Less Than Full Time Training

Please note:

 HEE NW Guidance on Less Than Full Time (LTFT) during COVID-19



The Health Education England fully endorses the principles set out in the NHS Employers document “Doctors in Flexible Training: Principles underpinning the new arrangements for flexible training”

The term “Flexible” has been replaced by “Less than Full-Time” to avoid confusion. “Flexible” implies that the trainee can elect when they wish to work whereas this will be determined by their training needs

Any trainee in a substantive deanery approved post can apply for less than full-time training and if they meet the eligibility criteria this will be accommodated as soon as practicably possible


Trust LTFT Training Champions

HEE is committed to providing junior doctors who wish to transition to LTFT training the necessary advice and assistance to ensure the process is relatively seamless, while at the same time also support those trainees who have already transitioned to LTFT training.

To this effect, we are now in a position to introduce the role of LTFT Trust Champions in each trust as agreed as part of the ACAS discussions between the British Medical Association (BMA), the government and employers during the contract negotiations for doctors in training.

These champions will have an overview of all LTFT trainees within their trust and will be available to advise and assist any trainee within that trust regardless of grade and specialty on any concerns they have over the LTFT process and the LTFT experience. This role is designed to improve existing support for LTFT training rather than replace existing support to individual trainees.

It is important that trainees are aware they will still be responsible for managing the process.

They will however now have a senior member of the trust onsite in an advisory role who should have contact with all stakeholders to enable trainees to fully complete all aspects of the LTFT process, particularly interaction with Medical Staffing and Finance departments.

They will also take ownership of returning the fully completed post approval form to the LTFT administrative team in Manchester at ltft.nw@hee.nhs.uk

A list of the trust LTFT Champions is available here

A list of the trust Training Programme Directors (TPDs) is available here



TIER 2 Less Than Full Time Training Applicants

Please find below a presentation given to the LTFT flexible training champions recently which identifies important updates to TIER 2/Skilled workers requirements when applying to undertake Less Than Full Time Training.

The final page provides a list of useful links and email addresses for additional information.

 Tier 2 Presentation

 LTFT process for Tier 2

 Tier 2 Minimum Salary Requirements 2021



Please note you are only eligible to train Less Than Full Time if you have a confirmed substantive post with Health Education England. If you are in the process of applying for a post, you may only apply for LTFT training once it has been confirmed.

All trainees can apply for less than full-time training, but must have well founded reasons why full-time training is impractical

There are three eligibility categories:

Category 1:  Those doctors in training with:-

  • A disability or ill health
  • Caring responsibilities for children up to and including the age of 16 (in line with “The Flexible Working (Amendment) Regulations 2009”
  • Caring responsibilities for other dependents (spouse, parents etc.)

Category 2:   Those doctors in training with:-

  • Unique opportunities for personal/professional development not necessarily medically related

Category 3:    Those doctors in training who:-

  • Choose to train LTFT as a personal choice that meets their individual professional or lifestyle needs.  That choice is not subject to the judgement of anyone else and is only limited by service considerations. 

Category 1 will always take priority, but every effort will be made to accommodate Category 2 as well

Category 3 is a pilot and is currently available to trainee doctors in Emergency Medicine, Paediatrics and Obstetrics and Gynaecology only. 

Further LTFT Category 3 Guidance for each of these specialties including deadlines for applying can be found here


You can access the Eligibility Screening Form hereWhen completed please send the form to ltft.nw@hee.nhs.uk under the subject heading "Eligibility Request", failure to do this may result in a delay in your eligibility being confirmed. 

Once eligibility is confirmed trainees will be sent the Less than Full-Time Training Approval Form and a Step by Step Guide to assist in it’s completion. Please note that for training approval LTFT trainees have to work a minimum of 50% (5 sessions) of the full-time equivalent although 60% is the norm.



Whenever possible LTFT trainees will be placed in a slot share occupying a full-time post, with each partner working 60% (to both facilitate effective handover and enable each partner to benefit from the formal teaching programme).

If a slot share is not possible then working reduced hours in a full-time post will be considered. It is possible to work up to 80% (the maximum for LTFT training). On-call should be pro-rata; however if willing a LTFT trainee can do the full-time on-call providing the total hours worked do not exceed 40

Only if a slot share or reduced hours in a full-time post are impossible will a supernumerary post be considered. Where this is will be determined by the trainee’s educational requirements. Such posts are the most difficult to arrange as although the basic salary comes from the Postgraduate Medical and Dental LTFT Budget the host trust has to meet the banding cost. (N.B. for all LTFT trainees on-call banding is calculated individually and is based on actual hours worked, the proportion that are “anti-social”, and the work intensity - for more information, please see here)


Changing posts

It is essential that well before a LTFT trainee rotates the prospective new host trust is aware of their LTFT status and confirms that they will meet any associated additional cost. For this reason 3 months in advance of a move the LTFT Administrator should be contacted to request a LTFT Training Approval Form which must then be completed and returned as soon as possible following the Step by Step Guide. This process must be repeated for every move whilst the trainee remains LTFT and is the trainee’s responsibility


Day in the Life

Tessa Davis is an ST4 trainee, currently on maternity leave, and due to return to a Less Than Full Time post following maternity leave: for her “day in the life” article click here.


LTFT e-learning package for supervisors

Health Education England e-Learning for Healthcare (HEE e-LfH) has developed an e-learning session for Educational Supervisors of less than full time (LTFT) trainee doctors. The session aims to equip healthcare professionals with the knowledge and skills to effectively supervise a LTFT trainee and raise awareness of the supervisors’ responsibilities.

HEE is committed to improving Junior Doctors’ working lives and championing flexible working more broadly. With work/life balance highlighted as a mounting concern to doctors in training, and the risk of “burnout” affecting recruitment and retention in some specialties, the need for increased understanding and positive promotion of Less than Full Time Training is essential. 

Course Outline

  • 20-25 minute e-learning session for supervision of a less than full time trainee
  • Your duties as a supervisor of a LTFT trainee under the Equality Act 2010
  • The implications of LTFT training in relation to Certificates of Completion Training (CCT) dates, Annual Reviews of Competence Progression (ARCPs) and training extensions
  • What LTFT training is and reasons why trainees may wish to apply
  • The benefits of LTFT training
  • How LTFT training is arranged and the different types of post arrangements available.

Target Audience

  • Highly recommended for completion by all Educational Supervisors, Training Programme Directors and Heads of School.


  • To access the learning content please click here
  • If you already have an account with e-LfH you can log in at this stage to access the content. Otherwise please register for an account using your work email address.


Representation and Support

HENW LTFT trainees are supported by two elected trainee representatives who sit on the LTFT Advisory Group and HEEE trainee forum.  HENW (North West) trainees are represented by Dr Zurqa Rasul ManchesterLTFTRep@gmail.com and HENW (Mersey) trainees are represented TBC. Representatives can be contacted for advice and support on LTFT issues.

For any LTFT queries please email the LTFT team on ltft.nw@hee.nhs.uk or for emergency queries you can contact the LTFT on 0161 268 9578 or 0161 268 9676. Shirley Remington, the Associate Dean for LTFT Training, can also be contacted about any LTFT issues; shirley.remington@hee.nhs.uk 


Less than Full-Time Training – GMC Position Statement, October 2011

 Less than full-time training - GMC position statement - 18 October 2011.pdf

Less than Full-Time Training – GMC Position Statement, Nov 2017

For your information, please find attached the GMC position statement for Conditions for less than full-time training. Below is a link for accessing this statement on the GMC website.



Useful links

LTFT Flowchart

Equitable pay for flexible medical training