You must discuss any plans for Flexible Training with your Training Programme Director (TPD) and Medical Workforce Officer (MWO) or your Foundation School Director (for FY1s and FY2s) before beginning your application.

i) Eligibility Form

Your first step is to email christobel.gunasekera@londondeanery.ac.uk with ‘Eligibility Form request’ in the subject line and your postal address in the body of the email. We will then send you a very simple and quick form to complete which will establish your eligibility to train flexibly.

ii) Flexible Training Approval Form

Once we have received your completed eligibility form and you have been deemed eligible, we will send you a Flexible Training Approval Form (FTAF). This needs to be completed by you and your Trust and then returned to us. We ask that where at all possible the FTAF should be with the Flexible Training Team 2 months before you begin your post.

2. Which Deanery do I apply to if...

i) I will be working in a London Trust?

You apply to London Deanery regardless of grade or specialty.

ii) I will be working in a KSS Trust?

You apply to KSS Deanery regardless of grade or specialty.

iii) I will be working in an Essex or Hertfordshire Trust?

You apply to London Deanery regardless of grade or specialty.

3. What is the Flexible Training Approval Form (FTAF)?

All flexible trainees must complete and return an FTAF at least two months before the start of the post. This form confirms that posts that are reduced sessions or slot-shares have educational approval, and trust approval, and by signing it the flexible training office confirms any funding that has been agreed. If your post is supernumerary, you will need to apply for educational approval (see part 2 of this section).

The form must be completed, whether or not the flexible training budget is funding the post.
We reserve the right to refuse retrospective funding if the approval form is submitted late.
Starting a post before a form has been completed is at the risk of the trainee and the trust, both educationally (because the funding for the post will cease immediately if the post is subsequently found not to be a recognised educational post) and financially (because the Deanery may not have the funding for the post).
A new form must be completed for every move to a new post, or every year, whichever occurs earlier. Each new form must be submitted two months before the start date.

4. How do I complete the Flexible Training Approval Form?

Please ensure that you complete all of the personal information and placement fields on the front page of the FTAF. If we have any queries about the form and need to get in touch with you, we will need your current phone number and email address. Otherwise, we will need to return the form to you, delaying the whole process. We also need to be able to read what you have written so please make sure the form is completed legibly!

You will need to tick all the relevant boxes and sign and date the trainee statement on the back page.

Your flexible training approval form should be sent to the Finance or Medical Staffing/Recruitment department in your Trust for them to sign it off. The last section must be signed by Medical Staffing and someone who is a nominee for the Director of Finance. This does not necessarily mean your consultant. If your form has been signed by your consultant, this will delay processing your form by the flexible training team as we will have to check with your Trust that the consultant is an acceptable nominee. Some Trusts are quite clear that consultants are not nominees for the Director of Finance which means the form has to be returned to them for re-signing.

5. Have you received my Flexible Training Approval Form?

The flexible training team aim to process FTAFs within 5 working days and three photocopies of the form will be sent to you as soon as it is processed. If you do not receive copies of your form two weeks after you have passed it on to your Trust to complete, please contact the Trust department who are responsible for signing off the form to see whether they have done so. If they have completed the form and sent it to the London Deanery and at least two weeks has elapsed since they sent it, please contact us to check that we have received it:

If your surname begins with A-E or S-Z, please contact Allison Franklin

If your surname begins with F-L, please contact Stephen Mitchell

If your surname begins with M-R, please contact Joseph Impraim

6. If you don’t receive the FTAF before I begin my training post, will my pay be affected?

No, absolutely not. The Trust is your employer and they pay you. The Deanery makes a funding contribution towards your salary if you are slot-sharing or are a supernumerary.

7. Who is eligible for flexible training?

Flexible training is accessible to doctors in training who have a well-founded reason for being unable to work full-time. In practice, the majority of flexible trainees are women and men who wish to look after their young children for part of the week, and there are a small number who look after other family members. Also eligible are people who have physical or mental health problems, who would like to continue their training but are unable to do so full-time. The national guidance on eligibility for flexible training is that the following groups are automatically eligible and take priority for funding (Category One):

Parent of young children who wish to spend part of the week at home
People caring for an ill or disabled child, partner, relative or other dependent
People 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.**

The following can apply for Category Two flexible training providing they are already in an approved training post and are employed by a trust in London:

Doctors wishing to train part-time, while in other paid or unpaid employment for the remainder of the week

People wishing to train part-time in order to follow non-medical interests e.g sport, music

A Category II flexible trainee has to reapply for eligibility for flexible training each time they change employer as this category of flexible training is entirely at an employer’s discretion.

The following are not currently considered eligible for either category of flexible training:

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 through direct negotiation with an employer).

8. London Deanery Hospital Retainer Scheme

Trainees who are eligible for Category One flexible training are able to apply for the London Deanery Hospital Retainer Scheme designed to allow trainees to work for two sessions with no out of hours for up to a year for compassionate reasons. The two sessions are organised by the trainee, funded by the Deanery and are not recognised for training.

9. If I am eligible for flexible training, does that mean I am guaranteed funding?

No. The budget for flexible training is limited, and the number of people requesting flexible training is growing all the time. For this reason, and because it is advantageous to flexible trainees to be seen as part of mainstream training, trainees are placed either in full-time posts on reduced sessions (where no extra funding is required), or in a slot-share (where just one salary requires funding by the flexible training budget). Flexible training is currently guaranteed to those for whom one of these options is possible. Trainees for whom neither option is possible will need a supernumerary placement, subject to funding availability.

10. Do I have to have my eligibility confirmed by the flexible training office if I am applying for a substantive part-time training post?

Yes, unless the Trust advised you otherwise because the post will be completely Trust funded.

11. I am not currently in a job (e.g. on maternity leave). How do I go about applying for flexible training?

All flexible trainees have to be appointed in open competition. Ask for an eligibility form (see above) and then apply for full or part-time posts in the normal way. If you apply for full-time posts you are not obliged to state that you would like to train flexibly until after you have accepted the post.

12. May I be asked about my intentions to train flexibly at interview?

No. It is against equal opportunities legislation to ask questions at an interview that relate to the candidate’s ability to work full-time, or indeed any other aspect of a person’s private life that has no direct bearing on their competence to do the job. Many people are concerned that if they apply for a full-time post without mentioning their intention to work part-time, prospective employers will be annoyed if they do so once they have been offered the post. For this reason, some prefer to mention their intention at the application stage. Anyone may decide to do this, but you are not obliged to by law.

13. I’ve got a LAT. Can I train flexibly?

As a principle, people who are unable to work full-time should not be disadvantaged in their careers as compared to full-timers. Therefore, given that LATs can be accredited for specialist training, and that experience as a LAT is seen as an advantage when it comes to applying for StR posts, people wishing to work flexibly in a LAT may do so, subject to the normal conditions, for a maximum of one year full-time equivalent.

14. I am a full-timer and having a difficult pregnancy. Can I become a flexible trainee now?

Your terms and conditions of work allow you to modify your hours and duties if you are unable to work normally due to pregnancy. Talk to your occupational health department.

Part 2 FOR DOCTORS WHO HAVE BEEN ACCEPTED FOR FLEXIBLE TRAINING

1 How do I obtain educational approval for my post?

a) Reduced session in a full-time post & slot-shares

If you are working reduced sessions or as a slot-share, you do not need to apply for educational approval as your post is already approved.

However, once you have drawn up your proposed weekly training timetable with the relevant consultant, this should be compared with a full-time programme, and the proportion assessed. Accreditation used to be assessed on the basis of the number of daytime sessions worked. However, now that it is unusual for full-timers to work five full days a week, given time off in lieu for on-call duties, this is an inappropriate method in most instances.

The timetable and this proportional assessment should then be sent to the appropriate Royal College, for the attention of the regional specialty adviser. It is advisable to ring the College first to obtain the particular arrangements for that College, as these vary.

b) Supernumerary posts

Supernumerary posts are those posts which are in addition to the usual complement of training posts in your employing Trust. Some training units in Trusts have permanent supernumerary posts but for the purposes of educational approval each trainee in the post needs to apply for their own educational approval. It does not matter if the education and training content of the post is unaltered from trainee to trainee, educational approval must be applied for by each trainee in the post.

In order to apply for educational approval, you should complete a London Deanery Form 19a and send this with a copy of your CV and your timetable to the Flexible Training Department. You should also include the recalculated CCT date from the JRCPTB or JCST or from your Royal College Regional Advisor.

Please email allison.franklin@londondeanery.ac.uk for a Form 19a.

Failure to submit all of the educational approval documentation within two months from the start date of your supernumerary post may mean that educational approval will not be granted and in turn this could affect your final CCT date. Once your educational approval has been granted, you will receive a letter informing you of this.

Please ensure that each document has your name on it.

2. General Practice

People training for general practice should obtain educational approval from the Department of General Practice at the London Deanery (on behalf of the RCGP) for each specialty post. Further information is available in the GP flexible training handbook on the Deanery website. http://www.londondeanery.ac.uk/general-practice/gp-recruitment/gp-flexible-training

Failure to obtain educational approval before you start leaves you open to your training not being recognised at a later date.

3. Where can I find details about training in my specialty?

Please refer to www.london-pgmde.ac.uk for specialty information. Contact details for Royal Colleges, Specialist Training Committees, etc., are the same as for full-time trainees, and these records are not maintained by the flexible training staff.

4. What will my pay banding be?

Guidance notes as to banding arrangements for flexible trainees are provided on this website, see: “Equitable pay for flexible medical training”. For more detailed or personal guidance, please consult the BMA and/or your human resources department. The flexible training office cannot negotiate banding on behalf of individual trainees.

5. Can flexible trainees insist on doing on-call?

In general, a flexible training programme should be equivalent, pro rata, to a full-time programme, and this applies to on-call. Thus, if you are working 60% of full-time, you should be doing roughly 60% of the on-call.

However, since the introduction of the new pay bandings, there has been pressure on some flexible trainees to do little or no on-call in order to reduce costs. The bottom line on these decisions is that the training programme must be approved for training, and if this requires on-call, then on-call must be included. Where it is possible to obtain experience of emergency work with normal working hours, some colleges are prepared to accept this, but this must be agreed before starting the post and in writing. If on-call is not required for training approval, there is no compulsion upon the trust to provide this.

6. Is it possible to be exempted from on-call?

The rules on this apply equally to full and part-timers, and vary between colleges. European legislation allows exemption from on-call if breast-feeding, and you should be able to obtain exemption, or other modification of working hours, if you are pregnant. If there are good reasons for not doing on-call, it may be possible to obtain educational approval for emergency work that is done within the working hours of 8.00 a.m. to 7.00 p.m. Most colleges will treat applications for exemption on an individual basis, and you should contact them directly.

7. Can I increase/decrease my sessions?

It is normally possible to alter the number of sessions you work up to a maximum of eight sessions. Due to the change in EU law, you may now apply to work only one session per week but please note that flexible funding is only available for educationally viable training. If you choose to work fewer than 5 sessions per week, you will need to apply for educational approval, details of which can be found in Point 1 of these notes.

8. What should I do if I am going on, or returning from maternity leave?

Please inform us in writing as soon as you know when your maternity leave will start and give a rough indication as to when you plan to return if possible.

When planning to return from maternity leave, please contact your programme director or consultant in order to agree the arrangements for your return, at least four months in advance. You should request an approval form from christobel.gunasekera@londondeanery.ac.uk as soon as you have settled your return date and placement. Please assume that any form predating your maternity leave has been expired.

9. Is any of my maternity leave accredited for training?

Most colleges allow around three months off due to ill health or maternity leave without modifying the CCT date. Apply to your college for their allowance.

10. How much study leave do I get?

Flexible trainees are allowed the same amount of funding as full-timers. The time taken out for study leave, however, should be pro rata. Individual arrangements may be negotiated with your employer.

11. What if I want to move to another Deanery?

For doctors on SpR rotations it may be possible to move from one deanery to another without reapplying for a training number, if that doctor’s circumstances have changed since joining the rota. Inter-deanery transfers may be applied for by writing to the Postgraduate Dean, stating your specialty, current rotation and where and when you wish to move. An inter-deanery transfer form will then be sent to you for completion. If you would like to continue training flexibly in the new deanery, you should contact the Associate Dean for Flexible Training at that deanery in addition to completing the transfer form.
Please note that the funding for your training post does not ‘follow’ you and the next Deanery may have a waiting list.

12. Can I take time out-of-programme?

Applications for out-of-programme experience, or time out-of-programme should be addressed to the Associate Dean for your specialty, as for full-timers. The Flexible Training Office must be notified of any decisions made and all relevant dates.

13. When is my next RITA/ARCP?

Enquiries about RITAs should be made to the Medical Workforce Department. These are not dealt with by the Flexible Training Office. RITAs are carried out annually for flexible trainees, as for full-timers. Your specialty will have its own generic email address and this can be found at www.londondeanery.ac.uk/Contact us/enquiries.

14. When is my CCT/CCST?

Reviews of CCST/CCT dates are carried out by the Royal Colleges, and not by the Flexible Training Office.

15. Is the ‘period of grace’ that follows completion of training extended pro rata for flexible trainees?

No, the period of grace is six months whether you are part or full-time. As this period is intended to give people time to find consultant posts, there is no logical reason why this should be extended for part-timers. In all cases, a single extension to the period of grace may be granted by a Postgraduate Dean, if there are good reasons why that person is unable to obtain a consultant post. Such reasons may include: shortage of jobs available, demonstration of having applied unsuccessfully for jobs, geographical limitation due to spouse or family commitments. Extensions are more like to be granted if more than one of these apply, and less likely to be granted to people in shortage specialties.

16. How do slot shares work?

Slot sharing is an arrangement whereby two flexible trainees work in the same department, sharing a full-time slot or post. You do not share a salary, and can both work between six and eight sessions each.

Slot shares are to be arranged by the trainees with their Training Programme Director, Medical workforce Officer and Trust, not by the Flexible Training Department.

Advantages of slot shares

Flexible trainees are doing ‘proper jobs’, rather than being additional pairs of hands, leading to greater integration with the team and less marginalisation.
Fewer problems with educational approval.
No ‘dilution’ of available experience, especially in specialties where practical skills are an important element, as in surgery and cardiology.
Useful experience and skills development for those who go on to job shares as GPs or consultants.
Discourages the minority of flexible applicants who try to ‘cherry-pick’.
Less cost, both to Trust and Deanery and, therefore, reduces problems of Trusts refusing to accept flexible trainees.

Both trainees have equal status

Both are paid on the appropriate flexible pay band for the hours worked
Both may work up to the maximum of eight sessions each.
The trainees may wish to share the work contained in the full-time post, or it may be more appropriate for the trainees or department for them to work independently.

The funding

In order to increase incentive for trusts to support slot share, the Deanery funds one full basic salary from the flexible training budget, and another full basic salary is funded from the usual arrangements for funding full-time posts. This provides the trust with a total funding contribution of 200% (150% for ST1/ST2 posts) of a full basic salary, leaving the trust to pay net excess costs arising from the appropriate banding supplements. This is usually cost-neutral to the trust or better.

17. What happens if the slot share breaks down?

Inevitably share arrangements break down from time to time, either because one person is leaving or going on maternity leave, or because their training requirements take them to another post. In these instances, the options are:

Forming another slot share arrangement with another trainee
The remaining trainee reverting to full-time while their partner is away
The remaining trainee occupying the full-time post on reduced sessions
The remaining trainee becoming supernumerary funded by the flexible training budget.

PART 3 MMC

1. I am an SpR but don’t want to move across to ST grade. What do I need to do?

You don’t have to do anything. But before making a decision, do read through the new curriculum thoroughly to see if you already meet a lot of the competencies. You might be able to obtain your CCT quicker in the new grade.

2. Will specialist training rotation posts undergo transition to run-through training?

Doctors who already hold a National Training Number (NTN, in Type 1 training) by 31 December 2006 will complete their specialist training under the existing arrangements, in the current SpR grade – although it will be possible to train using new curricula through local discussion.

Doctors who are currently undertaking fixed-term appointments (Type 2 training) under existing curricula will, of course, need to apply for competitive entry into specialist training, once their fixed term appointment has come to an end. Doctors already in the SpR grade at the end of December 2006 will complete their existing training programme subject to satisfactory progress, though in some specialties there may be an option for them to change their programme to the new curriculum.

3. What if I need to reduce my hours urgently?

Sometimes a trainee needs to become a flexible trainee urgently, perhaps because of ill health either in themselves or a member of their family. In these circumstances, the process can usually be expedited.

4. What are the minimum and maximum hours that can be worked by a flexible trainee?

Flexible trainees are funded to a maximum of 80% of a full-time programme and can apply to work as little as 10% of a full-time programme. However, flexible funding is only available for training which is educationally viable and any trainee wishing to work less than 50% of a full-time programme is required to apply for educational approval using the process outlined in Part 2, Point 1 of these guidelines.

Sections

FAQs

PART 1

FOR DOCTORS ENQUIRING ABOUT FLEXIBLE TRAINING

Part 2

FOR DOCTORS WHO HAVE BEEN ACCEPTED FOR FLEXIBLE TRAINING

PART 3

MMC