1401 More or less than full time? A new era for flexible training in paediatrics

Abstract

<h3>Aims</h3> Paediatric specialty training has earned a reputation as a specialty that welcomes trainees who choose or need to train less than full time (LTFT). The demand for even more flexible training has been acknowledged in the last two years by Health Education England, with the introduction of Category 3 LTFT training. This allows trainees to apply to train LTFT citing work-life balance only. We sought to review the prevalence of LTFT training in paediatric specialty training in the UK, and how popular the introduction of Category 3 LTFT training in England had been. We were interested in the whole time equivalent (WTE) percentage that trainees were choosing to work at. An additional objective was to ascertain if any deaneries were unable to accommodate applications for LTFT training, and, if so, what methods were in place for management of these requests. <h3>Methods</h3> A request was submitted under the Freedom of Information Act 2000 (General Rights of Access) to Health Education England, NHS Education for Scotland and Health Education and Improvement Wales. This requested data for paediatric specialty trainees as of September 2021 enrolment. <h3>Results</h3> There were 4180 trainees enrolled in paediatric specialty training in the UK as of September 2021. These were spread across the eleven Health Education England Deaneries, Scotland and Wales. Of these trainees, 38.2% were training LTFT (1596/4180). The category of LTFT training was available from nine of the thirteen Deaneries (<b>figure 1</b>). Category 3 LTFT training is not currently available in Scotland or Wales. In the seven English deaneries offering Category 3 LTFT, there were 2653 trainees total, with 1033 of this training LTFT (38.9%). Within that, 210 trainees were working under Category 3 (7.9% of total workforce, 20.3% of LTFT trainees). The whole time equivalent (WTE) percentage earned was reported from eight deaneries (<b>figure 2</b>). There are more trainees working at 80% WTE (517) than at 60% WTE (497). One Deanery reported refusing LTFT applications, citing the impact on departmental rotas. This affected five trainees in a single deanery, all of whom were applying under Category 3. No Deaneries reported using a waitlist to manage applications to train LTFT. <h3>Conclusion</h3> The introduction of Category 3 LTFT training in England has enabled a new group of trainees to train less than full time in paediatrics. There are more trainees training LTFT than ever before, with one deanery stating more LTFT trainees than FT trainees. Trainees are working at many different WTE%, with more trainees reported as working at 80% than at 60%. Rotas and departments should be designed and supported to anticipate and accommodate these increasingly flexible working patterns. Only one deanery reported having to refuse LTFT applications. However, future consideration will need to be paid towards how the changing working pattern of the paediatric workforce will impact both training and departmental operations.