Guidance

Protections against experiencing detriment due to exception reporting

This guidance provides examples of what form detriment can take if it has a direct link to exception reporting.

18 December 2025

Chapters

What is exception reporting and who it applies to

Exception reporting applies to all doctors and dentists in training (referred to collectively hereafter as ‘the doctor’) who are substantively employed under the Terms and Conditions of Service for NHS Doctors and Dentists in Training (England) 2016 (2016 TCS) and to those whom the provision has been extended locally. It is recognised that the 2016 TCS are widely mirrored in other employment contexts, and we encourage employers in England to make every effort to extend exception reporting where appropriate*.

The purpose of exception reporting is to ensure prompt resolution and / or remedial action to ensure safe working hours are maintained, secure patient safety, and safeguard the delivery of agreed educational opportunities. Exception reporting is also the mechanism used by doctors to ensure compensation for all work performed and uphold agreed educational opportunities.

This exception reporting guidance is intended to provide direction and advice on how to interpret and implement the changes to exception reporting being enacted via version 13 of the 2016 TCS. This guidance seeks to provide recommendations and best practice approaches to implementing and adhering to these changes.

The overriding principle of these changes is to trust doctors to conduct themselves professionally, and to remove previously existing barriers to exception reporting.

* For example: Academic trainees who hold a national training number/deanery number and are substantively employed by universities. For these doctors, it is encouraged that their exception reporting provision should be extended by clinical employers through a standardised contract. Armed forces trainees who hold a national training number/deanery number. Public health trainees. Locally employed doctors whose terms of employment substantively mirror the 2016 TCS. Locally employed doctors whose terms of employment do not substantively mirror the 2016 TCS, but to whom ER has already been extended at a local level by their employers.

What is detriment?

Detriment in an employment context is when an employer, or colleagues, treats an individual unfairly or subjects them to a disadvantage for the sole or main reason that they asserted an employment right.

The below list is not exhaustive, but provides examples of what form detriment can take if it has a direct link to exception reporting, where relevant proof of information breach may be required by the GoSWH alongside:

Reduced opportunities for training, development or progression compared to their agreed work schedule.
Reasonable workplace requests rejected unfairly or without consideration as a result of exception reporting.
Reassignment of duties outside of agreed work schedule review processes and unfairly applied compared to other colleagues in equivalent positions.
Informal changes to working patterns outside of work schedule review processes and unfairly applied compared to other colleagues in equivalent positions.
Subjected to demeaning comments or treatment, following exception reporting.
Subjected to disciplinary action following a legitimate exception report.
Being bullied or ostracised, as a result of exception reporting.

Actual detriment

Following a decision to submit an exception report(s) and as a direct result of this, a doctor:

is subsequently denied access to, or reinstatement of, a training opportunity - this would be following an information breach
is subjected to bullying or demeaning comments about their decision to do so, making the workplace environment hostile.
receives unjustified complaints or excessive scrutiny, or faces unjustified disciplinary action.
is awarded an unsuccessful outcome during their ARCP, with reference to their exception reporting, which prevents their training progression - this would be following an information breach.

Threat of detriment

A doctor mentions their intent to submit an exception report and their supervisor making discouraging remarks, hinting at possible negative consequences.
After raising concerns via an exception report a doctor is being purposely excluded from informal team discussions and worries this may affect future opportunities, even though no formal action has been taken.
A doctor notices that colleagues are scrutinising their work more closely after exception reporting and a proven information breach, threatening that this could lead to disciplinary action.
A consultant suggests in a departmental meeting with all resident doctors that any resident who exception reports may receive poor feedback for their ARCP.

What should a doctor do if they experience detriment because of exception reporting?

The exception reporting reforms outlined in the 2016 TCS makes clear that no doctor should be discouraged from exception reporting, or experience detriment as a result of doing so, along with mandating mechanisms by which detriment can be reported and captured.

The reform introduces a requirement that as part of GoSWH quarterly reports they should report on whether doctors have experienced detriment as a result of exception reporting (Schedule 6, paragraph 12). This information is to be collected via a survey of doctors within the organisation to enable them to report whether they have experienced actual or threat of detriment (Schedule 6, paragraph 15a), it is hoped that doctors engage with that survey.

Finally, a category of exception report has been created as part of the reform to enable doctors to report immediately if they experience actual or threat of detriment due to engagement with exception reporting (Schedule 5, paragraph 12), which can be used at any time to report for the GoSWH’s information.

Should a doctor experience detriment or threat of detriment, there are different mechanisms by which they can escalate the matter, as set out below, with clarification provided as to when one would be appropriate over another.

- The role of the GoSWH is to ensure safe working hours, along with advocating on behalf of doctors in relation to safe working hours. They can raise issues directly with the medical director or trust board, while adhering to the confidentiality requirements of exception reporting data, unless the doctor grants consent to do so.
- Report patterns of detriment in quarterly reports.
Where a formal complaint or grievance is raised in relation to exception reporting, it is not the responsibility of the GoSWH to oversee that process, and normal organisational procedures should be followed.
All trusts have a FTSU guardian, who provides a confidential route for staff to raise concerns — including experiencing detriment due to exception reporting. The FTSU guardian can:
- listen to concerns confidentially
- escalate issues to senior management - identifiable information can only be shared with consent from the doctor
- support employees through local processes.
This should not be used as the mechanism to raise a formal grievance or complaint.
Every employer should have a grievance policy that covers complaints about treatment at work. A doctor can raise a formal grievance if they believe they’ve suffered detriment for exception reporting.

The stages usually are:
- informal resolution (discussion with supervisor or HR)
- formal grievance submission (written statement of concern)
- investigation and hearing
- appeal, if outcome is unsatisfactory.
If the detriment relates to patient safety or systemic wrongdoing, it may fall under protected disclosures (Public Interest Disclosure Act 1998). Doctors are protected by law when making such disclosures and can raise concerns through:
- FTSU guardian
- medical director or HR
- NHS England or General Medical Council (if internal routes fail).

What can employers do?

Employers should review the GoSWH board report for the detriment survey results and look for anywhere improvements can be made. This could be an educational element, raising awareness that staff should not be discouraging doctors from exception reporting.