Exception reporting reform FAQs

FAQ 01: Will there be further support and guidance available to employers to help deliver the necessary changes?

Yes, the 2016 Terms and Conditions of Service Version 13 (England) and associated framework agreement document refers to various required updates to resources and new guidance. The Resident Doctors Implementation group (RDI) will produce and publish further resources to support employers with the implementation of these reforms. Employers are encouraged to sign up to the NHS Employers workforce bulletin email to receive updates on the publication of new and updated resources.

Guidance in production:

• Evidence of additional hours worked: how will timestamp, geolocation and corroboration work in evidencing.
• Non-resident on-call: how exception reporting works for NROC including evidencing.
• Small departments and non-hospital settings: how information breaches will work in small departments and non-hospital settings.
• Time off in lieu (TOIL): a clear process for TOIL including situations where TOIL is mandated for safety reasons, how TOIL is communicated and allocated and how this is reflected in the system.
• Sharing exception report data: information sharing and specific pathways which will require exception reporting data (identifiable and non-identifiable data)
• Fines: cost codes and funding flows.
• Distribution of fine money: how these funds could be used to enhance health and wellbeing, facilities, study leave, IT provision and other resources for resident doctors.
• Board reports: reviewing the board report templates, and including additional fields on detriment surveys, fines for access and completion and fines for information breaches.
• Detriment: guidance setting out the categories of detriment (with examples) and local policies and procedures that resident doctors should follow if they have experienced detriment.
• Software specification: setting out the 2016 TCS V13 (England) changes that will need to be reflected in the software.
• Directors of medical education (DME) guidance.

FAQ 02: Will there be webinars to learn more?

Yes, NHS Employers held a webinar outlining the exception reporting reforms for resident doctors on the 2016 Terms and Conditions of Service in England on 8 April 2025. The event was targeted to employers in medical HR, medical workforce leads and guardian of safe working hours (GOSWH) roles. NHS Employers also ran a series of engagement webinars with medical staffing/HR colleagues and GOSWH in October 2025. Future webinars may be planned to provide further support to employers and their GOSWHs.

FAQ 03: When is the effective date of implementation for the new arrangements?

The implementation date is set for 4 February 2026. Those able to can choose to adopt the provisions prior to this date. NHS Employers are supporting early adopters of the reform - see FAQ 04.

FAQ 04: Can we implement these reforms early or do we need to wait until 4 February 2026?

Employers are encouraged to implement these reforms as soon as they feel able to do so, but no later than 4 February 2026. Employers wishing to explore early adoption of the new arrangements can get in touch for further information. NHS Employers has established an early adopter network to facilitate group learning/sharing with those interested in early adoption of the new arrangements.

FAQ 05: When will the fines come into effect?

The 2016 TCS V13 (England) introduces several new fines where new contractual provisions have not been met. Fines for a proven information breach, and in instances where access to an exception reporting system is not provided to eligible doctors, will be applied from 4 February 2026. A reduced fine rate will temporarily apply for access and completion between 4 February 2026 to 4 August 2026.

FAQ 06: Who is eligible to exception report?

Exception reporting is a contractual right for those doctors and dentists who are employed on the 2016 TCS in England. Where these TCS have been mirrored in other employment contracts e.g. academic, public health and armed forces trainees we encourage employers in England to make every effort to extend the reforms set out in the framework agreement to these doctors. The ESR system can generate reports to identify eligible doctors based on pay codes.

However, a manual review of individual contracts is required for those whose contracts do not substantively mirror the 2016 TCS.  Additional details are contained within the Framework Agreement (detailed in the Scope section).

FAQ 07: At our trust, we do not extend exception reporting provisions to our locally employed doctors, what are the expectations for this group of staff?

Employers should review their locally employed doctor workforce to identify eligible residents as determined by the framework agreement and in FAQ 6. As noted above, employers are encouraged to make every effort to extend the exception reporting provisions locally to those on mirrored 2016 TCS V13 (England) terms and are encouraged to do so. 

FAQ 08: Is there any additional funding to support implementation and maintenance of the new exception reporting requirements?

There is no additional funding associated with the exception reporting reforms. There are additional administrative requirements associated with this process which will need to be taken into consideration when preparing for implementation of the reforms. We also expect there to be an increase in the amount of exception reporting following the implementation date, until such a time as any issues are resolved via work schedule reviews. Employers should take action to ensure safe working hours are maintained. 

FAQ 9: As an employer, what can be done now to prepare for this?

Employers should sign up to the NHS Employers workforce bulletin email to receive notifications about new publications, guidance, and news relating to this work. To prepare for the 4 February 2026 implementation date, employers can start to plan now.

There is a checklist available to help guide initial conversations. 

By taking these steps, employers can start to prepare for the upcoming changes and to help identify any potential funding and staffing obstacles to delivery.

FAQ 10: We use software to support our exception reporting process, will suppliers be informed of these changes?

NHS Employers have been engaging with current software providers that offer exception reporting solutions and have provided them with a software specification to ensure products can be updated prior to the implementation date. The NHS Employers team have been gathering views and suggestions from employers and guardians on what may be required. Software companies are engaged so that employers have a clear understanding of their system development timescales and what additional training will be necessary to support system updates. 

FAQ 11: We don’t have a software system for exception reporting, how do we ensure we can implement all parts of the agreement?

If you have a local provision for exception reporting, review the 2016 TCS V13 (England) and further resources when they are available, and consider required updates. Alternatively, you may choose to undertake a tender to use an external software provider moving forward.

FAQ 12: Will doctors and dentists in training be able to submit an exception report towards the end or after they have finished their placement?

Doctors are encouraged to exception report as soon as possible, but no later than 28 days after the date of the occurance. For the end of a placement, the process is outlined in Annex D paragraph 23 of the 2016 TCS V13. If the doctor has already changed placements, any compensation will be paid and not be given as TOIL as outlined in Annex D paragraph 24. If employers experience a pattern of late submissions at the end of a rotation, they may choose to explore why this is happening. 

FAQ 13: Will an employer be fined if they have provided access information to the doctor, but it goes to their junk email folder, or they have not completed a report yet?

Access and completion fines occur only when:

• a doctor informs their employer that they are not able to access or submit an exception report and,
• Their employer fails to provide access within 7 calendar days.

A fine is not applied if the access details are created and inadvertently ends up in a junk folder, or if the doctor does not raise that they don’t have access. If access cannot be provided due to a reason outside the control of the employer, the employer can follow the process outlined in the 2016 TCS V13 (England) Schedule 05, paragraph 21.

FAQ 14: Does this reform cover SAS and speciality doctors?

No, the changes will apply to all doctors and dentists in training who are substantively employed under the 2016 TCS V13 (England). Employers can choose to extend the provisions locally to other doctors and dentists as detailed in FAQ 6.

FAQ 15: Will an employer incur an information breach fine if the doctor themselves shares the information?

No, fines for information breach will only occur when a doctor reports a suspected unauthorised breach of exception reporting information by the employer, and that breach is proven as determined by the GOSWH as per 2016 TCS V13 (England) Annex D paragraphs 33 and 34. Scenarios such as a doctor submitting their TOIL entitlement would not result in an information breach fine.

FAQ 16: What if a doctor or dentist in training chooses to work additional hours rather than is required to?  

Exception reporting does not apply to occasions where an individual may choose to undertake educational activities for personal development or career enhancing purposes, which are outside of contractual requirements, the agreed personalised work schedule or are not an essential activity to pass ARCP. 

This is set out in Schedule 05, paragraph 2 of the 2016 TCS V13 (England). 

If trainees wish to stay and do additional activities for their portfolio/personal education outside of their usual rota, an employer may consider encouraging the trainee to discuss this with their educational supervisor to incorporate all educational requirements into their personalised work schedule and gain prior approval to attend. 

FAQ 17:  What does ‘co-located in a clinical workforce’ mean?

This refers to the provision set out in Annex D, paragraph 5 and is intended to reduce the likelihood of an information breach occurring. The review of exception reports ideally should be done with privacy in mind, to avoid any unintended breach of information. Employers may also wish to consider utilising , privacy screens and confidentiality reminders to support this process. How this issue will be addressed can be discussed with your Resident Doctor's Forum (RDF) or Local Negotiating Committee (LNC) if required; particularly if there are any barriers to delivering this provision.

FAQ 18: Is the fines process optional?

No, the fines process is detailed in the 2016 TCS V13 (England) and is therefore contractual for all doctors and dentists in training on the 2016 TCS V13 (England) contract.

FAQ 19: How does the new 28-day reporting window affect exception reporting practice?

For instances of immediate safety concerns, doctors will raise this orally and follow up immediately using local processes, for example the DATIX reporting system. While it is important that doctors submit exception reports as soon as possible, the extended window to submit is now up to 28 calendar days following the date of the occurance. The reform strikes a balance between flexibility and responsiveness. This change offers doctors more flexibility to reflect and report concerns, especially during a busy rotation. A prompt submission will support a timely resolution. If a doctor submits a report after 28 days, the GOSWH can make the decision to accept the submission locally. 

FAQ 20: How will the exception reports for over two additional hours worked be managed?

Exception reports for more than two additional worked hours should be subject to a locally determined process as per 2016 TCS V13 (England) Schedule 05, paragraph 13. This process should be in addition to the process set out in the TCS for under 2 additional hours. This process will not incur an information breach fine.

FAQ 21: Do you know when exception reporting software will be ready?

NHS Employers has engaged with a group of software providers and developed a software specification. We encourage employers to engage with your providers and sign up to any updates on the delivery of updated solutions they can provide directly to you. 

FAQ 22: Does any money from the new fines introduced in 2026 go to the doctors?

No, unlike the previous fines. Fines for access and completion, or information breach fines will not be paid directly to doctors, as per 2016 TCS V13 (England) Schedule 05, paragraph 28.

FAQ 23: What measures are in place to ensure doctors submit truthful exception reports?

A: For each exception report the doctor will confirm via a self-declaration as outlined in the 2016 TCS V13 (England) Schedule 05, paragraph 9, alongside their report and evidence. Local policies also apply, such as fraud and grievance processes, which doctors should be made aware of at induction.