Less than Full Time Working Policy

 

CONTENTS

Introduction

Purpose

Scope

Eligibility

Supporting Documents

Funding Arrangements

Training Placements

  Slot-Share

  Part Time in a Full-Time post

  Supernumerary

Rotations

Working Hours

Out of Hours Work

Other Work

Pay

Study Leave

Frequency of ARCP

Period of Grace

Acting Up

Inter-Deanery Transfer

Application Process

Appeals Process

  Eligibility for appeal

  Registering an appeal

  Process following an appeal being registered

  The appeal panel

  How the appeal is carried out

  Decision of appeal

 

INTRODUCTION

Less than full time training (LTFT) is the means by which trainees undertake their training when they are unable to work and train full time for “well-founded” reasons or to increase flexibility within Postgraduate Medical Education by allowing LTFT training for personal choice.

 

PURPOSE

The purpose of this policy is to clarify how the LTFT training scheme works, who is eligible to apply and the arrangements necessary to secure approval.

 

SCOPE

This policy applies to all trainees taking up appointments in Specialty Training or Foundation posts that are both educationally approved by Health Education England working across the South West and the General Medical Council (GMC) and applies to the following grades: -

 ¨        Foundation Year 1 Trainees

¨        Foundation Year 2 Trainees

¨        Core Trainees (CT1 – CT4)

¨        Specialty Registrars (StR)

¨        Academic Clinical Fellows (ACF)

¨        Clinical Lecturers (CL)

 This policy is written to complement ‘A Reference Guide for Postgraduate Specialty Training in the UK’.   It is recommended that trainees review the Gold Guide in addition to this policy.

 

ELIGIBILITY

All trainees are eligible to apply for LTFT working.  Those wishing to do so under category 1 or 2 must show that training on a full-time basis would not be practical for them for well-founded individual reasons.

 

CATEGORY 1

  • Trainees with a disability or ill health – This may include ongoing medical procedures such as fertility treatment;
  • Trainees (men and women) with responsibility for caring for children;
  • Trainees with responsibility for caring for ill/disabled partner, relative or other dependant.

 

CATEGORY 2

Unique opportunities

  • A trainee is offered a unique opportunity for their own personal/professional development and this will affect their ability to train full time (e.g., training for national/international sporting events or a short-term extraordinary responsibility such as membership of a national committee or continuing research as a bridge to progression in integrated academic training).

 

Religious commitment

  • A trainee has a religious commitment that involves training for a particular role and requires a specific time commitment resulting in the need to work less than full time.

 

Non-medical development

  • A trainee is offered non-medical professional development (e.g., management courses, law courses or fine arts courses), which requires a specific time commitment resulting in the need to work less than full time.

 

Category 1 applicants will have priority and will be supported.

Access to category 2 is dependent on individual circumstances and might be limited by service considerations.

As part of HEE’s work to Enhance Junior Doctor Working Lives there is now a third category:

 

CATEGORY 3

  • Trainees who choose to train LTFT as a personal choice that meets their individual professional or lifestyle needs.  Whilst that choice (and access to it) are not subject to the judgement of anyone else it is dependant upon and might be limited by service considerations.

 

Access to Category 3 is as per the phased expansion plan, details of which are available here.

Applications for Category 3 will be via one or two windows per year (typically September and March) with trainees commencing from the next planned rotation date.  The application window will be open for three weeks.  Where it is necessary to restrict applications due to service considerations a random allocation process will be utilised.   

Subject to eligibility, trainees may train less than full time from the outset or transfer from full time to less than full time (and back again if required).

Where a trainee no longer wishes or is no longer eligible to work on a less than full time basis, they will return to full time training when an appropriate placement becomes available.  Until that time the trainee will continue to work on a less than full time basis.

Any trainee wishing to work less than full time must have obtained a post in open competition.  All competitively appointed posts are offered on a full-time basis. 

 

SUPPORTING DOCUMENTATION

 

Category

Circumstance

Supporting Documentation

Expiry Date of Eligibility

 

Category 1

Disability / ill health

A letter from your GP/ Occupational Health Consultant/ Medical Specialist which includes:

 

  • Nature of disability/health requirements for LTFT Training

 

It must be on letter-header paper or be from an official email address which can be validated. The letter should be dated within the past 3 months.

 

Until end of training

Responsibility for care for children

You will need to confirm the anticipated or actual date of birth of your youngest child on the application form. (Please note you do not need to continue to re-apply upon each period of maternity leave, eligibility is automatic until your youngest child is 18 years old).

 

Until youngest child is 18 years’ old

Responsibility for caring for ill/disabled partner, relative or other dependent.

 

A letter from your GP or Medical Specialist involved in the care of your partner/relative/dependent which includes:

 

  • Level of care anticipated that you will need to provide.

 

It must be on letter-header paper or be from an official email address which can be validated, dated within the last three months.

Until end of training

 

Category 2

All circumstances

 

Complete the free text boxes on the application form detailing the nature of your request. You can attach letters of support and job descriptions to the application form should you wish.

 

Category 2 applications will be reviewed on a regular basis and continuation is not automatic.

 

Category 3

All circumstances

 

Complete application form.  No supporting information required.

As per phased introduction initially but following full implementation until end of training

 

FUNDING ARRANGEMENTS

The national medical postgraduate tariff is not applicable to LTFT trainees. 

HEE will provide funding from the LTFT budget for:

  • Salary support for slot-share top ups (where two LTFT trainees’ slot-share a full-time post)
  • Salary support for LTFT supernumerary posts*

*Note – supernumerary placements will be exceptional and subject to the agreement of the Postgraduate Dean.

Statutory leave costs and out of hours enhancements are an employer funding responsibility.

 

TRAINING PLACEMENTS

 Less than full time training may be undertaken in one of three ways listed below.

 

Slot-sharing

Slot-sharing works on the basis that two trainees occupy one full time post and manage the out of hours work between them. 

Whilst each trainee may work up to 80% WTE consideration must be given to the educational capacity within the department and the financial impact.  The TPD or HoS should discuss with the Deputy Postgraduate Dean proposals to slot-share trainees at greater than 60% WTE. 

Flexibility will be required where specific working days are required by either or both parties.  Typically, slot-sharers will work separate days of the week with overlap on one day or more.

Opportunities for slot-sharing should be explored before any alternative arrangements are considered.

 

Part time in a full time slot

A trainee occupies an established full-time post but works reduced hours. 

As an established post no additional funding will be provided, however the employer may utilise any surplus funds to backfill any service gap.

 

Supernumerary

Supernumerary posts are those that are in addition to the usual complement of training posts in an employing Trust.

This option may only be considered provided there is no detrimental effect on other trainees within the training programme.

Supernumerary placements will only be considered in exceptional cases and with the agreement of the Postgraduate Dean.

 

ROTATIONS

Trainees will normally be expected to move between posts within rotations on the same basis as a full-time trainee in the same specialty, to ensure they receive a coherent programme of training that is educationally comparable with full time trainees.

Trainees on a programme that rotate through different specialties, such as the Foundation Training Programme, Internal Medicine Training, General Practice and Core Surgical Training may find their rotations change to enable opportunities to slot-share. 

Trainees working less than full time may also find that their completion date for training may not correspond with August.

 

WORKING HOURS

Less than full time training is counted exactly the same as full time work in all respects.  The table below will assist in calculating the less than full time training required to meet the full-time equivalent quota for training.

 

 

 

 

6

Months

 

 

12

Months

 

18

Months

 

24

Months

 

30

Months

 

36

Months

F5 (50% WTE)

 

12

Months

24

Months

36

Months

48

Months

60

Months

72

Months

F6 (60% WTE)

 

10

Months

20

Months

30

Months

40

Months

50

Months

60

Months

F7 (70% WTE)

 

9

Months

17

Months

26

Months

34

Months

43

Months

51

Months

F8 (80% WTE)

 

8

Months

15

Months

23

Months

30

Months

38

Months

45

Months

              

For example, a trainee on a three-year full-time training programme working 60% whole time equivalent may take 60 months (five years) to complete, subject to satisfactory progression.

The table above should be used as a guide only.  The duration of training for less than full time trainees will be determined in consultation with the Training Programme Director / Head of Foundation School. 

In line with the GMC position statement (2017) on less than full time training, trainees will be required to undertake no less than 50% full time training. 

Only where a trainee experiences exceptional difficulties may the Postgraduate Dean reduce the time requirement further.  The absolute minimum is 20% of full-time training with the expectation that trainees should not take a placement at this level for more than 12 months.

 

OUT OF HOURS WORK

Day time working, on-call and out of hours duties will be undertaken on a pro-rata basis to that worked by full time trainees in the same grade and specialty.

The only exceptions to this are circumstances for LTFT training which make this impossible, provided that legal and educational requirements are met.

 

UNDERTAKING ‘OTHER WORK’ WHILST TRAINING LESS THAN FULL TIME

Trainees on LTFT placements are not precluded from undertaking other work although they should ensure that in undertaking this work they practice according to the GMC’s good medical practice and that this does not impact negatively on their training.

Where undertaking additional work within the remit of holding a licence to practice the trainee must utilise the annual submission of the Form R to ensure the Postgraduate Dean as their designated Responsible Officer is aware.  

 

PAY

The basic pay for doctors training less than full time is pro rata to the basic salary for a doctor employed full time calculated on an average of 40 hours per week. 

Basic pay and pay enhancement queries should be directed to the employing Trust, usually via the Medical Staffing department.

 

STUDY LEAVE

Less than full time trainees are expected to make appropriate personal arrangements to access fixed training days when they are not rostered to work.  This will require flexibility on part of the trainee to ensure they have access to all of the educational components of the training programme equivalent to their full-time counterparts.

Less than full time trainees should refer to the Study Leave guidelines for information on the allocation and application process.

 

FREQUENCY OF ARCP

Less than full time trainees will have an ARCP at points where decisions relating to progression in training are required and should be assessed not less than annually.  There should be no more than a 15-month interval to facilitate Revalidation.  Consequently, LTFT trainees will have more ARCPs than a full-time trainee.

 

PERIOD OF GRACE

The purpose of the period of grace is to provide Specialty Registrars (excluding those in General Practice) time to secure a Consultant or other post following attainment of their CCT. Please refer to the POG policy for more information.

The maximum duration of the period of grace is six months whether the trainee is full time or LTFT.

 

ACTING UP

Trainees may apply to act up as a consultant and credit that time towards a CCT.  This will normally be for a period of three months or pro-rata for LTFT trainees.  Please refer to the Acting Up as a Consultant Policy

 

INTER DEANERY TRANSFER

Trainees accepted into the South West via an inter-deanery transfer who are already working LTFT under categories 1 or 2 will not have to re-establish eligibility provided they have evidence of their eligibility to work less than full time.

Trainees working LTFT under category 3 will not be eligible to continue training LTFT upon transfer to another training programme.

 

APPLICATION PROCESS AND NOTICE PERIOD

Trainees should discuss any plans for LTFT training with their Training Programme Director before submitting an application.  If the trainee is unaware of who their Training Programme Director is then they should contact the relevant Education Programme Manager. 

Trainees must give at least 16 weeks’ notice of their wish to train LTFT to allow sufficient time for the employing Trust to be notified and to discuss with the Training Programme Director for the purposes of rotation planning.  If less notice is received the trainee’s application will still be considered but the start date may be delayed.

Requests to train LTFT received at short notice on health grounds will be agreed on a case-by-case basis.

 

APPEALS PROCESS

An appeal is an opportunity to question a decision or complain about treatment which a trainee considers to be unfair. An appeal will allow all parties to have the case heard before an independent panel, and a decision to be reached on the facts that have been presented.

 

Eligibility for appeal 

Trainees refused access to the less than full time training scheme are eligible to appeal.

The appeals process should not be used for:

  • Issues with the employing Trust relating to salary calculation or pay enhancements.
  • Provision of out-of-hours in excess of those (if any) required for educational approval.
  • Employers’ refusal to employ a less than full time trainee on costs grounds.

Registering an appeal

Appeals should be submitted using the ‘Notification of Appeal’ available from the website.

The Notification of Appeal form must be sent to traineeinformation.sw@hee.nhs.uk within 15 working days of the decision about which you are appealing being made.

 

Process following an appeal being registered

The trainee will be invited to attend an appeal hearing to be held within 15 working days of the submission of the appeal where possible.

The trainee will be required to provide a Statement of Case which will need to be provided at least 5 working days before the hearing.

The relevant Associate Dean / Head of School who refused access to less than full time training will also be required to provide a statement of case at least 5 working days before the hearing.

Both parties will be given copies of each other’s statement of case.

The statement of case will allow the Postgraduate Dean (or nominated deputy) to study all written material and should include the following:

  • The reason for appeal
  • A simple list of events in date order
  • Copies of all correspondence and written evidence

 

The appeal panel

The appeal will be heard by an independent appeals panel.

The appeals panel will comprise as follows: - 

  • Postgraduate Dean (or nominated deputy) who will chair the appeal.
  • One doctor in training nominated by the BMA.
  • Lay person

The panel members will not have been involved in the original decision that gave rise to the appeal.

 

How the appeal is carried out

The appeal will be a meeting between the panel, the relevant Associate Dean / Head of School and the trainee.

The trainee, or representative, will be given the opportunity to put forward the reason for appeal. 

The relevant Associate Dean / Head of School will be given the opportunity to explain why the decision was made.

Each side will have the opportunity to question the other on issues of fact.

 

Decision of appeal

The decision of the panel, and the reasons for making that decision, will normally be announced at the end of the appeal; this decision will be confirmed in writing within 5 working days.  If, for any reason, a decision cannot be made at that time, a further date may be arranged to hear any further evidence pertaining to the appeal.

The decision of the panel is final.