Quick links – Resources, Events and News
Exception Reporting
Exception reporting is a contractual mechanism available to doctors and dentists in training that allows them to formally record when the actual work experience differs from the agreed work schedule, whether due to additional hours worked, missed training opportunities, or breaches of safe working conditions.
Its core purpose is to support safe working hours, protect patient safety, and ensure that trainees receive fair compensation (either pay or time off in lieu) for additional hours worked, or reinstatement of missed educational opportunities.
The reforms being introduced through version 13 of the 2016 Terms and Conditions of Service emphasise professional trust, streamlined reporting, and clearer responsibilities for all parties involved. In practice, exception reporting should be completed promptly after an occurrence and enables remedial action, work schedule reviews, and departmental improvements where patterns of concern emerge.
From 4 February 2026 , several key changes will apply across training environments:
- Educational exception reports will go directly to the Medical Director for Education for review
- Reports relating to additional hours worked will go to HR/medical workforce teams for which doctors will have a choice of payment of time off in lieu (TOIL) for additional hours, except where a rest breach requires TOIL by contract.
The Guardian of Safe Working Hours (GoSWH) will maintain oversight of all reports to identify unsafe patterns and systemic issues.
Confidentiality protections are strengthened by limiting access to identifiable exception reporting data to only those roles essential for processing (HR, MD for Education, GoSWH), and new fines and accountability measures apply to employers who fail to provide timely access to reporting systems, mishandle confidential data, or do not process reports efficiently.
Reporting deadlines and processes are also clarified to empower doctors and reduce administrative barriers, while educators and trainers will need to engage with updated procedures, support work schedule reviews, and help communicate these changes to trainees.
The Undergraduate Hub at St James’s University Hospital
The Undergraduate Hub is home to a dedicated team of experienced educators and professional support staff who are committed to delivering a high-quality, inclusive learning experience for undergraduate medical students.
Led by Dr Sarah Campion, the Hub supports teaching across the MBChB programme and plays a central role in coordinating undergraduate medical education within Ä¢¹½tvÊÓƵ.
The team works closely with clinical services and the University of Ä¢¹½tvÊÓƵ to ensure students receive consistent, well-supported, and curriculum-aligned learning opportunities throughout their placements.
Clinical Teaching Fellows (CTFs) are a core part of this team and play a vital role in the delivery and development of undergraduate medical education across Trust sites.
Based primarily at St James’s University Hospital, CTFs deliver a wide range of teaching activities including small-group teaching, bedside and ward-based learning, simulation, and one-to-one student support.
They contribute to curriculum delivery, programme development and evaluation, and provide tailored support to students, including identifying and supporting those who may need additional guidance.
CTFs are also actively involved in educational innovation, technology-enhanced learning, OSCE delivery, and quality improvement, working collaboratively with senior educators and the wider faculty to continually enhance the student learning experience.
Library and Knowledge Services
The Trust has a range of high-quality library and knowledge services available to all staff.
You have access to library facilities which include PCs, study space and materials available at both Ä¢¹½tvÊÓƵ General Infirmary and St. James’ University Hospital sites.
We offer access to a range of healthcare databases, e-journals and e-books via . You can also access BMJ BestPractice with your NHS OpenAthens account or via the link in PPM.
Library and Knowledge specialists can also assist you with evidence searches and training in a range of information skills including searching, accessing online resources and critical appraisal.
Please visit the for the available opening hours and directions across the Ä¢¹½tvÊÓƵ.
Study Leave and expenses
We have reviewed our internal processes to ensure we can reimburse resident doctors in training within 4-6 weeks of receiving valid receipts for all approved study-leave expenses.
To submit your study leave applications and expenses, please follow the below steps:
STEP 1 – Accent Leave Manager
Please submit your application for Study Leave on Accent Leave Manager, login details will have been sent to you from NHS England. Your application will be approved/rejected by your key approver on ALM (this is done electronically).Â
All estimated expenses must be added to the application.
The links below include a quick guide, to the Accent Leave Manager system.
ALM accounts are created automatically.
For instructions on how to activate your account, please see below:
STEP 2 – Assure (SEL Expenses)
Following the NHSE Study Leave guidelines for claiming back expenses – YOU MUST submit your approved study leave expenses within 6 weeks of the course/event/training – in exceptional circumstances this can be extended if agreed by NHSE & LTHT.
Early reimbursement is now available on any upfront costs you have had to pay out and have a valid receipt for.
Once you have approval on ALM, you can then submit your approved expenses to Assure (known as SEL Expenses) this is the platform used by LTHT to reimburse your expenses to your salary.
A curriculum delivery (funded Study Leave) form will need to be completed (part 1 only) and sent directly to: [email protected]. The team will create an account for you and send your login details directly. Once you have an Assure Expenses account and the event has taken place – you will be able to submit expenses claim for your approved Study Leave, together with receipts.