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Delivering greater flexibility

Giving doctors in training greater flexibility.

HEE is committed to increasing flexibility in postgraduate medical training. As a part of HEE’s work to Enhance Junior Doctors Working Lives several initiatives have been developed with partners to increase flexibility within Postgraduate Medical Education. Feedback from trainees indicate that many would appreciate the opportunity to pursue a more flexible approach to their training.

Less Than Full Time Training

HEE is committed to increasing flexibility in postgraduate medical training and fully supports Less Than Full Time (LTFT) Training.

From August 2022, all 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.

How To Apply

  • Please contact your HEE Local Office (Deanery) and Training Programme Director (TPD) for more information on the application process.

  • It is important to give at least 16 weeks’ notice of your wish to train less than full time to allow sufficient time for the employing Trust to be notified and to discuss with the TPD for the purposes of rotation planning. 

  • Acceptance of your application may be dependent upon and might be limited by service considerations as well as the capacity of the training programme itself.


Please refer to your HEE Local Office (Deanery) for further information of the application process.

North East and Yorkshire

North East Lead Employer Trust Policies 

North East Education and Training Policies 

Yorkshire and Humber

North West

North West

East of England

East of England


East Midlands

West Midlands



South East

Kent, Surrey, Sussex

Thames Valley


South West

Peninsula Deanery 

Severn Deanery 

Further information

Read LTFT Training Guidance here.

Read LTFT Frequently Asked Questions here.

Below are three short videos which explain Less than Full Time training in more detail:



Rota Patterns


How has HEE expanded LTFT training opportunities?

Over the last several years, HEE piloted a new category of LTFT, giving doctors in training the ability to apply to train LTFT through personal choice. This new initiative was referred to as LTFT Category 3.   

LTFT Category 3

LTFT training had traditionally only been available to those with caring or health needs (Category 1) or those with unique opportunities for personal development (Category 2). Responding to valued trainee perspectives, HEE began piloting a new flexibility initiative in 2017: LTFT Category 3.

LTFT Category 3 allowed doctors to opt to train on a LTFT basis for an individual, professional or lifestyle need, aiming to improve their work-life balance and to promote retention. The choice to train LTFT  was not subject to any judgement, but may have been constrained by local service considerations. Following the success of pilots in selected specialties, this initiative was rolled out to include all specialties. 

Initially, LTFT Category 3 was piloted in Emergency Medicine, Paediatrics and Obstetrics & Gynaecology. In response to the pressures of the Covid-19 pandemic on doctors in training and their wellbeing, HEE accelerated the roll out of the initiative, making it available as a short term offer in all other specialties in 2020 and 2021, and as a full offer for the August 2022 rotation.

Following the publication of the Gold Guide (9th Edition, July 2022), the categories for LTFT training have been removed, allowing all doctors in training the opportunity to apply to train LTFT for any well-founded reason, including for their wellbeing or through personal choice.

Evaluation of Category 3

RSM UK Consulting LLP (RSM) was commissioned by HEE in 2020 to conduct a three year longitudinal evaluation of the LTFT Category 3 initiative. The Year 1 Report explores the profile and views of LTFT Category 3 trainees, and the perceptions of other trainees, Champions of Flexible Training, educators and employers of the impacts of the initiative. This report also provided a series of further recommendations to enhance the ongoing development of the programme.

This evaluation has now completed the second year, and a summary of these findings can be found below:

Impact of the LTFT Category 3 initiative on trainees:

  • 100% of survey responders agreed/strongly agreed that it has increased their sense of work/life balance
  • 100% of survey responders agreed/strongly agreed that it has increased their sense of wellbeing
  • 93% of survey responders agreed/strongly agreed that it has increased their likelihood of remaining in training

Impact on future career plans:

  • 86% of LTFT Category 3 survey responders intend to become an NHS consultant 

Impacts on service provision:

  • 29% of wider trainees and 61% of educators regarded LTFT Category 3 as having negatively impacted on service provision. Interviews with employers suggested a similar perception.

Interest in training LTFT:

  • 86% of FT survey responders would consider training LTFT. The majority of these trainees (79%) would consider an 0.8 WTE role. 

An infographic showing the full results can be downloaded here.

The third and final evaluation report and its findings will be published in 2023.  

For further information, contact the team.