Guidance

Fines guidance for exception reporting

Guidance outlining the changes to existing GOSWH fines in Version 13 of the 2016 TCS and includes two new fines introduced for exception reporting.

26 January 2026

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.

Types of fine

These fines are levied when verified exception reports confirm breaches of contractual working time limits or rest requirements. These fines are separate to the penalty rate paid to the individual doctor. The value of these fines is set out in Annex A of the 2016 TCS. In accordance with Schedule 5, they must be paid into a localised fund.
These fines are applied where a doctor has missed contractual breaks on at least 25% of occasions and the exception report is validated. A fine must be levied at the rates set out in Annex A of the 2016 TCS. No penalty rate is levied to the doctor in conjunction with these fines. These fines must be paid into a localised fund.
Exception reporting serves as a safeguard for maintaining safe working hours and educational opportunities. As such, doctors must have access to an exception reporting system and be able to submit reports when necessary.
Employers must provide doctors with access to the exception reporting system:
- within seven calendar days of starting employment or work
- whenever a doctor changes host employer, work site, or rota.
Doctors are required to submit a test exception report, which will be sent to the guardian of safe working hours for cross-validation. This is to allow all eligible employed doctors to be cross-checked against the list of doctors and dentists who have access to the exception reporting system to identify any issues that require to be resolved.
Employers should give consideration to those within scope of exception reporting who start outside of main rotation dates and ensure appropriate processes are in place.

Reporting issues

As per Schedule 5, paragraph 19, doctors must be provided with a simple way (such as email or quick access link) to raise to the guardian of safe working hours and HR if they are unable to access the exception reporting system or complete an exception report after the initial seven calendar days of starting work, changing work site, changing employer, or any other related transition. The software specification requests providers to have functionality on their exception reporting platforms for doctors to report when they’re unable to either access or complete an exception report. There must always be an alternative method available for doctors to escalate to the guardian or HR inability to access the relevant exception reporting systems or complete an exception report. This could take the form of email inbox address, or quick access link, which is shared and widely communicated with doctors during onboard. Employers may wish to set up a dedicated mailbox which should be monitored for this purpose.

If a doctor is prevented from accessing or completing an exception report this can result in a fine being levied by the guardian. To avert a fine being applied employers must investigate and remedy the problem within seven calendar days of it being raised by the doctor. Details of the relevant fines that apply in this situation are detailed in Schedule 5, paragraph 27 of the 2016 TCS version 13.

Access issues should be reported to:

HR/medical workforce HR to rectify any issues accessing
The guardian of safe working hours for monitoring and levying fines.

The doctor has a responsibility to report access and completion issues. No fine will be applied if a doctor has failed to report an issue. Evidence of this escalatory report will be needed for the guardian of safe working hours to investigate and to levy an access and completion fine if required.

Failure to resolve fines

If access or completion issues are not resolved within seven calendar days of them being raised by the doctor, the guardian must levy a fine as per Schedule 5, paragraph 27 of the 2016 TCS.
This fine will recur every seven calendar days until resolved.

Exemptions from access and completion fines

Employers should review the causes of access and completion issues when they occur in order to take the appropriate action. Employers can provide the Local Negotiating Committee with details of an incident and rationale for mitigation of fines. If approved by the Local Negotiating Committee, fines will not be applied when delays result from circumstances outside of the employer’s control. Employers should investigate the causes of access issues when they occur in order to take the appropriate action.

Examples of such circumstances may include (but are not limited to):

cyber-attacks
software or system failures
a significant incident event is declared and endures for a prolonged period
where the resident doctor does not reasonably engage with the process to remedy the situation.

Information breach

To protect doctors, exception reporting data must be treated as confidential and cannot be accessed, shared or requested to be shared without the doctor’s explicit consent, outside the specific pathways listed in the TCS and in jointly produced guidance. A doctor may report suspected unauthorised information breach to the guardian of safe working hours for investigation. Evidence would need to be provided to support this claim. If proven, the guardian of safe working hours must levy an information breach fine.

An instance of information breach is categorised as follows:

If multiple doctors are affected in a single unauthorised exception reporting data disclosure, a separate penalty will be applied for each affected doctor.
If multiple unauthorised exception reporting data disclosures occur over time related to a single doctor, a separate penalty will be applied for each individual instance.
If information related to multiple exception reports from a single doctor is leaked to multiple individuals in a single instance, a single penalty will be applied for that instance.

Scenarios

A doctor submitted a claim to HR for payment of additional hours worked. An HR officer sent an email to payroll which included identifiable information to allow for payment. However, while sending to the payroll department, the officer copies to the department’s rota co-ordinator.
As this was information related to a single doctor and is a single occurrence it would be a £500 fine.
A guardian of safe working hours created a shared folder on the hospital’s intranet labelled “Exception Reports Q4.” However, the folder was not password protected or access restricted. It was accessible by anyone in the trust with intranet access. The folder contained 100 exception reports, many with identifiable information.
A fine of £500 would apply for each affected doctor.
A paper is presented to the medical education team, prepared by HR regarding exception reports across all medical specialties.
Four exception reports were made in the last quarter in dermatology, where there is only one doctor eligible to submit exception reports, therefore this doctor would be identifiable.
As this information relates to multiple exception reports leaked in a single instance, it would incur a £500 fine.

Fine amount

Breach type	Date	Fine amount
Proven information breach	4 February 2026 onwards	£500 per instance
Access and completion breach	4 February 2026 - 3 August 2026	£250 per week on a rolling 7 calendar-day basis if unresolved
Access and completion breach	4 August 2026 onwards	£500 per week

Access and completion fines will be received into a central fund administered by the GOSWH; no portion of these fines will go directly to doctors.

Information breach fines will be received into a localised fund administered by the GOSWH; no portion of these fines will go directly to doctors.

Fund structure

Monies paid into GOSWH-administered funds must not be paid directly to doctors, and fine monies may only be used for the purposes outlined below or agreed at RDF. Employers should aim to utilise funds in order to prevent them from being subsumed into routine annual financial management processes.

Central fund

The purpose of the central fund is to support organisation-wide improvements to benefit the education, training and working environment of doctors and dentists, ensuring that any fine monies arising from systemic or cross-departmental breaches are used to deliver benefits that extend across the doctor and dentist workforce.

The central fund:

must be ringfenced and clearly identifiable in the employer’s financial systems
must be overseen by the GOSWH
receives all access and completion fines, and information breach fines where affected doctor(s) choose to redirect (schedule 5, paragraph 29)
must only be used for improvements that benefit doctors.

Localised funds

The purpose of localised funds is to help ensure that fines monies generated from issues within a department are used to address problems that affect that department’s doctors. These localised funds should in effect act as sub-accounts of the central fund.

Localised funds:

Must be established for each clinical department, or for each relevant community / geographical training area (that is GP registrars in a training region).
Must receive all safe working hours breach fines, missed break fines, and information breach fines except where the affected doctor(s) choose for it to be paid into the central fund.
Must be overseen by the GOSWH, in collaboration with doctor representatives (for example the Resident Doctors’ Forum).
If any fines received into these localised funds are unspent after four months of being received, they will be transferred into the central fund (Schedule 5 paragraph 29).
Affected local doctors can also choose to transfer funds to the central fund.

Collection and recording of fines

The GOSWH will levy fines immediately once a breach is validated under Schedule 5, regardless of whether it is for an information breach, access and completion, missed breaks, or breach of safe working hours. This ensures consistency, fairness and protection of the contractual system.
Employers must maintain accurate and auditable records of all fines received and how they were allocated.
Schedule 5 requires that all fine-related transactions are included in the employer’s annual financial accounts, which must be independently audited. Employers must ensure that the GOSWH has access to all financial information needed to fulfil their oversight role.

Governance and oversight responsibilities

Under Schedule 6, the GOSWH must:
- oversee the distribution and use of fine monies
- ensure spending aligns with the requirement that fine monies are used to benefit the education, training and working environment of doctors
- work closely with the Resident Doctors’ Forum to identify suitable initiatives
- report transparently on income and expenditure in quarterly and annual reports.
Employers must support the GOSWH by:
- ensuring ring-fenced financial structures are maintained
- providing direct access to financial expertise
- ensuring all expenditure complies with Schedule 5 paragraph 30
- maintaining transparent governance processes.
The RDF has a scrutiny and advisory role. Its input should be sought for suggestions as to how fine monies should be used to improve working, training and wellbeing conditions for doctors, and provide doctor insight to support decisions on prioritisation and spending (Schedule 5, paragraph 30).

Permitted uses of fine monies

Schedule 5 paragraph 30 requires that fine monies must be used only to benefit the education, training and working environment of doctors, and should prioritise wellbeing-focused initiatives. All spending must demonstrate a clear and direct benefit to doctors. Disbursements of fines will focus on initiatives that enhance doctors’ wellbeing (Schedule 5 paragraph 30).

Examples of appropriate uses include:

Improving rest and break facilities (for example sleep pods, on-call improvements beyond required minimum).
Enhancing communal or wellbeing spaces (for example improvements to the doctors’ mess).
Funding tools, training or resources that support a better educational experience (for example wellbeing days, workshops, or peer-support training).
Initiatives that address issues highlighted through exception reporting patterns (for example access to counselling or stress management programmes).

The GOSWH should devise the allocation of funds in collaboration with the employer/host organisation and Resident Doctors' Forum (Schedule 5 paragraph 30).

Prohibited uses of fine monies

Fine monies must not be used to:

replace or subsidise employer-mandated resources (for example IT provision, essential equipment, instead of study budgets)
cover service delivery costs such as rota backfill or locum staffing
support managerial or non-doctor-related projects
contribute to general operational budgets or deficit reduction
fund improvement to facilities not directly linked to doctors’ working conditions.

These restrictions ensure that fine monies provide additional value and are not used to compensate for under-investment elsewhere.

Transparency and reporting

Employers must ensure compliance with Schedule 6 reporting requirements.

To maintain the confidentiality of exception reporting information, and to avoid possible information breaches that attract a fine, personally identifiable data should be excluded from the board reports.

The details of the guardian of safe working hours fines will be published in the organisation’s annual financial report (accounts), which are subject to independent audit.

The guardian of safe working hours annual report will include clear detail on how the money has been spent.