Less Than Full-Time Training (LTFT)

Giving trainees greater flexibility in their working lives

NHS England (Workforce, Training and Education) is committed to increasing flexibility in postgraduate medical training.

The key aims of LTFT training are:

  • To retain doctors within the NHS workforce who are unable to train on a full-time basis
  • To promote career development and work/life balance for doctors training within the NHS  
  • To ensure continued training in programmes on a time-equivalent (pro rata) basis
  • To maintain a balance in LTFT arrangements with regards to educational needs and those of the service  


New LTFT process from 1 March 2023

NHS England has refreshed the Standard Operating Procedure (SOP) on LTFT arrangements to ensure greater flexibility for Doctors in Training.  This work has been part of the Enhancing Junior Doctors Working Lives aligns closely to Gold Guide 9th Edition.  

  • Postgraduate doctors in training across England in any specialty have the right to apply to train LTFT for any well-founded reason, including for their wellbeing or through personal choice
  • Postgraduate Doctors and Dentists in Training should meet with their TPD prior to submitting their application 
  • Trusts are consulted with on applications that have less than three months' notice 


NHSE's Statement for LTFT Trainees Working as Locum's

LTFT trainees can do locum shifts but it is expected that this will be in the department where they are working and have educational supervision.  Trainees must follow the Good Medical Practice standards.  The expectation is that 1-2 locum shifts per month may be undertaken.  If it is more than this then this needs discussion with your Training Programme Director, Associate Dean for LTFT Training to discuss working at a higher percentage of full time.  Trainees are encouraged to discuss any issues regarding doing locums they are uncertain about.  An LTFT trainee should not be doing locum shifts for slots left empty by them by working LTFT.  The other restriction is that postgraduate doctors in training should only be doing locums in the East Midlands and not in other deaneries, to do a locum in another deanery needs Postgraduate Dean's permission.                        

How to apply

For any change in percentage training time, you need to complete the application form (see below).  This includes returning to full-time training.  

Foundation, Secondary Care, Public Health, GP and Dental 


If you are on a Tier 2 or Skilled Worker visa please make sure the LTFT percentage you apply for complies with the requirements of your visa. The sponsorship team have a full list of FAQs which can be found here.


Contact us

If you have any queries about working LTFT or changing your percentage please contact us on:


Secondary Care and Dental

0116 312 0670



0116 312 0670


General Practice

0116 312 0619
england.publichealth.midlands@nhs.uk Public Health 0116 312 0619


Further information

Pay: How working LTFT affects your pay


Rota Patterns: How to calculate your rota pattern when working LTFT


Peer Support

You can find support from your peers on LTFT below!

Facebook:  A group of volunteer admins, who are also LFT trainees, run a Facebook group for all LTFT doctors.  This is a public forum intended to offer peer support, respond to common LTFT queries and sign-post for further advice.  This group is searchable on Facebook as 'LTFT Trainees Forum', and there are a series of joining questions.

The rules for participating in this group are in line with all online activity: be polite, kind professional and respectful and don't post anything you wouldn't be prepared to sign.


Educator Information

Educator Information

Educator roles in the process

Educational supervisor

Each trainee should have a named ES who is responsible for overseeing that trainee’s educational progress over a period of time.

The ES is a trainer who is selected and appropriately trained to be responsible for the overall supervision and management of a specified DiT’s trajectory of learning and educational progress during a clinical training period and/or series of periods. The educational supervisor’s role is to help the student or trainee to plan their training and achieve agreed learning outcomes. They are responsible for the educational agreement and for bringing together all relevant evidence to form a summative report.

In relation to LTFT applications the ES is responsible for supporting a DiT to make career planning decisions at the right time and think about what is needed for their planned consultant/next training level practice.

Training Programme Director

All programmes are overseen by a TPD, or FPD in Foundation. A speciality TPD is a member of the Speciality Training Committee (STC)/Training School and responsible for the delivery of training in that speciality according to the standards set by the GMC and relevant Royal College or Faculty. They manage the programme alongside supporting individual trainees needs and training. They are responsible to the Head of School and Postgraduate Dean. 

In relation to LTFT applications the TPD is responsible for considering whether the programme can accommodate the request. They may also support the DiT and ES with guidance about potential opportunities. They may also consult the Associate Postgraduate Dean for Trainee Experience for advice.