Application Process
Application Criteria
All postgraduate resident doctors, including those in academic programmes and foundation programmes, can apply for LTFT training.
Resident Doctors can apply for LTFT training either at the point of application for entry into a training programme or at any time once they have been accepted for training. You do not have to declare at your interview your intention to apply to train LTFT.
Application Process
You must give at least 3 months' notice of this change to your working pattern. If your request is because of a health problem, Occupational Health may be able to make some short term recommendations to bridge the 3-month gap.
The application process is very well outlined on the Scotland Deanery website:
The process outlined below is due to change slightly in 2025 - please check the NES website for the most up to date details.
Documents
Alternatives to LTFT Training
Flexible Working
Flexible working is an agreement with your employer to vary your working patterns from standard patterns. This may for example, mean an agreement to work fewer, longer days (e.g. four ten hour days rather then five eight hour days). This could work well in settings where a standard day is longer (e.g. in some GP practices) or for senior resident doctors who have some autonomy over their workload. Flexible working patterns may be combined with LTFT status: an example of this is that some GP resident doctors may work a 70% working pattern over 3 days.
However, even though there is an NHS Scotland Flexible Working Pattern policy and all employees have the right to apply, flexible working is not guaranteed (e.g. if service needs cannot be met) and there is currently no formal process for resident doctors (or any doctor) to apply for this. A discussion with your Training Programme Director (TPD) would probably be the first place to start.
Reasonable adjustments for health or disability
While working LTFT may support some resident doctors to maintain health or those with disability, in some cases it may not address the challenges you identify at work which impact on your physical or mental health. It may be possible to make more appropriate adjustments to your working patterns on the advice of Occupational Health.
A resident doctor who has epilepsy notices that working night shifts worsens his seizure pattern. He sees his GP about this. The resident doctor considers applying for LTFT training to reduce the frequency of night shifts; however, he would still work night shifts. He meets his Clinical Director to discuss and is referred to Occupational Health. Occupational Health identify that a change in working pattern, i.e. no night shifts, would best meet his health needs and reduce the impact of work on his health.
Frequently Asked Questions
What is a "well founded reason"?
Your reason for going LTFT can be anything that is sensible and can include personal choice and wellbeing. Other common reasons include caring responsibilities, physical health, mental health, to improve work/life balance and avoid burnout, to pursue some sort of personal development (e.g. sporting, academic or non medical development). Currently, it is the Associate Dean (LTFT training) and where appropriate, the Postgraduate Dean, who ultimately determine whether a resident doctor's request to train LTFT is "well founded".
What % LTFT can I go down to?
In its 2017 position statement, the GMC state that the minimum LTFT is 50%, although in exceptional individual circumstances, it can go down as low as 20% for up to 1 year. In reality, you will often be advised by your TPD a minimum % that balances educational progression and skill mastery with time away from work, and this would usually be in the region of 60-80%.
Within Scotland, the majority of LTFT resident doctors are 80% (approximately). On some rotas, it may be possible to train at 90% it this is what suits you best, although your hours need to be carefully counted to ensure on average, you do not exceed 40 per week.
Can I work LTFT in a Locum Appointment for Training (LAT) post?
Yes. The application process is the same. Because of the fixed-term nature of such appointments, you would not be entitled to a pro-rata extension to the duration of the LAT.
What happens if my LTFT application is declined?
Your application for LTFT may not be supported by NES (this is uncommon) or may be declined by the service (NHS Lothian). Whoever declines your LTFT application must give you a written reason for this. Bear in mind, although they should try to accommodate your request where possible, all health boards reserve the right to refuse applications for LTFT.
If refused, contact your TPD/Associate Postgraduate Dean in the first instance to look for a bespoke solution e.g. your TPD might be able to rotate you to a department that does have the funding/capacity for LTFT resident doctors on the rota, or you may be accommodated if you wished/were able to cover 100% out of hours (OOH) shifts (see 'Rota' section) or there may be some alternative working patterns which may benefit you (see 'Alternatives to LTFT Training' section).
If it is a funding issue from the NHS Lothian side (remember the salaries of Resident Doctors are paid by both NES and NHS Lothian) then this could be escalated to the Medical Director, but it is unlikely to yield an easy or quick result. Involve your Educational Supervisor and TPD if you are considering this step.
There is an appeals process if your LTFT application is not supported by NES. This involves completing a Form E (found on the Scotland Deanery website) and submitting with a covering email to training.management@nes.scot.nhs.uk.
What if I am working for another health board within Scotland when I apply to go LTFT?
The process should be the same. If you are transferring between deaneries you will need to contact your new TPD in advance of starting to complete Form A.
What happens if I change my training programme?
For instance, the progression from foundation to core training or from core training to speciality training. You will need to fill in a new Form A and re-apply for LTFT training. Early contact with your new TPD after you have received the offer will help to expedite the process.