Less Than Full Time Training

Please note:

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

 You can download the HEE LTFT local policy at a glance here

You can download the full LTFT policy here


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The term “Flexible” has been replaced by “Less than Full-Time” to avoid confusion.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 are eligible for less than full-time training and 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 england.ltft.nw@nhs.net

A list of the trust LTFT Champions is available here

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

A 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 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.


The latest window of opportuntiy will open on Monday 11th September 2023 and close on Friday 14th October 2023. This will be for all doctors in training who rotate between February 2023 and July 2024.

From August 2022 applying for LTFT training under category 3 is no longer in pilot status and changes to LTFT guidance now means that all trainees will be able to apply for LTFT subject to completing local processes.All trainees who wish to commence LTFT training at or after August 2022 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 minmum of 16 weeks notice must be provided where practically possible. 

To simply 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.

3. Initial application for LTFT will be in 2 windows mid March to mid April and mid September to mid October.

The current window of opportunity opens September 11th 2023 and closes October 15th 2023, this is for any doctors in training who rotate between February 2024 and July 2024.

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.

Each subsequent rotations for a LTFT trainee will be managed as at present.


You can access the Application to Commencement LTFT Training 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 if a trainee rotates to a new trust, changes the percentage they wish to train and if the type of training changes.

Any trainee who stay in the saem 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 trainees 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

All LTFT doctors in training will receive full support and advice from the LTFT flexible champion at the trust where you are training, a list of flexible champions is available under the LTFT trust training champions sections at the top of 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 ltft.nw@hee.nhs.uk or for emergency queries you can contact the LTFT on 0161 268 9578 or 0161 268 9676. Alison Gale, the Associate Dean for LTFT Training, can also be contacted about any LTFT issues at Alison.Gale@hee.nhs.uk  


Useful links

LTFT Flowchart

LTFT Flowchart for trainees already working LTFT

Equitable pay for flexible medical training