Fatigue decision record template
This page provides an original template for recording fatigue-related decisions — for example when fatigue risk has been identified, reviewed, escalated, or mitigated before work proceeds.
It records the reasoning behind a decision and may help document why a decision was made. It is a record prompt, not an approval form.
Important disclaimer: Completing this record does not prove the work was safe, does not guarantee compliance, and does not replace your organisation’s procedures or competent person judgement. It does not determine fitness for duty. Should be reviewed by competent persons. Sector-specific requirements may apply. This is not legal advice.
When to use a fatigue decision record
Section titled “When to use a fatigue decision record”Consider using a decision record when:
- A roster or assignment has elevated modelled or assessed fatigue exposure
- Planned work differs from actual hours, travel, or breaks — see planned vs actual fatigue
- A credible fatigue report has been received — see worker fatigue reporting
- Overtime, overruns, or shift changes alter exposure from the last assessment
- Management needs a documented basis for review before proceeding with controls
- An audit or investigation asks what was known and decided at the time
A record supports accountability — see management accountability for fatigue. It does not replace a full fatigue risk assessment where one is required.
How to use this template
Section titled “How to use this template”- Complete close to the decision — while context is fresh.
- Be specific — describe the pattern, deviation, and factors considered.
- Name people and roles — not only job titles in the abstract.
- Record mitigations — what controls apply if work proceeds.
- Set follow-up — when the decision will be reviewed.
- Retain the record as part of the audit trail — see fatigue records and audit.
Section 1: Decision context
Section titled “Section 1: Decision context”| Field | Entry |
|---|---|
| Record reference / ID | |
| Date and time | |
| Organisation / site / contract | |
| Role(s) or team affected | |
| Reason for record (trigger) | |
| Related assessment reference (if any) |
Describe briefly: What decision is being recorded and why now?
Section 2: People / roles involved
Section titled “Section 2: People / roles involved”| Role | Name or post | Involvement |
|---|---|---|
| Decision-maker (accountable) | ||
| Assessor / reviewer | ||
| Operational supervisor | ||
| Workforce representative (if involved) | ||
| Others consulted |
Section 3: Planned work pattern
Section titled “Section 3: Planned work pattern”| Factor | Planned detail |
|---|---|
| Shift date(s) | |
| Start / finish times | |
| Duty duration | |
| Rest before / after | |
| Consecutive duties in sequence | |
| Breaks planned | |
| Travel / door-to-door (if relevant) |
See shift pattern review checklist and door-to-door planning checklist.
Section 4: Actual or expected deviation
Section titled “Section 4: Actual or expected deviation”| Factor | Planned | Actual / expected | Notes |
|---|---|---|---|
| Shift times | |||
| Duration / overtime | |||
| Rest gap | |||
| Breaks | |||
| Travel | |||
| Task / workload change |
Prompts — check whether:
- Deviation is temporary or may recur
- Planned vs actual monitoring flagged this change
- Reassessment of the underlying fatigue risk assessment is needed
Section 5: Fatigue risk factors identified
Section titled “Section 5: Fatigue risk factors identified”| Risk factor | Description | Severity of concern (organisation scale) |
|---|---|---|
Examples to consider: night work, early starts, quick returns, consecutive shifts, long travel, high workload, missed breaks, heat/isolation, disruption.
Section 6: Modelled outputs, if used
Section titled “Section 6: Modelled outputs, if used”| Field | Entry |
|---|---|
| Tool / method used | |
| Inputs summary | |
| Outputs (e.g. FI / RI if applicable) | |
| Assumptions documented? (Y/N) | |
| Interpreter name / role |
If using a fatigue risk index (FRI), read limitations of fatigue models first. Outputs are modelled estimates — decision-support, not verdicts.
Section 7: Worker reports or concerns
Section titled “Section 7: Worker reports or concerns”| Field | Entry |
|---|---|
| Any fatigue reports received? (Y/N) | |
| Summary (if yes) | |
| How concerns were considered |
Do not dismiss credible reports because a model score looks acceptable.
Section 8: Controls and mitigations considered
Section titled “Section 8: Controls and mitigations considered”| Mitigation | Applied? (Y/N) | Notes |
|---|---|---|
| Roster change / recovery period | ||
| Task adjustment | ||
| Additional supervision | ||
| Travel mitigation (passenger, rest, accommodation) | ||
| Break adjustment | ||
| Other controls |
See mitigation and the fatigue risk assessment template for wider control thinking.
Section 9: Decision taken
Section titled “Section 9: Decision taken”| Field | Entry |
|---|---|
| Outcome (describe neutrally) | |
| Conditions attached (if any) | |
| Work proceeds / postponed / redesigned / referred for further review | |
| Date decision effective |
Use neutral wording — record what was decided and why, not implied guarantees of safety.
Section 10: Named accountability
Section titled “Section 10: Named accountability”| Field | Entry |
|---|---|
| Named accountable person for this decision | |
| Role / post | |
| Date | |
| Signature / electronic record (per org policy) |
Clear ownership supports management accountability. Absence of a named reviewer when exposure is elevated is a governance gap.
Section 11: Follow-up and review
Section titled “Section 11: Follow-up and review”| Field | Entry |
|---|---|
| Follow-up actions | |
| Owner | |
| Review date / trigger | |
| What will be monitored (actual hours, reports, incidents) |
| Follow-up date | What was checked | Outcome | Reviewer |
|---|---|---|---|
Example neutral wording (illustrative)
Section titled “Example neutral wording (illustrative)”Following review of the planned pattern, [deviation], workload, travel, and [any model outputs], [name/role] recorded that [summary of fatigue factors]. Mitigations agreed: [list]. The decision taken: [proceed with controls / postpone / redesign / refer for further review]. This record documents the basis for review at the time; it does not confirm legal compliance or that all fatigue risk has been eliminated. Follow-up review scheduled: [date/trigger].
Adapt to your organisation. This example is illustrative only.
What this template does not cover
Section titled “What this template does not cover”- Approval or authorisation language implying the record permits unsafe work
- Network Rail exceedance levels, threshold matrices, or standard wording
- Fitness for duty or medical conclusions about individuals
- Automatic outcomes from model scores or completed form fields
- Audit-proof claims — records support assurance; they do not prove safety
- Replacement of competent judgement, safe systems of work, or statutory risk assessment
- Driver hours, tachographs, aviation FTL, or fleet compliance
- Software or product promotion
For how organisational policy relates to law and standards, see law, guidance, standards and policy.
Related pages
Section titled “Related pages”- Fatigue records and audit
- Management accountability for fatigue
- Planned vs actual fatigue
- Worker fatigue reporting
- Fatigue risk index (FRI)
- Limitations of fatigue models
- Fatigue risk assessment template
- Fatigue management plan template
- Law, guidance, standards and policy
References
Section titled “References”- Managing rail staff fatigue — ORR — Check and Act, review and learning concepts (paraphrased; not reproduced)
- Managing shift work (HSG256) — monitoring, review, and organisational learning
- Fatigue — HSE — fatigue as a hazard; management and review
- RR446 — The development of a fatigue / risk index for shiftworkers — modelled outputs where tools are used