Less than full time training


Quick LTFT links

Return to Work forms
HESL (Deanery) Flexible Training

LTFT London Anaesthesia Forum

What is LTFT training?

LTFT trainees work a reduced number of sessions compared to a full time trainee. This is expressed as a percentage of whole time equivalent (WTE) and trainees can work between 60-80% WTE. Training recognition is awarded pro-rata, e.g. for a trainee at 60% WTE then ten months of training would equate to six months WTE. Out of hours duty is also organised pro-rata and should include the full range of shifts and duties.

Who is eligible for LTFT?

LTFT is available to doctors in training who have a justifiable reason for being unable to work full-time. The vast majority of LTFT are parents of young children, 2011 figures from RCoA showed that 8.5% of trainees are LTFT and 95% are female.

There are two categories for eligibility for LTFT. Trainees who fulfil Category One criteria are automatically eligible and take priority for funding.

Category One:

•       Parents of young children who wish to spend part of the week at home
•       Trainees caring for an ill or disabled child, partner, relative or other dependent
•       Trainees who are unable, for health reasons, to work full-time

**Anyone training flexibly under Category One is not permitted to undertake any other paid or unpaid working, including locums.**

Category Two:

•       Doctors wishing to train part-time, while in other paid or unpaid work for the remainder of the week
•       Trainees wishing to train part-time in order to follow non-medical interests

Trainees can apply for Category Two LTFT training providing they are already in an approved training post and are employed by a trust in London. They will need to reapply each time they change employer as this category of LTFT is at the employer’s discretion.


•       Doctors wishing to spend part of the week on research or an academic course.

In these circumstances it may be possible to arrange reduced working hours by negotiation with the employer.

Types of LTFT training

Slot sharing

This is now the commonest type of LTFT training. Two LTFT trainees share one full-time training slot. The trainees share the on-call work associated with the full-time post but may work some of the same standard days during the week. They do not have to be at the same stage of training.

Slot sharing partnerships are not for the remainder of the training programme. For Imperial, it varies depending on the stage of training; slot-share partnerships tend to last longer amongst pre-FRCA trainees who may rotate to several different hospitals together. For post-FRCA trainees, the slot-shares generally last for the duration of the hospital placement due to differing training requirements.

Reduced hours in a full-time slot

Where a slot share partner is not available a LTFT trainee may work reduced hours in a full-time slot. For example, a LTFT trainee working at 70% would work 70% of the total hours of a full-time trainee and 70% of the on-call commitments.


Due to funding constraints, supernumerary posts have become the exception in anaesthetics. An individual training post is created for a named person who is placed as an additional trainee within a department. The Deanery, in conjunction with the Regional Adviser, must ensure that any supernumerary posts created have prospective GMC approval, if they fall outside the maximum training capacity for the School.

Applying for LTFT

To begin the process trainees should discuss their intention to train LTFT with their Training Programme Director (TPD).

Trainees then need to apply via the Health Education South London Educational Resources Team. Firstly they need to request an Eligibility form and subject to their eligibility being confirmed they will then need to complete a Flexible Training Approval Form. The Funding Approval form is completed by the trainee and the trainee’s hospital trust. It also needs to be signed by the trainee’s TPD. Each time a trainee moves hospital or changes slot share arrangements they will need to complete a new Funding Approval Form. All LTFT paperwork is now submitted electronically.

Pay Banding for LTFT

Salaries for LTFT trainees are determined according to Equitable pay for flexible medical training.

As for full-time trainees, LTFT trainees receive a basic salary plus a supplement for out-of-hours duties. The LTFT basic salary is determined by the actual hours worked and is divided into bands that correspond to a proportion of the equivalent full-time basic salary.

Added to the basic salary is a banding supplement. There are three banding groups, with FA being for trainees working at the highest intensity and at the most unsocial times. Most anaesthetic posts are either band FA or FB.

More detailed information on LTFT rota design and salaries can be found on the London Anaesthetic LTFT website.

Childcare Vouchers

What are Childcare Vouchers?

Childcare vouchers are a tax benefit to help parents with the costs of registered childcare. The schemes run by NHS hospital trusts follow a salary sacrifice model – you agree  for a portion of your salary to be paid as childcare vouchers and this portion is then exempt from tax and national insurance contributions. The employer also benefits as they are exempt from employers’ tax on the voucher.

Since 2011 the limits have been £124/month for higher tax rate payers.  Typically the voucher is paid into an account with a childcare voucher provider and then you can use the money in your account to pay for childcare.

The childcare must be registered or approved childcare, e.g. Ofsted registered nurseries, childminders or nannies. They cannot be used to pay for childcare provided by relatives or unregistered providers. How you use the money in your voucher account will depend on your preference and your childcare provider, e.g. you pay a portion of each month’s childcare costs and top-up the additional cost or you save up the vouchers until you have a full month’s payment.

Who can receive them?

The childcare vouchers can be received by anyone with parental responsibility for a qualifying child.  Both parents are entitled to claim separately.

The child will qualify:

•       until 1 September following their 15th birthday, or
•       until 1 September following their 16th birthday, if they are disabled.

How do I start claiming?

Contact your hospital trust’s HR department to find out who has responsibility for their childcare voucher scheme. Unfortunately each move to a new hospital trust is treated as a new employment so you will have to leave and re-join the scheme as you change trusts. In addition the hospital trusts use different childcare voucher providers, however you can hold more than one voucher account and setting them up is relatively straightforward.

Further information

HMRC Childcare Voucher Leaflet

NHS employers have a useful webpage including a link detailing the childcare provision and childcare co-ordinators for the different hospital trusts –with the caveat that this webpage is only updated intermittently.

NHS Employers Childcare Vouchers Webpage or search for NHS Employers childcare vouchers.


More detailed information on LTFT training can be found on the LTFT London Anaesthesia Website. General information & the application process is available on the London Postgraduate Medical and Dental Education website. There is also guidance from the RCoA & the AAGBI.


Return to Work forms
London Deanery Flexible Training

Within the school please contact Dr Jenny Illingworth, LTFT Trainee Rep and LTFT Consultant Advisor, Dr Sian Jaggar.


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