This success reflects the strength of our collective voice - and the value of fighting for safe working hours, fair compensation, respect for doctors' time, and restoring the profession. As this framework is now complete, we have come out of dispute. However, if there are issues progressing through the remaining process to implementation, we will not hesitate to re-enter dispute.
This page summarises the changes agreed under the framework agreement, which will now move into the next stage of the process. This includes:
- Drafting new contractual wording
- Co-producing detailed national guidance
- Educating Trust staff in the new process once contractualisation and guidance has been completed.
- Rolling out implementation across all employers in England by 12 September 2025
Key wins include:
- Rolling fines for Employers who fail to onboard residents onto an ER system within 14 days of starting work
- Financial penalties for employers who breach new confidentiality processes for ER data
- All residents must receive their choice of either payment or time off in lieu (TOIL) for all time worked above contracted hours following ER, except when a breach of safe working hours mandates the award of TOIL. All resulting payments and TOIL must be facilitated by responsible parties and must not be substituted without residents’ consent. Additional hours reports go to HR and the GOSWH, not your supervisor
- Educational exception reports go to DMEs
- Doctors clinical judgement around working additional hours will not be challenged.
- Window to submit an exception report increased to 28 days
This summary and FAQ are a simple snapshot designed to help doctors understand what’s changing. Further updates and national guidance will follow as implementation progresses.
Comparison: current vs. reformed exception reporting system
| Aspect | Current system | New framework agreement system |
|---|---|---|
| Who signs off my Exception Reports? | A consultant, SAS, or GP supervisor (clinical/educational) | HR / Medical Workforce HR for additional hours worked. DME for educational ERs. |
| What role do my clinical seniors have? | Central role in processing all ERs | No role in standard process for ER for up to two additional worked hours. Involved only at a resident’s discretion for educational ERs. |
| Processing timeframes | Often unclear; delays common | Hard limits: 10 days (7 days from Feb 2026) |
| Enforceability | No fines; contract terms often ignored or unenforced | Fines of £250–£500 for access, completion and data breaches; triggered easily , non-reclaimable, and monitored quarterly |
| Employer incentive to comply | Low — reputational only | High — financial penalties, quarterly public reporting, and BMA oversight |
| Up to two additional hours worked rules | No distinction; all additional hours ERs treated similarly | The merits of the doctors’ decision to work additional hours will not be challenged when determining whether to make payment for the additional hours. |
| Over two hours | Subject to supervisor review, may challenge judgement | Investigation to maintain safe staffing, not to contest doctor’s judgment. |
| Meeting requirements | Frequently required | No in-person meetings. GOSWH may request remote discussion in rare Level 2 escalation |
| Verification of additional hours | Typically requires meeting and supervisor's subjective judgment | Based on objective evidence, self-declaration, and HR-level rota reviewchecks; meetings not required |
The current system lacks teeth - even where contractual rights exist, there’s often no consequence for employer non-compliance. The new framework brings regulatory mechanisms into play via fines, real-time reporting, and transparent oversight, making the contractual obligations both enforceable and visible.
Key dates
- By 12 September 2025: Full implementation deadline for all employers.
- From February 2026: Faster processing times (7-day deadlines), and all fines set at £500.
- From August 2027: Formal national evaluation of reforms begins.
Member FAQs
Core process changes
Q1: Who does this apply to?
These changes will apply to all resident doctors under the 2016 TCS in England, and any resident doctors to whom trusts have given access to under the current system. Employers are encouraged to extend this to academic trainees, public health trainees, armed forces trainees, and locally employed doctors.
Q2: When will exception reporting change?
These changes will be implemented from the 12th of September 2025. Fines will begin from this date, with Access fines beginning at £250 and escalating to £500 from February 2026, and information breach fines being set at £500 from the 12th of September 2025.
Q3: What's the biggest difference between the old and new systems?
The new system removes your clinical supervisors from the process of reviewing work hours exceptions. Reports now go directly to HR and the Guardian of Safe Working Hours (GOSWH), providing greater confidentiality and reducing potential conflicts of interest or detriment.
Q4: Will my professional judgment be questioned?
The new system is designed to empower doctors and trust their professional judgement. For claims of two hours or less, the only verification is confirmation that the hours were worked—not why you stayed. For claims over two hours, reviews focus on staffing safety patterns rather than challenging your decision to stay.
Access and system issues
Q5: When must I be given ER access?
Within 7 calendar days of starting a new post, new site, or employer. This will likely coincide with your trust or departmental induction.
Q6: What if I can’t access ER or the system won’t let me complete a report?
You can raise it with HR and the GOSWH. If these are unresolved within another 7 days, a fine is levied weekly until your ability to access or complete exception reports is restored.
Q7: What if I work across multiple employers or in a GP practice?
Your lead employer (or clinical employer for academic trainees) is responsible for ensuring you have access to exception reporting systems and bears responsibility for any fines incurred due to access issues.
Submitting exception reports
Q8: How long do I have to submit an Exception Report?
Residents should submit reports as soon as possible but no later than 28 days from the day they occurred.
Q9: What documentation is required when submitting an ER?
The system will require:
- Evidence of time, date, and location of the exception. Or an optional alternative to this is support from a regulated professional if the above evidence is either not preferable or unavailable. This is similar to current locum timesheets (this option cannot be mandatory)
- Your exception report
- A copy of your rota
Processing, award and compensation
Q10: Who processes my exception reports?
Exception reports for additional hours worked go to HR (not your supervisor). Educational exception reports go to your Director of Medical Education (DME). Supervisors are no longer routinely involved unless you choose to involve them.
Q11: How quickly should my exception report be processed?
Initially by 10 days, reducing to 7 days from February 2026. This is a hard deadline, with monitoring and reporting requirements placed upon trusts to ensure they are delivering a system that works.
Q12: Can I choose payment instead of TOIL?
Yes. Except where TOIL is mandated for safety reasons (such as following overnight breaches of safe working hours), your choice must be honoured and cannot be substituted without your consent.
The three-level process
Q13: Will I need to meet someone to justify my ER?
No. The system will use a three-level HR-led process that starts with self-declaration and objective evidence. Meetings are not required unless a report is escalated to a GOSWH review and further clarification is needed. In person meetings are not required. GOSW meetings will be done remotely.
Q14: What is the review process for ERs for up to two additional hours worked?
- Level 0 (Standard process): HR reviews your evidence and approves payment/TOIL if information aligns
- Level 1 (Clarification): Only if discrepancies exist, HR contacts you to resolve them
- Level 2 (Escalation): Only reached if you maintain the ER is accurate after HR rejection; the GOSWH reviews and makes a final decision
Protection and enforcement
Q15: What protects me from retaliation or breaches of confidentiality?
Strict safeguards are in place. Detriment is prohibited. Only specified individuals can access your ER data. Information breaches will result in £500 fines per instance and are reported quarterly.
Q16: What if the employer ignores their responsibilities?
Unlike the current system, this framework includes new financial penalties for employers who fail to meet access, completion, or data standards. Fines can never be reclaimed and must be spent on resident wellbeing or education, as decided by the Resident Doctors Forum.
Q17: Where does the money from fines go?
Money from "access or completion" fines accumulates in a central pot. "Information breach" fines can either go to department-level sub-accounts (to be used by the doctors who were directly affected) or to the central pot at the affected doctor's discretion. Current exception reporting fine money allocation may go to sub accounts. Penalty rates are unaffected. If in a lead employer arrangement, fine disbursement will be led by the lead employer rather than the host trust or practice.
Special circumstances
Q18: What if my trust has an alternative system that works well?
It can stay, provided the current system aligns with the 12 negotiated principles and has the confidence of the resident doctor workforce (verified by electronic ballot of the RDF, LNC, or equivalent).
Non-resident on-call (NROC)
Q19: How does the new system handle NROC exceptions?
All hours worked on NROC above those stated in your work schedule can be exception reported. If no hours are explicitly stated in your schedule, then all NROC hours are reportable.