Less Than Full Time Training (LTFT)

The aims of LTFT training are to:

  • retain in the workforce doctors who are unable or do not wish to continue their training on a full-time basis
  • promote career and personal development as well as work/life balance for doctors training in the NHS
  • ensure continued training in programmes on a time equivalence (pro rata) basis

GUIDANCE (adapted from the national SOP)

Applications for less than fulltime training

All employees have a legal right to request flexible working – not just parents and carers.  All doctors in training can apply for LTFT training and section 3.123 of the Gold Guide provides a list of illustrative examples for requesting LTFT training: –

1. Trainees with a disability or ill health – This may include ongoing medical procedures such as fertility treatment.

2. Trainees (men and women) with caring responsibilities (e.g. for children, or for an ill/disabled partner, relative or other dependant)

3. Welfare and wellbeing – there may be reasons NOT directly related to disability or ill health where trainees may benefit from a reduced working pattern. This could have a beneficial effect on their health and wellbeing (e.g. reducing potential burnout).

(NB HoS/TPDs/ES should ensure that any trainees with potential health issues are assessed and reviewed by OH to ensure appropriate support and oversight is in place to support their training. Trainees with health issues would not usually apply under the health and wellbeing criteria

4. 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 medical research as a bridge to progression in integrated academic training).

5. 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.

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

7. Flexibility for training and career development with the option to train less than full time with flexibility that might enable development of a broad career portfolio

All well-founded reasons will be considered. Support to progress the application will be dependent on the capacity of the programme and the effect the request may have on the training available to other doctors in training on the programme. 

It is expected that all those applying due to disability or ill health and caring responsibilities (1/2 above) will be accommodated.

Out of hours (OOH) commitments

Trainees working LTFT are expected to do the SAME percentage OOH as their daytime commitment (unless there is specific OH guidance). For example if you work 60% LTFT you should expect to work 60% OOH, regardless of the specialty you are working in.

Agreement to LTFT working

Support at the Deanery level does not automatically mean that a trainee will be able to work LTFT. We ask that you discuss your plans with your ES/(F)TPD in advance of applying.

Application Windows

Some schools (for example General Practice and Acute Medicine) receive large numbers of applications from trainees wishing to work LTFT. This may mean that you must apply within a specific window, usually at least three months ahead. This allows the school to consider all the applications they receive together, so that they can be prioritised when not all applications can be accommodated or where administrative/rota arrangements need to be put in place

Examples of windows (Medicine) who require 4 months

Application window examples:

  • By 11th April for consideration of LTFT for 1st August start date
  • By 12th October for consideration of LTFT for 1st February start date

We recognise that standard rotation dates can vary, and the same principle will be applied with the application date closing 16 weeks before the start date.

Percentage Hours for LTFT trainees

Trainees can indicate a preference for the % of LTFT working (90% or less). However, there is NO GUARANTEE that the TPD or the employer will be able to offer a particular %. The % offered will depend on the capacity of the programme to accommodate the LTFT applicant, and the needs of the employer when considering service commitments.

This may not apply for those with health issues where OH advice will be followed.

Working days

Days of the week worked in a LTFT post are determined by the School/TPD, considering trainee preference where possible. This will ensure that the quality of training and educational requirements of all trainees are met.

Trainees should also be aware that days of the week may need to be changed to ensure training and educational needs are met. In this circumstance trainees will be given at least 3months notice of this requirement.

Job/Slot Share Arrangements

The preferred option for many NHSETV training programmes is for two trainees to job share, usually with each trainee working at 60%. It is the responsibility of trainees in a job share slot to agree individual patterns of work that ensure the whole working week is covered. There is no capacity/requirement for Trusts to provide additional locum cover for gaps that might arise because of ‘clashing’ preferences.

Trainees may not always start in a slot share but if one becomes available, they may be required to move into a slot share arrangement.

Locum/additional work

LTFT trainees are permitted to take on additional work. This should not impact training. It would also be unusual to take on regular additional work such that the trainee is effectively reverting to fulltime employment.

All additional work should be discussed in advance with the ES and declared annually on the scope of practice form.

Tier 2 or Skilled worker visa

Trainees who are subject to (Tier 2/4 or Skilled Worker Visa) must ensure they check their sponsorship requirements before submitting their application or requesting to amend their LTFT percentage.

More information can be found here:-https://www.gov.uk/skilled-worker-visa

Annual review

All LTFT trainees will be reviewed annually.


All doctors in training can apply for LTFT training either during their training or ahead of starting.


Trainees should first discuss a potential application for LTFT training with their Educational Supervisor, Training Programme Director (TPD) and Programme Manager and ask them to complete their part of the application form below before sending it to us.

Complete the application form and submit, along with copies of supporting documents (e.g. Birth or marriage certificate), to mailto:England.ltft.tv@nhs.net

Our aim is to respond to requests as quickly as possible, in most cases within two weeks.

The Gold Guide (section 3) contains more details on arrangements for LTFT training.

Requests to change percentage of the hours you work when you ALREADY work LTFT

Once a trainee has been accepted for LTFT at a particular percentage, any request to change will need to be considered and agreed by the TPD/HoS. Trainees should plan these requests at least 3 months in advance.

Please be aware that whilst trainers will always try and respond positively to such request’s adjustments may not always be possible, or there may be a delay in effecting change.  No trainee has a right to expect the training programme to accommodate such requests.


GP Change of Percentage Form

Speciality Change of Percentage Form

Guidance and a helpful online LTFT calculator https://thamesvalley.hee.nhs.uk/wp-content/uploads/sites/5/2024/01/LTFT-Calculator.xlsx

Principles for Supporting Programme Management of LTFT Doctors in Training