Out of Programme Pause: FAQs


What is Out of Programme Pause and how does it differ from other forms of out of programme?

Trainees told Health Education England (HEE) that existing out of programme mechanisms (out of programme experience [OOPE], out of programme research [OOPR], out of programme career break [OOPC] and out of programme training [OOPT]) provided a degree of flexibility, however none of these mechanisms recognised that trainees sometimes wish to “pause” their training to undertake an NHS non-training post, gain further experience, take stock of their training, work in another related specialty, or concentrate on their wellbeing.

Out of programme pause (OOPP) allows trainees to step out of formal training for up to one year to undertake an NHS or other patient facing UK based non-training post. This flexibility initiative can be a vital tool to support trainee wellbeing.

The initial pilot for OOPP was launched in Spring 2019, where OOPP was offered to Anaesthetics trainees in the East Midlands. Phase 2 commenced in summer 2019, with selected specialties in Wessex, North Central and East London, and the North East taking part, along with the remaining specialties in the East Midlands.

The scope of the pilot has been supported by the GMC, and this phase 3 extension of the pilot will now encompass all specialties across England for the next 12 months, in large part as a response to the effects of the Covid-19 pandemic on trainee wellbeing. A robust external evaluation of the pilot is underway.

This pilot initiative also gives trainees the opportunity to have any competencies gained whilst out of training assessed upon their return. This may allow trainees to minimise the impact on the time out of programme has on their CCT date. OOPP differs from out of programme for experience (OOPE) because in OOPE, none of the experiences or competencies/capabilities gained whilst OOPE can be directly counted toward CCT.

Who should apply for Out of Programme Pause?

  • Trainees who wish to take a break from training and expect to receive either an outcome 1, 10.1 or 10.2 at their most recent ARCP.
  • Trainees who feel it would be beneficial for their wellbeing.
    • The appropriateness of OOPP would be discussed between the trainee and Educational Supervisor. If appropriate the Educational Supervisor may liaise with the PSW to explore if alternative or additional further support is needed for the trainee.
  • Trainees who want to step out of training and also use the opportunity to gain additional competencies as a consequence of the impact of COVID.

Time out of programme on OOPP will not normally be agreed until you have been in a HEE approved training programme for at least one year of training (unless at the time of appointment, deferral of the start of the programme has been agreed for leave on statutory grounds).

What if I’m on a tier 2 visa?

If you are on a tier 2 visa sponsored by HEE, please be aware that upon undertaking an OOPP post, your visa sponsorship with HEE will be cancelled and you will need to apply for sponsorship with your new employer whilst undertaking your OOPP placement.

Upon returning to your training programme with HEE you will need reapply for sponsorship to the HEE Tier 2 team, you will not need to go through recruitment process again and can commence directly back into training. If you are considering any other immigration route other than Tier 2 while out on OOPP you are advised to contact the Tier 2 team ( tier2@hee.nhs.uk ) before your sponsorship is withdrawn as you may be subject to a 12 month cooling off period, set by the Home Office, before returning to training with HEE.

What stage of training do I need to be at to be eligible to apply for OOPP?

Time out of programme (OOP) will not normally be agreed until you have been in a specialty training programme for at least one year of training (unless at the time of appointment, deferral of the start of the programme has been agreed for leave on statutory grounds) and you have received (or expect to receive) either an outcome 1, 10.1 or 10.2 at your most recent ARCP.

Leaving training

What is the process for applying for OOPP?

If you elect to take a period OOPP you must discuss and agree this with your educational supervisor and training programme director. This agreement is to ensure that going OOPP does not destabilise the educational or service sufficiency of the programme you are in. After this, the application can proceed once details of when and where you will be spending the time out of programme have been confirmed. The OOPP section of the OOP form should be completed, together with the OOPP initiation document that sets out your plan for OOPP, your intended scope of practice, indications of possible capabilities you may acquire, plans to return to training and any pertinent indemnity considerations.

How much notice am I required to give?

Where possible in line with all applications to take time out of training, you will be expected to give three months’ notice. As with other OOP requests this should align with programme rotation dates. When you are considering applying for OOPP you should keep HEE informed of plans as early as possible and continue to update on progress and any changes to plans to return to training on a regular basis.

However, we note that due to the short term nature of the pilot and the pace of introduction, there will be instances where a shorter notice period may be given. In the first instance you should contact your local office to determine whether you can undertake OOPP with a shorter notice period. Where programs are having to accommodate increased numbers of trainees with extensions in a training programme, local offices may be able to accommodate a notice period of less than 3 months.

Who can I speak to about how this will affect my pay, pension and employment rights?

Please talk to your employer and/or trade union. You should be aware that any time spent out of programme in a non-NHS setting will have an effect on both your cumulative NHS serviceyou’re your continuous employment. This has practical implications for employment rights such as pay, pension entitlement, maternity leave and pay, parental leave, and other entitlements. If you are considering going out of programme, you can speak to your employer and, if you are a member, the BMA, for further advice on these issues.


Will my pension be affected by taking time out of training?

Your NHS pension may be affected due to a break in service if you are working for a non-NHS organisation. For further advice speak to your employer, trade union and/or the NHS Business Services Authority

Who will be my employer whilst out of programme?

The employer will normally be the organisation paying your salary during your period working OOPP.

Can I apply for study leave funding whilst on OOP-P?

Study leave will only be funded if it is for a clear curriculum requirement for your individual specialty. It you choose to take it whilst on OOP-P, then this would mean you would not be eligible to fund it again once you have re-joined the training programme. Employer mandated training should be funded by the employer.


Who will my Responsible Officer be whilst out of programme?

Whilst on OOPP, your RO will remain your postgraduate dean. The specific considerations around revalidation our outlined below. You will be asked to identify who the RO of the employing organisation you will be working with during your OOPP in your OOPP initiation form, where this is applicable.

What process will I need to go through to ensure my revalidation is up to date?

The process for ensuring revalidation requirements are met whilst out of training are on the COPMeD website.

Whilst Out of Programme, if you are undertaking a substantive role you need to engage with the revalidation governance arrangements of your employer and submit details of work undertaken, involvement in significant events and any complaints and compliments about your work in your ARCP form R.

Issues surrounding OOP Post

What roles can I undertake?

To proceed with OOPP you must take a patient facing role with a UK registered organisation. Whilst the majority of roles would therefore be based in the UK, this does allow you to undertake roles overseas with organisations such as MSF.

Does my OOPP post need prior approval from HEE?

No prior approval is required of the post or posts that you will undertake during the OOPP period, however, your educational supervisor will need to be confident it is a suitable placement for you, taking into account your level of training and the support that will be available. Any post (and any changes) must be recorded against your scope of practice.

What if the OOPP post comes to an end earlier than expected?

Should an Out of Programme Post come to an end sooner than expected, you should contact your HEE office as soon as is practically possible to facilitate a return to your training programme. This will be subject to programme capacity. Once returning, the standard process for assessing competence gained whilst in the OOPP post will commence.

Do I need to have a confirmed offer of a post before applying for OOPP?

Unlike other forms of OOP, you will need to have an offer for a confirmed post when applying for OOPP.

Returning to training

Do I have to return to training?

Whilst you are not obliged to return to your training programme from a period OOPP, a decision to not return should be communicated formally to HEE in line with an appropriate notice period relevant to the level of training, to indicate your resignation from the training programme and your wish to relinquish your national training number.

What happens should I not return to my training programme?

As above.

What is the process for returning to training?

You would return from OOPP alongside/after completing any relevant return to training (RTT) programme elements and have an initial educational appraisal meeting with your Educational Supervisor to consider the experience and any competencies gained during your OOPP. A ‘gap analysis’ would be conducted with a judgement on what may have been achieved with respect to both Generic Professional Capabilities and specific curriculum outcomes. This would form the basis of a training plan.

Once the initial educational appraisal meeting has taken place, you will have an opportunity to demonstrate your skills and capabilities as part of your prospectively approved training programme. This would ideally be undertaken in the first three months following return to training, to allow you and your Educational Supervisor to ensure the training plan is appropriate and properly focus learning objectives in advance of the next Annual Review of Competence Progression (ARCP);

Following OOPP, if you and your Educational Supervisor do not want to count competences and did not feel an adjustment to the CCT date would be appropriate then there would be no requirement to do so.

At the ARCP, a formal determination of outcome would be made with an adjustment to the CCT in light of demonstration of competencies evidenced following return to training and the Educational Supervisor’s report; this would be in accordance with Gold Guide and GMC guidance.

How much notice do I need to give of my intention to return to training?

You should plan your return to work with your training programme faculty educators, who work on behalf of the Postgraduate Dean. Although usually you will be accommodated as indicated on your initiation form, which will generally be in the next available suitable vacancy in their specialty, there is no guarantee of return date and it may take time for a suitable vacancy to arise. If there are likely to be problems accommodating you back into the programme, wherever possible, you should be advised as soon as practicable during the period of you being out of programme.

Will going OOP-P affect my ability to go on other forms of OOP within my training programme?

Other forms of OOP will remain available but applying to go on other OOP opportunities will be subject to the normal procedures whereby the relevant specialty school and the Postgraduate Dean would make an informed decision in each case, in line with all other such applications.