Less Than Full Time Training

Please note: The process for applying for Less Than Full Time Training has now changed

Please note that as of 1st April 2024 there will are changes made to the LTFT process and guidelines. From 1st April 2024 you will need to complete a new form for your next rotation if you wish to change your LTFT percentage or you wish to go back to full time.


The Post Graduate Doctors in Training (PGDiT) will only need to gain Training / Foundation Programme Director approval for the application.


The Lead Employer will be notified of the LTFT change via TIS (Trainee Information System) and rotation so pay rates can be amended in good time.


It is the responsibility of the PGDiT to liaise with the trust / GP practice to arrange their work schedule. The LTFT champion will be able to signpost the PGDiT to the rota coordinator for their department. A list of trust champions is available on below.


The PGDiT will remain on the approved LTFT percentage and TIS updated at each rotation until the LTFT team are notified differently via an amended LTFT form.


It is the PGDiT’s responsibility to ensure that they liaise with the trust / GP practice to arrange their work schedule for each new rotation.

In order to ensure adequate support is available to LTFT PGDiTs, NHS England will share relevant data with ‘Trust Champions’. The sharing of this data is within NHS England’s legitimate interests as a public authority.


Please ensure that you read the new updated policy document and other information regarding the new process that will be available on this page.


In the meantime, if you have any further queries, please do not hesitate to contact us at england.ltft.nw@nhs.net

Further updates to this webpage will take place in the next few days.


pdf icon NHS England - North West Guidance on Less Than Full Time (LTFT) during COVID-19
pdf icon You can download the NHS England LTFT local policy at a glance here
pdf icon You can download the full LTFT policy here




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The term “Flexible” has been replaced by “Less than Full-Time” to avoid confusion.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


Any PGDiT in a substantive deanery approved post are eligible for less than full-time training and this will be accommodated as soon as practicably possible.



Trust LTFT Training Champions

NHS England is committed to providing PGDiTs 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 PGDiT 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 PGDiTs within their trust and will be available to advise and assist any PGDiT 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 PGDiTs.


It is important that PGDiT 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 PGDiT 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 at NHS England via england.ltft.nw@nhs.net


pdf iconA list of the trust LTFT Champions is available here
pdf iconA list of the trust Training Programme Directors (TPDs) is available here
pdf iconA list of  the trust Medical Staffing Manager contacts which is correct to the best of our knowledge is available here



TIER 2 Less Than Full Time Training Applicants

Please find below a link to the website which identifies important guidance for TIER 2/Skilled workers. Requirements have changed; please ensure you meet all requirements before applying to undertake Less Than Full Time Training.






Please note you are only eligible to train Less Than Full Time if you have a confirmed substantive post with NHS 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 PGDiTs will be able to apply for LTFT subject to completing local processes. All PGDiTs who wish to commence LTFT training will need to identify one of seven different opportunities they wish to apply for in accordance National LTFT guidance.


These options are as follows, and are included in the Application to Commencement LTFT Training Form:

  • Disability/ill Health
  • Caring Responsibilities
  • Welfare and Wellbeing
  • Unique Responsibilities
  • Religious Responsibilities
  • Non-Medical Development
  • Career Development


All applications will need to be completed with at least 16 weeks’ notice as per National guidance. This is so we can adhere to the 12 weeks code of practice to allow Trusts notice to complete the required work schedules.


Although you will not need to re-apply for LTFT at the start of each rotation (unless you wish to change percentage or return full time) you will need to liaise with each host placement regarding your work schedule prior to each placement.


To simplify the process below are points which will activated for everyone in the future.


  1. LTFT will commence only at rotation points – unless an unexpected reason is identified during a placement for example health, carer, parental leave, this includes changes in any percentage in LTFT training.
  2. Increasing back to fulltime will only be allowed at a rotation change and with notice unless exceptional circumstances apply.


All PGDiTs who wish to commence LTFT training rotation will no longer need to state under which a category they wish to apply under when they complete the Application to Commence LTFT training form, they will however need to identify one of seven different opportunities they wish to apply for following an update in National LTFT guidance.


These options are as follows and are included in the Application to Commencement LTFT Training Form:

  • Disability/ill Health
  • Caring Responsibilities
  • Welfare and Wellbeing
  • Unique Responsibilities
  • Religious Responsibilities
  • Non-Medical Development
  • Career Development


For welfare and wellbeing (work/life balance) this can only be applied for during one of two application windows annually, for all other opportunities a minimum of 16 weeks notice must be provided where practically possible.


The form will ask for the reason as it does now and in the case of ill health ask for confirmation of engagement with health care /OH (duty of care) – this will allow us to monitor the situation.


You can access the Application to Commence LTFT Training form here. When completed please send the form to england.ltft.nw@nhs.net under the subject heading "Eligibility Request". Failure to do this may result in a delay in your eligibility being confirmed.


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




Whenever possible LTFT PGDiTs 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 PGDiT 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 PGDiT’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 PGDiTs, 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 PGDiT 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 if a PGDiT rotates to a new trust, changes the percentage they wish to train and if the type of training changes.


Any PGDiT who stay in the same trust, same percentage and type of LTFT training, needs to send an email to the LTFT team to confirm this is the case. This is the PGDiT’s responsibility.



LTFT e-learning package for supervisors

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


NHS England is committed to improving Junior Doctors’ working lives and championing flexible working more broadly. With work/life balance highlighted as a mounting concern to PGDiT, 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

All LTFT PGDiT will receive full support and advice from the LTFT champion at the trust where they are training, a list of LTFT champions is available under the LTFT trust training champions section further up this page. In addition, LTFT specialty advisors are also available to provide support and advice, if you wish to contact any of these ask your TPD for details.


For any LTFT queries please email the LTFT team on england.ltft.nw@nhs.net, or for emergency queries you can contact the LTFT team on 0161 268 9578. Ruth.Gottstein, the Associate Dean for LTFT Training, can also be contacted about any LTFT issues at Ruth.Gottstein1@nhs.net  



Useful links
external link iconLTFT Flowchart
external link iconEquitable pay for flexible medical training