application form. All fields are mandatory. Form will be submitted to england.ltft.eoe@nhs.net
You are not eligible to commence LTFT training until you have received written NHSE EoE approval for your Form 1: Eligibility Assessment & Training Plan (or the change in plan form).
Where an application is refused by NHSE, the applicant has a right of appeal. The training capacity of a training programme and service commitment will have to be taken into consideration. If a doctor in training has had their application to train LTFT declined, they may appeal in writing to the relevant Postgraduate Dean. The Postgraduate Dean’s decision will be final. It is recommended that you first attempt to resolve any issues informally via discussion with your TPD and our Associate Postgraduate Dean for LTFT,
You will need to discuss with your Educational Supervisor, the Training Programme Director and Medical staffing department. If you are rotating to a new placement and do not know your new ES then contacts the Specialty tutor in the new department.
Changes to LTFT must be made on the same forms and need 12 weeks’ notice. This includes if you are choosing to revert to fulltime.
Change in plan (Located on the same form)
If you wish to change the percentage of LTFT you are working or change your slot share partner, then you must submit a Change in plan form which is located on the Form 1 document.
Please ensure you carefully read the instructions on page 1 of the LTFT application form prior to completion.
NHS Terms and Conditions handbook: https://www.nhsemployers.org/employershandbook/tchandbook/afc_tc_of_service_handbook_fb.pdf
The extension to you training will depend on the % LTFT you work and can be calculated using the CCT calculator at RCEM CCT Recalculations - RCEM. For example, if you work at 60% the training is roughly 1.67 times longer.
OR, you can calculate by dividing 12 months by portion of LTFT, e.g. for 60% LTFT, the time needed to complete the whole time equivalent is 12 /0.6 = 20 months
Basic pay is calculated pro-rata but you will still receive the full banding/nodal pay supplements for anti-social hours working
Less than full-time trainees pay explainer
https://www.nhsemployers.org/sites/default/files/2021-07/LTFT-pay-guidance-February-2017.pdf
Annual leave and study leave are pro-rata.
ARCPs will occur annually to assess whether you are progressing at the expected rate for your working percentage. Required competencies are expected to be reached over a longer training period.
As your training is extended, you will have more ARCPs than a trainee on full time. You may need additional ARCPs at critical progression point in training.
In principle, locum work is permitted. All locum work must be declared on your Form R 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.
Full guidance can be found at this link: https://www.copmed.org.uk/images/docs/publications/Guidance_on_Undertaking_Additional_Work_.pdf
All employees have a right to take 52 weeks maternity leave. For those eligible for maternity pay, this is based on the employees' average weekly earnings, averaged over a period of at least eight weeks up to and including the last payday before the end of the qualifying week. The qualifying week is currently the 15th week before the week the baby is due. Further information 8 on leave and pay for new parents can be found in section 15 of the NHS terms and conditions of service handbook.
A reduction in hours will mean a drop in salary and this could impact on your eligibility to work on a skilled worker visa. When applying for a new visa, you should ensure that your salary meets the minimum requirements, there are minimum salary requirements for a skilled worker or Tier 2 visa. Therefore, skilled worker applicants need to liaise with their HEE Local Office and UK Visas and Immigration (UKVI) to ensure that any proposed reduction in working pattern (and therefore reduction in hours and pay) does not compromise your visa requirements. This is the responsibility of the doctor in training. All sponsored doctors in training, 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 7 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.
For employers to effectively manage rotas, you will need to negotiate with your employing Trust what day/s you do not work. However, when you rotate to a new Trust, these arrangements will have to be discussed and renegotiated with your new Trust, and it may sometimes be the case that your arrangements have to change in your new rotation. Try and make these arrangements with as much notice as possible.
Emergency medicine requires out of hours working including nights and weekends in proportion to your working percentage unless there is an occupational health reason this cannot be undertaken.
Please consult the RCEM document on night workings for trainees due to be published soon.
Slot sharing means that two (occasionally three) trainees share one slot (two slots if three trainees) on the rota, which supports a greater number of trainees to access LTFT.
For example, an 80% LTFT trainee not involved in a slot share would normally be expected to undertake 80% of the on call of a WTE. However, where trainees are in a slot share which exceeds 100% WTE, local discussions will be needed to agree on call arrangements and frequency.
The funding for all on call is paid by the Trust. It is expected that the LTFT trainees in the slot share will cover at least the WTE element of the on call on a 50:50 basis. In a slot share the resident doctors may not be able to work more than 50% OOH as the OOH work is split equally between the slot shares.
Any on call above this will be negotiated, funded and agreed locally. The only exceptions to this are circumstances for LTFT training which make this impossible, provided that legal and educational requirements are met.
LTFT online forum, regional LTFT Champion, ES, Specialty tutor. Each Trust should also have a Flexible Working Champion.
All LTFT trainees are entitled to an annual allowance of £1,000. This allowance is to recognise the relative increased costs of training that doctors training LTFT face because of being less than full-time. This payment is only for doctors training LTFT. It is paid in full and not pro-rated in any way. Contact the HR department in your Trust to ensure this is paid. More information can be found at the below link, should your Trust be unaware of the payment:
https://www.nhsemployers.org/news/junior-doctor-ltft-allowance-update
If a doctor in training changes HEE Local Office through the Inter Deanery Transfer process and wishes to continue working LTFT, they would have to request this via the new HEE Local Office through the normal processes in order to reconfirm the status.
You should select your parent specialty when applying, but approval would be required for both the parent and second specialty.
Trainees working on LTFT will result in a pro-rata extension to training time. Beyond the ACCS programme, as the training is assessed by evidenced capability and not solely time based, requests for an earlier CCT date will need to be through the RCEM acceleration process.
Yes, you could be considered for ‘acting up’ as consultant in your final year of LTFT training. The RCEM allows a maximum of three months of WTE and pro-rata for LTFT trainees. However, it has some other conditions to meet. Please visit the RCEM AUC document.