Contract Junior doctor England Medical academic

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Exception reporting - Academics and non-clinical work

Academic trainees with an NHS contract of employment must consider the impact of their clinical work on academic commitments when exception reporting. There should be a means of exception reporting variations to their scheduled academic activity, bearing in mind the need for individual discretion to apply this flexibly (if, for example, they opt to work late to complete particular academic activities).

The 2016 TCS state that '[w]here the doctor is on an integrated academic pathway, the academic components of the placement also need to be reflected in the work schedule, in accordance with Follett principles' (Schedule 4, paragraph 4). As such, academic trainees should seek to record academic activity in their work schedule and have this jointly agreed and signed off by both employers.

Where their clinical activity causes a deviation from agreed and scheduled academic activities, the trainee should be able to exception report this via email to their academic supervisor, copying in their clinical supervisor or another representative of their NHS employer. It would then be for both employers to consider how the issue can best be addressed, including a review and restructuring of the work schedule.

It’s worth noting that not all academic trainees will have an NHS contract of employment, working instead with a university as a lead employer. There are no specific provisions which allow for those not on a substantive NHS contract to have access to a guardian, or to utilise the exception reporting mechanism. However, we are strongly encouraging guardians to consider and robustly represent the interests of trainees not on a substantive NHS contract but who are working in their organisation or an organisation for they are responsible.

A guardian would not be able to enforce a change to their work schedule, as they would for a trainee on an NHS contract following an exception report, but where safe-working concerns are raised we would still expect a guardian to highlight these to the employer and recommend appropriate changes. The guardian should also include feedback on safe trainee working issues for the whole trust, including those experienced by trainees not on an NHS contract, in their regular reports to the board.



Slemani is an Academic Clinical Fellow whose work schedule consists of 75% clinical work and 25% academic work. He finds that his clinical work sometimes runs over his scheduled hours, invariably cutting into his protected academic time. Slemani submits an exception report requesting a work schedule review and sends this to his clinical supervisor, with the guardian and the academic supervisor copied in.

The clinical supervisor and Slemani have a discussion regarding Slemani’s work schedule. They agree that his actual hours spent on clinical work do not reflect those in the work schedule.

The clinical supervisor first suggests that the work schedule is adjusted to reflect the actual hours Slemani works, however Slemani finds that this would not address the issue of clinical work cutting into his academic work. They discuss further options, and agree that more support should be provided during unsocial hours in order to ensure Slemani can leave work on time. The academic supervisor agrees with this approach.

This agreed outcome is set out in an email sent by the clinical supervisor to Slemani, with the guardian copied in.


Read about exception reporting outcomes