Less than full time (LTFT) Training
TVEM supports all trainees wishing to apply for Less Than Full Time Training (LFTT) at any point during or prior to starting their training.
The aim of LTFTT is to retain a workforce who might not be able to or wish to train full time, to promote diverse career opportunities, and to encourage a sustainable home: work balance on an individual basis whilst enabling doctors to continue in a training programme.
Eligibility for LTFTT application
Since the successful implementation of the 2019 trial to increase access to LTFTT all Emergency Medicine Trainees currently in post are eligible to apply for LTFTT.
This is under one of three categories:
Disability or ill-health
Responsible for children under the age of 18
Other caring responsibilities
Unique opportunities for personal/professional development
Other services to the NHS
Personal/general reasons with no further details required on the application
Trainees can request an unspecified length of time at 50, 60, 70, or 80% full-time equivalent.
Approval of applications is subject to service conditions via TPD approval after discussion with your Educational Supervisor.
Further details and the application process can be found on the Thames Valley Deanery website here.
Effect of LTFTT on pay, leave and training
Pay is calculated at each Trust according to an individual schedule of work. Full-time hours are reduced proportionate to the percentage full time Equivalent (FTE) worked, and base salary adjusted accordingly. Out-of-hours supplements are calculated from the number of nights/weekends/lates worked on your schedule of work, calculated by HR. This is proportionate to your FTE. For example, as an 80% FTE trainee you will be rostered for 80% of the number of nights/weekends / day shifts / EDT compared to a FTE trainee at the same trust. There is also a flexible trainee pay supplement.
Here is a helpful link to the BMA which fully explains LTFT pay.
Annual leave and study leave allocation is reduced in proportion to the percentage FTE worked, although LTFTT will naturally have more ‘off’ days in their schedule.
The possibility of ‘fixed’ off days to enable regular non-work commitments are not guaranteed but can be negotiated with the specific department.
The Royal College of Emergency Medicine suggests that trainees should complete the required training time ST1-6 in full. If trainees are working on a LTFT basis this will prolong their total time in training in order to equal the same number of training days.
For example, ST4-6 takes at FTE trainee 3 years (36 months) to complete. A LTFTT will take increased time in proportion to their percentage FTE:
80% FTE (36/0.8) = 45 months
70% FTE (36/0.7) = 51 months
60% FTE (36/0.6) = 60 months.
In view of the RCEM Faculty Governance Standard assessment process for trainees - where consultants in a department agree on observed competencies of trainees - and the inherent nature of shift work, it is suggested that LTFT trainees ensure they are raising awareness with consultants on shift of their time in resus and competencies therein.
The Royal College of Emergency Medicine should be updated with any time out of training and change in the rate of progression through training email@example.com in order to accurately calculate the anticipated CCT date.
The application process
Are you considering becoming less than full-time?
Discuss with your Educational Supervisor and Training Programme Director
Complete the application form - access through the Thames Valley website
Send the completed application with detailed supporting documents to LTFT.TV@hee.nhs.uk
Allow at least 3 months notice from submission of application to planned change in schedule.
Resources & Information
Your local TV LTFTT rep - please contact via email
Includes link to the TV application form and submission guidance
Academy of Royal Colleges’ agreed standard on LTFTT
2017 Current legal position
Can I change the percentage I work, including returning to full time work?
This is normally possible but requires advanced notice (minimum 3 months) and discussion/agreement with your training programme director. Some trainees at 60% may be in a slot share for the year and increasing hours will depend upon the local trust agreeing to fund the increase in hours due to clinical need.
How much will I get paid?
This will depend on your base salary, out of hours commitments, and percentage FTE. The BMS explain in more detail here
Will I receive the same study budget?
There is currently no fixed individual study budget. Percentage worked and previous applications are considered on an individual basis within the application process.
Can I have fixed days off?
This will depend on your local rota coordinator and departmental policy.
At my ARCP will I be expected to have the same sign off achievements as a FTE trainee?
No, the panel will look for evidence that you are progressing at a rate proportionate to your %FTE work. You will be aiming for an Outcome 1 - Satisfactory Progress - more in this RCEM learning post
Can I progress between years of training at a time other than August?
Yes, this is becoming increasingly common. You may need an ‘out of synch’ ARCP (ie at a time other than June) if you are progressing from one stage of training to another (core to intermediate, etc.) or finishing training - please discuss with your TPD if this is the case. Remember there is a salary increase ST3 to ST4, and ST5 to ST6. If you transition whilst working in the same trust you may need to remind HR of this.
Can I work locum shifts if LTFT?
The Gold guide states that trainees should not be precluded from other work, but that the full scope of practice should be reflected on the Form R for discussion at ARCP.
I appear to be working the same number of nights and weekends as a full time trainee in my department despite being LTFT. Is this right?
No, according to the gold guide your schedule should reflect the same balance of work as your full time colleagues. Day-time working, out of hours, EDT, study leave and annual leave should all be undertaken on a prorata basis.
I have concerns about my rota. Who can I contact?
Try to discuss with the rota coordinator in the first place, and potentially your Educational Supervisor. Other local contacts include the Thames Valley LTFT rep and the training programme director (see resources for contact details). The BMA will also provide advice on rota compliance.
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