Becoming part time (in training speak “less than full time”, LTFT) is possible during your GP training. It is not a given right, but is strongly supported by both PGME and at patch level.  All PGME expectations for LTFT working can be found here.  Please also check on your local patch training website as it might contain subtly different bits of information about how things work locally.

Step by step process to becoming an LTFT trainee

  • Inform your local patch administrator of your intentions at all stages of the process. This will allow for communication to all those who need to be aware of your change in circumstances.
  • Liaise with your local Programme Director (PD) to discuss options and the implications that working LTFT will have on your training.
  • Apply to Geoff Wright for LTFT funding approval (via the deanery website).
  • On approval, the GP school will also need to be told. Confirm your date of change with Kirsty Merrills for Eportfolio requirements and Julie Edwards, the recruitment manager.
  • Your local patch administrator will inform the relevant HR departments about your leave arrangements for the jobs you’ll be missing, when dates are confirmed.
  • You need to keep in close contact with the patch administrator and local PD to ensure they know the timings of leave and return dates as soon as you’re aware of them. The sooner you are able to let the VTS know when you are hoping to return, then there is a greater likelihood that they are able to build a suitable new rotation for you.
  • Some patches (e.g. Bristol) meet with all those on LTFT schemes every 6 months to ensure the training requirements have not changed and trainees are on track to receive their CCT.
  • We strongly recommend that you contact the RCGP certification unit a few months before they enter the final (ST3) GP component of training. This means that the completed rotations can be checked and validated well in advance of completion of training. Trainees should register with the RCGP Certification Unit at the beginning of their training.

LTFT “rules”

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

Communication with the local team is very important; the sooner you are able to let us know about any changes eg. return dates after maternity leave, the more likely we will be able to arrange and plan your rotations successfully.

The ‘Gold Guide’

is your reference guide for postgraduate specialty training in the UK NHS.

It states that trainees will:

  • reflect the same balance of work as their full-time colleagues
  • normally move between posts within rotations on the same basis as a full-time trainee
  • not normally be permitted to engage in any other paid employment whilst in less than full-time training

CCT

Our first priority is that on completion of your training you will have achieved the necessary requirements for gaining a certificate of completion of training (CCT). The Training Programme Directors (TPDs) balance the needs of all of the trainees who require placement; taking into account any jobs that they have done previously in GP training, to ensure that all trainees complete training within the guidance issued by the RCGP.

Any job must usually be a minimum of 3 months full time equivalent (FTE) to count for training. It is possible, however, to gain all the competences required in a shorter period, assuming the agreement of the ARCP panel. This depends upon regular e-portfolio entries demonstrating learning during this period, evidence of review meetings with your CS and ES during this time, and no periods of sick leave during the post. A job may last longer than the minimum time for your specific training requirements; however, the post still needs to be completed.

WPBA

Work Placed Based Assessments requirements are pro-rata for LTFT trainees – we suggest that you look on the RCGP website for details.

Allocated Training Rotations

If you become part-time, or take time out of training you will leave your originally allocated training rotation. On return to training, the administrator & TPDs slot you back into whichever posts are available at that time; as a result there will be significant uncertainty about which jobs you will be doing during the remainder of your training. The team aim to fill any vacant GPST hospital posts, in order to avoid compromising patient care. Unfortunately the choices you made about rotations & your personal preferences for locations etc at recruitment are extremely difficult to accommodate under such circumstances.

Post Allocation

Posts for LTFT job-share GPSTs are allocated from the pool of available local jobs and these posts change frequently due to trainees vacating them for various reasons. The future availability of posts is therefore mostly unknown, and consequently jobs cannot be guaranteed in advance. Often the decisions have to be made late in order to accommodate late changes in trainee circumstances, which have knock-on effects on other GP trainees.

Ultimately, if no local job exists you may be offered a post in another patch within the deanery, or if no there are other options for local training then you may be offered a post in another area. We do our very best to avoid placing trainees out of area, but it is occasionally unavoidable.

Timing of Allocations

Posts are usually allocated by the patch administrator and TPDs, and if necessary with input from the Patch Associate Postgraduate Dean (APD). All trainees who have left their allocated training rotations are considered individually and allocated their next post. This will take place at least 8 weeks prior to the end of each job, and trainees are usually notified within 1 week of the decision.

Hospital vs GP Placement

Total time spent in hospital posts may be longer or shorter than 18 months (the current standard). Total training time is not always exactly the minimum 36m (full time equivalent, FTE) and may last slightly longer. There is a minimum time in both hospitals and GP of 12m FTE over a 3-year scheme. The remainder can be made up from either area.

LTFT Hospital Posts

LTFT trainees must work at 60% of full time during their hospital jobs. To ensure that each post is adequately covered from a service point of view, job-sharing must be worked out with your job-share partner and the lead consultant of the department you’ll be working in.  Two trainees working at 60% gives 1.2 whole time equivalents. This means there is in-built capacity for handover and for attendance at the VTS sessions.

Job Shares

If a job-share breaks down, training plans and rotations may need to be completely re-organised.  Often, a hospital department cannot accommodate a single trainee working at 60% of full-time.  Unfortunately, no rotations can be 100% guaranteed.

Annual Leave & Study Leave

Annual leave and study leave are altered by going on maternity or off sick – discuss this with your local GPST administrator and HR, or look on the PGME website for details.

GP Specialty Training Attendance

GPSTs are expected to attend all of the usual training sessions for 12 months or LTFT pro-rata over a longer period. Please contact your patch administrator for further information, as arrangements vary between patches.

Examples

  • ST1 & 2s: 30 sessions normal attendance for 12 months or at 60% = 30 sessions over 20 months = 1.5 session per month, on average
  • ST3s 40 sessions normal attendance for 12 months or at 60% = 40 sessions over 20 months = 2 sessions per month, on average

Please be aware that if you are not attending the GP teaching you will be expected to be work unless you have discussed your learning needs with your supervisor and requested appropriate study leave.

E-portfolios

Your ePortfolios need to be altered to ensure the annual reviews are competed at the right time – discuss with Kirsty Merrills at the deanery as and when you know which jobs you’re doing, and when you’ve had periods of leave so that she can input this to the ePortfolio. Every LTFT trainee should put a scanned copy of their timetable into the ePortfolio as evidence of time spent in a department as evidence, if the hours are challenged. New timetables should be scanned in at the each change in job.

Extending Training

Current RCGP advice to PGMEs includes advice regarding the need to extend training following a prolonged absence. Any sick leave longer than 2 weeks per year; one week in any post, will require an extension of training.

With regard to maternity leave, an extension to training may be requested if the period of absence is greater than 12 months in total (for example, where leave or sickness is added to maternity leave) when there is less than 3 months until the end of training. In these circumstances it would be expected that a period of additional training would be necessary to allow adequate time for the Educational Supervisor to assess the doctor’s competencies. We would anticipate that this period might usually be of three months duration.

Further details

Please e-mail your Patch Administrator or TPD responsible for rotas if you have any further queries about your future post, they will also be able to put you in contact with your local LTFT peer support groups which are run by LTFT trainees.

With thanks to Lizzie Eley APD Gloucestershire,

Tom Agombar TPD Gloucestershire & Tom Pelly, APD Excellence & Foundation