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Delivering greater flexibility

Giving trainees greater flexibility in their working lives.

Health Education England are working with partners to build greater flexibility in training:

Less Than Full Time 

Enabling train higher specialty trainees in emergency medicine to train Less Than Full Time, giving them greater flexibility in their working lives.

Out of Programme Pause 

Allowing trainees to step in and out of training, and to the have their learning during this period assessed on their return and potentially count towards their CCT. More information for trainees considered Out of Programme Pause (OOP-P) below. 


For further information, contact the team.

In 2017, Health Education ran a pilot that allowed higher specialty trainees in emergency medicine the ability to train at 50%, 60% or 80% of a full-time rota for 12 months, without having to meet the criteria set out in the Gold Guide.

Following the success of this we are now running a second pilot, which was open to applications from all existing higher emergency medicine trainees and run-through ST3 trainees in England, who are expected to progress to ST4.

These pilots have been developed in partnership with the Royal College of Emergency Medicine (RCEM) and the British Medical Association Junior Doctors Committee (BMA JDC), in response to concerns raised by junior doctors regarding inflexibility in their work patterns. It is hoped that this approach could reduce ‘burn out’ and attrition; boost morale; and aid recruitment in a high-intensity specialty.

The Academy of Medical Royal Colleges, the BMA, the General Medical Council, NHS Employers, NHS Improvement and the RCEM have expressed their support for piloting this approach to flexibility. We are working with partners to develop a detailed and robust evaluation process, before making further recommendations based on the pilot’s outcomes.

For further information contact the team.