Out of Programme Pause (OOPP) pilot extension in response to COVID


This information pack is intended for the following stakeholders:

  • Doctors in Training
  • Directors of Medical Education
  • Heads of School
  • Training Programme Directors
  • Educational Supervisors
  • Medical Staffing
  • Trust HR


  • Health Education England (HEE) is committed to supporting trainees during and post COVID, by ensuring mechanisms are in place to support trainee’s wellbeing and educational provision.
  • As a result HEE is exploring how to utilise existing flexibility offers to provide this support. Out of Programme Pause is one such offering which is currently being piloted in selected sites and specialties and provides trainees with an opportunity to step out of training for an extended period of time whilst also providing service.
  • Therefore, offering OOPP to trainees may provide a welcome opportunity to take a break from their current training post, after the pandemic.
  • At the same time, trainees who undertake OOPP will also have the opportunity to gain competencies which they may not previously have been able to due to the impact of the pandemic.

Out of Programme Pause

Out of Programme Pause (OOPP) allows trainees in specialty training to step off the training ladder and undertake work in the NHS or a similar patient-facing role in the UK. Experience and competencies gained outside of training may then be considered on the trainee’s return to their training programme.

The Offer

  • Expanding OOPP to all specialties in England for a one year application window under the remit of the current pilot.
  • This approach provides an additional supportive option for trainees and will assist HEE local offices and Trusts to support trainees as well as aid training programme management.

Who can apply?

  • Trainees who have two years post full registration experience, which will normally correspond to completing the first year of specialty training as per Gold Guide guidance for OOP.
  • Trainees who wish to take a break from training and have or are expecting to receive either an outcome 1, 10.1 or 10.2 at their most recent ARCP.
  • Where a trainee feels it would be beneficial for their wellbeing.
  • Trainees wanting to step out of training but also use the opportunity to gain additional competencies as a consequence of the impact of COVID

Change in Scope

  • This specific OOPP offer has some differences to the OOPP pilot currently available:
    • The main aim is to allow trainees to take a break from training.
    • Trainees can apply to undertake up to 12 months OOPP as opposed to 24 months.
    • This offer will be available for one year (applications to be submitted during this window)

What we hope to Achieve

  • This would allow trainees the opportunity to step off their training programme for a length of time which may provide them with a welcome break.
  • This offering will also aid training programme management.

image from OOPP policy ppt

Ensuring patient and staff safety

HEE understands that both trainees and service providers have been severely impacted by the pandemic, as such additional principles have been added to ensure trainee and patient safety and service provision is not compromised:

  • Training programmes will make every effort to provide the opportunity for trainees to gain all required competencies within their programme. However, for trainees who undertake OOPP, any relevant competencies gained can be assessed and counted on return to training.
  • Suitability of OOPP post will be reviewed in relation to trainee’s rationale for applying for OOPP e.g. if applying due to wellbeing, is OOPP the most appropriate option
  • Ensuring TPD and HoS support. Approval will be based upon trainee need and training programme stability.

Principles of pilot

  • It is expected in the majority of cases, where there has been an increase in extensions to trainees’ training programmes, the gaps from trainees undertaking OOPP will accommodate additional trainees still in programme, as a result of the pandemic. However, we recognise that in some cases there will also be fragility in the system where local offices will need to make informed decisions to ensure service provision is not compromised.
  • Consideration must be given to the viability of the programme and service demands. For larger training programmes it is reasonable that the maximum number of trainees permitted to undertake OOPP does not exceed 5-10% per training programme per region.
  • An evaluation is currently underway and this offer will form part of this, there will be a robust reporting system in place.