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Anaesthetics Less Than Full-Time training (LTFT)

A medical procedure in hospital. A&E. Treatment. Staff nurse wearing scrubs attending to a patient. Attaching oxygen mask. Anaesthetised patient lying on a treatment table.Over the past decade the numbers of doctors in flexible training has increased, supported by both the Royal College of Anaesthetists and the Wessex School of Anaesthesia. This recognises the gradual acceptance that not all doctors wish, or are able, to work on a full-time basis.

 

Useful Documents:

School of Anaesthesia Guide to LTFT training and Maternity Leave (Word)

Health Education England, Working across Wessex LTFT Training Policy

Health Education England, Working Across Wessex Return to Training Scheme

RCoA Return to Work Guidance (pdf)

RCoA LTFT A-Z guide (pdf)

The RCoA has described three ways of training LTFT:

  • Slot sharing is the term used when two LTFT trainees are placed by Health Education England, working across Wessex and/or the Programme Director in one full-time training slot. Slot-sharing trainees are usually, but not always, at the same stage of training. They share the out-of-hours work associated with the full-time post but may work some of the same days during the week – a factor that will vary depending upon childcare arrangements and the individual’s specific training requirements. Slot-sharing partnerships are not for the duration of the programme.
  • Working reduced hours in a full-time slot is the remaining option for LTFT.

 

The Training Directorate requires exact dates of all periods of leave (maternity, sick, accrued annual leave) to allow calculation of a provisional completion date. A completion date is calculated on the percentage of full-time hours the trainee works and it is acknowledged that this may vary between hospitals. Completion dates are not calculated until the trainee has entered ST5.

We remain one of the most popular hospital specialties after paediatrics for those who wish to work LTFT. The College recognises and values the contribution made by LTFT trainees to the specialty. College data and the 2010 anaesthetic flexible training survey indicate that the majority of LTFT trainees work 60-70%. The evidence suggests that part-time training at 60-70% supports career progression and a healthy work-life balance.

The College continues to follow the advice from ‘Principles underpinning the new arrangements for flexible training 2005’ that LTFT training be undertaken on a pro-rata basis, which includes OOH as this remains an essential component of the anaesthetic training programme:

  • An opportunity to experience and develop clinical decision-making
  • An opportunity to learn when to seek advice
  • A reflection of professional anaesthetic practice.

 

Within slot shares, there may be variations in how the OOH work is allocated. The College accepts that if training at 60%, a trainee working LTFT may work 50% OOH in conjunction with an increase in their day-time hours to 70%.

RCoA Advice for CT1 Trainees considering LTFT Training
Commencing as a novice anaesthetic trainee on a 50-60% LTFT basis is extremely stressful for both trainee and department. There are very few who start an anaesthetic career on a LTFT basis but information gathered at the College would suggest that many of these trainees have failed to gain their Initial Assessment of Competence by six months. The College Training Committee recommends that, if at all possible, the trainee should gain their initial three-month competencies on a full-time basis and then revert to LTFT training once this has been achieved.

Helpful hints from the RCoA for managing a successful transfer to LTFT:

  1. Contact your Deanery for an application form to train on a LTFT basis. All Deaneries will have someone who has responsibility for LTFT applications. The information on who to contact should be accessible via the Deanery website.
  2. After submission of your application form, await confirmation of eligibility to train on a LTFT basis. Confirmation of eligibility is essential to progress your LTFT application.
  3. If possible, speak to an existing LTFT trainee within your School who will have been through the process and may be able to answer specific questions about local arrangements.
  4. If you are already in a ST post (or CT post), please note that no interview is required.
  5. It is important to contact your School Programme Director and LTFT Specialty Advisor (if no School Advisor, then the Deanery LTFT Advisor) to ensure key people are aware of your intentions to change to LTFT.
  6. Once you have confirmation of eligibility, the Deanery in conjunction with your TPD have responsibility to identify a potential slot share (the most common LTFT arrangement in anaesthetics).
  7. Health Education England, Working across Wessex, TPD and the trainee agree a timeline for transfer to LTFT.
  8. It is recommended that you contact the College Tutor and department rota administrator in advance of starting LTFT, if you are starting in a completely different hospital.
  9. The Trust HR will need a timetable of your working week to confirm hours, working pattern and banding supplement.

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