Slot Share & Reduced Sessions Placements
In KSS, there are two forms of LTFT Training placements, which include slot share and reduced sessions:
How Slot Shares Work
Slot sharing works on the basis that two trainees share one full-time post and manage any out-of-hours between them. However, each doctor may work up to 80% whole time equivalent (WTE) and is paid as an individual trainee on the basis of actual contracted hours. Slot-sharing is distinct from job-sharing as it does not restrict the postholders to work 50% of a full-time post. This option tends to provide the most effective means of meeting the trainee’s educational needs and, in KSS, slot sharing must be explored before any alternative options are considered. LTFT trainees are encouraged to work a minimum of 50% in order to retain their skills and to achieve necessary competencies.
How Slot Shares Are Funded
The Deanery funding for slot shares currently provides the employer with surplus funds as an incentive, which can be used to support the LTFT Training placement. Whilst both trainees are paid for actual hours worked, subject to available funds, the employer will receive additional reimbursement as outlined in the Slot Share Example below. It is recognised that LTFT trainee slot share partners may change during the training programme. Depending on the individual training needs and circumstances, reasonable steps should be taken by the employer and the Deanery to accommodate the needs of the remaining slot-share partner, whilst trying to fill the vacant proportion of the training slot. It is also possible that the slot sharers may start/finish at slightly different times if this is necessary to accommodate a slot share arrangement, for example: A new LTFT trainee is due to start a slot share placement in August and the slot share partner is returning from maternity leave in September. If there is no scope for the two trainees to commence on the same date, this brief gap, where trainees are not concurrently in the posts may be feasible if the service can accommodate this.
Slot Share Example:
Trainee A works 0.7
Trainee B works 0.6
Trainee A + Trainee B WTE = 1.3
Trainee A is funded on the basis of 1.0 WTE (via Trust/MADEL)
Trainee B is funded on the basis of 0.3 WTE + 0.1 WTE (Via LTFT Budget)
Total Funding = 1.4
Funding covers the WTE of trainees in post plus a surplus of 0.1 WTE to acknowledge the extra work involved in hosting these arrangements.
How Slot Shares Are Identified
Specialty Trainees and Specialist Registrars- In KSS, these LTFT Trainees are advised to contact the relevant KSS Specialty Medical Workforce Project Officer, who works in close collaboration with the Specialty Training Programme Directors. They will usually liaise with the Trainee and Trust colleagues to seek to accommodate a slot share partnership. Specialist Registrars and Higher Specialty Trainees may liaise directly with their Training Programme Directors but the relevant Medical Workforce colleagues should be kept abreast of developments. A flowchart shows the typical process for completion of LTFT Training Approval Forms for specialty trainees: Specialty Approval Flowchart.
General Practice Specialty Trainees– In KSS, GP Specialty LTFT Trainees (ST1 and ST2) are encouraged to discuss slot share options with the relevant GP Programme Director. GP Programme Directors oversee delivery of the GP curriculum in hospital posts and co-ordinate educational programmes for trainees. Their contact details (including access to email) are available from the GP Department section of the KSS Deanery website at: GP Programme Directors. A flowchart shows the typical process for completion of LTFT Training Approval Forms for GP trainees: GP Approval Flowchart.
GP Registrars (ST3 and above)– Since this level of GP trainee will work in GP Practice placements rather than hospital placements, they are required to contact the Deanery GP Training Recruitment Manager via email: email@example.com if they wish to apply for LTFT Training.
Foundation Trainees– The South Thames Foundation School (STFS) falls within the scope of KSS Deanery and it is recommended that LTFT Trainees contact the relevant Foundation School Manager if they are considering LTFT Training. A flowchart shows the typical process for completion of LTFT Training Approval Forms for Foundation: Foundation Approval Flowchart.
In July 2010, a review of existing slot shares showed that they existed within: Respiratory Medicine, Paediatrics, Anaesthetics, General Surgery, Obstetrics and Gynaecology within NHS Trusts across Kent, Surrey and Sussex, as well as in Palliative Medicine.
What Factors Need to be Considered to Facilitate a Slot-Share?
-The potential working patterns need to be discussed between the trainees so that educational and personal needs can be appropriately balanced with service needs. This requires flexibility and professionalism on the part of the trainee to reach a workable compromise which suits the relevant parties, particularly where specific working days are required by both parties, eg. to accommodate child care needs or to attend medical appointments related to health concerns or disability.
-The slot sharers could work at separate times of the week or they could perhaps overlap for a day or more, particularly on busy days or to facilitate continuity for the service.
-Whether the trainees need to meet with each other for the purpose of handover or other shared roles and responsibilities.
-Shared (3-way) meetings with the Educational/Clinical Supervisor.
-Ensuring that the slot share partners' manager and colleagues know how the slot sharing arrangement works in practice, in particular when enquiries arise in relation to areas of responsibility for which the shared job role is responsible.
-Managing the slot sharing arrangement so that the two slot sharers are kept informed of each other's activities and progress, ensuring that repetition of work is avoided and that no activities or responsibilities fall into the gap between the two people.
-Arranging access to training for slot sharers where the two individuals do not work the same hours.
-Ensuring consistent performance standards between the two slot sharers, particularly where they are responsible for managing other members of staff.
-Timely maintenance of the slot share arrangement should one slot sharer leave or go on long-term leave
Reduced sessions in a full time post
Where it is not feasible to arrange a slot share, some LTFT trainees may stay in ‘full-time’ slots and work reduced hours, depending on the specialty and the opportunities for slot sharing. No additional funding is required from the Deanery as the full-time post is already funded from the Educational Contract, but the employer is able to retain the surplus funds to support the LTFT arrangement at local level. However, the trainee will still need to complete the LTFT Training Application and Approval Forms as there is a national requirement to report on LTFT Training arrangements to the Department of Health via the national LTFT Training Forum. The Trust will also need to confirm their written approval to support this arrangement on the LTFT Training approval form.