LESS THAN FULL TIME TRAINING FUNDING APPROVAL FORM |
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Trainees should not assume approval or commence in post until this fully completed approval form is returned to them by the Deanery.
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SECTION 1 – TRAINEE DETAILS - FOR COMPLETION BY THE TRAINEE /TRUST |
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First name: |
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Surname: |
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Address: |
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Postcode: |
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Email: |
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Telephone: |
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GMC No: |
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Have you secured a substantive full-time post in Open Competition: |
Yes No |
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Full time training completed in grade applied for (if applicable): |
(Number of months completed) |
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GP Grade (at preferred LTFT Training start date) |
ST1 |
ST2 |
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Employing Trust |
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Site |
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SECTION 2 –LTFT TRAINING POST DETAILS - FOR COMPLETION IN LIAISON WITH THE TRUST |
IMPORTANT NOTES: PLEASE READ BEFORE COMPLETING START & END DATES |
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(i) |
Approval is for the duration of either the ST1 or ST2 grade according to the sessions/WTE% agreed (e.g. 12 months of ST1 year at 5 sessions or 50% = 24 months). |
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(ii) |
Exact start and end dates must be provided. Failure to provide exact dates will delay the approval process. |
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(iii) |
Following Trust completion and signature, NO changes should be made to the start and end dates. |
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Agreed Start Date: |
/ / (DD/MM/YYYY) Please read above notes before completion. |
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Agreed End Date: |
/ / (DD/MM/YYYY) Please read above notes before completion. |
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Sessions: |
(e.g. 5) |
WTE%: |
(e.g.50%) |
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Band: |
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Less Than Full Time Training Option: (please tick where appropriate) |
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Supernumerary funded by Deanery (up to 2 August 2011) |
(By prior deanery agreement only) |
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Reduced sessions in a full-time post |
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Slot share (joint funded by Deanery/Employer) |
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Full name & GMC number of slot-share partner, in block capitals (if applicable): |
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Does your programme include a post within a GP Practice? ** |
Yes No |
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GP Practice Start Date: |
/ / (DD/MM/YYYY) |
GP Practice End Date: |
/ / (DD/MM/YYYY) |
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Please note that if you require LTFT Training within a GP Practice post you will need to apply separately via the KSS GP Department. Please download an application form via; http://kssdeanery.org/general-practice/trainees/gp-specialty-training |
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Funding approval will expire on the end date specified. If you wish to continue training LTFT after this date, please request a new extension pack via the LTFT Training Team KSS at least 4 months in advance of the original end date and return it to the Deanery within 3 months before the proposed start date of the new or extended post. Following financial approval, copies will be emailed to Medical Personnel at the Trust and the Finance Director. |
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TRAINEE DECLARATION: |
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I confirm that: |
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All the fields on this form are completed. I understand that it is my responsibility to request and complete new LTFT Training Approval Forms as required. I will notify the LTFT Training Team, Foundation School /Specialty School as appropriate of changes that affect my LTFT Training e.g. change of personal details, maternity leave, start and end dates, proposed changes to working time etc. |
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Signed: ………………………………………………………………………………………………………………..………. |
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Please print name: ……………………………………….... |
Date: ……………………..……………………………… |
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Medical Staffing Approval (not FOR consultant COMPLETION) (Approval via signature should be provided either by Medical Staffing or by Trust Finance as appropriate to local Trust procedure). |
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I am a member of Trust Medical Staffing and am authorised to sign on behalf of the Trust Finance Department. |
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I am a member of the Trust Finance Department. |
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I confirm that: |
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This trainee will train Less Than Full Time within the Trust and approval has been sought from the Finance Director. The above trainee was appointed in open competition (for LAT trainees) This post has Trust funding agreement and banding/study leave funding is agreed (Applicable regardless of whether the post is banded or not) |
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Signed: …………………………………………………..….. |
Position: …..…………………………………………….. |
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Email: ……………………………………………………..…. |
Telephone: ………………..……………………………. |
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Please print name: …………………………………………. |
Date: …………………………..………………………… |
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If the trainee is being considered for a post which exceeds the agreed basic salary for the training contract, the balance of the cost of employment would fall to the employing Trust. No funding to be provided towards the cost of intensity supplements or hours in excess of those contracted for educational purposes. |
APPROVAL FROM THE DEANERY – TO BE COMPLETED BY THE DEANERY |
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Funding approval checked with Deanery Finance & Business Manager: |
Yes No |
Signed: …………………………………………………..….. Dean |
Position: ………..……………………………………….. |
Please print name: ……………………………..………….. |
Date: ……………..……………………………………… |
Signed: …………………………………………………..….. Finance & Project Manager |
Position: ………………..……………………………….. |
Please print name: ……………………………………..….. |
Date: ……………..……………………………………… |
Please return documentation to: Less Than Full Time (LTFT) Training Adviser, Specialty Workforce Department, KSS Deanery, 7 Bermondsey Street, London, SE1 2DD.
Accessibility – If this document is not in a format that meets your requirements, please contact the LTFT Training Team via email at [email protected] or via telephone at 020 7415 3464.
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