- The HSE has proposed the biggest RIDDOR changes in over a decade; its consultation ran from 7 April to 30 June 2026 and has now closed, with responses being analysed.
- The reportable occupational disease list would expand from six to nineteen – nine previously removed conditions reintroduced, and four new ones added.
- Diagnosis of a reportable disease could be made by other registered health practitioners, including occupational health nurses, not only GMC-registered doctors.
- Work-related stress and work-related suicide are not included, and the changes are proposals, not yet law – so current RIDDOR duties still apply in full.
The Health and Safety Executive (HSE) has set out the biggest changes to workplace incident reporting in more than a decade. Between 7 April and 30 June 2026 it ran a public consultation on reforming the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 – known to most employers simply as RIDDOR – and the proposals would noticeably widen both what has to be reported and who can diagnose it. The consultation has now closed and the HSE is working through the responses, so nothing has changed in law yet. Even so, the proposals matter to employers – several concern occupational health directly, and would widen reporting duties well beyond where they stand now.
What RIDDOR is, and why it is changing
RIDDOR is the legal framework that requires employers, the self-employed and people in control of work premises to report certain serious workplace events to the HSE: specified injuries, a defined list of occupational diseases, and "dangerous occurrences" – near-misses with the potential to cause serious harm. The purpose is simple: to make sure the regulator hears about the most serious workplace risks, so patterns can be spotted and the next case prevented.
The current regime dates from 2013, when the list of reportable occupational diseases was cut to just six, following the 2011 Löfstedt review and its drive to reduce the burden of health and safety regulation on business. Those six are carpal tunnel syndrome, hand-arm vibration syndrome, occupational asthma, occupational dermatitis, tendonitis or tenosynovitis of the hand or forearm, and severe cramp of the hand or forearm. The HSE now says that pruning the list so hard means some cases of serious work-related ill health no longer come to its attention – and that is much of what these proposals set out to fix.
Nothing here is law yet. But the intent is clear: catch occupational disease earlier, and make sure it is counted.
A much longer list of reportable diseases
The headline proposal is to expand the reportable occupational disease list from six conditions to nineteen. That is made up of nine conditions being reintroduced, having been removed in 2013, plus four entirely new additions.
The nine returning conditions are weighted heavily towards respiratory and exposure-related disease: pneumoconiosis, including silicosis; asbestosis; hypersensitivity pneumonitis, such as farmer's lung; cadmium-related emphysema; beryllium disease affecting the skin and lungs; chromium-related ulceration; decompression illness and related conditions; oil folliculitis; and knee and elbow bursitis. The four new conditions are noise-induced hearing loss, bronchiolitis obliterans, occupational allergic rhinitis and occupational contact urticaria.
Many of these are conditions with long latency or gradual onset. Asbestosis and pneumoconiosis can take decades to appear, while noise-induced hearing loss and vibration injuries build quietly over years of exposure. That is what makes them easy to miss without deliberate monitoring, and why the HSE wants them back on the reportable list. For employers in construction, manufacturing, foundries and engineering, agriculture and the extractive industries, this represents a substantial widening of reporting duties, and a renewed regulatory focus on occupational health surveillance – because surveillance is very often how these conditions are first picked up.
Good practice
These are proposals, not law. The current six-disease list and existing RIDDOR duties still apply in full until any change is made and comes into force. Acting now is about being ready, not reacting in a hurry.
Who can diagnose – a change that matters for occupational health
One proposal has had less coverage than the disease list but may matter just as much in practice. At present, a RIDDOR-reportable occupational disease must be diagnosed in writing by a doctor registered with, and licensed by, the General Medical Council. The HSE proposes extending this to other registered health practitioners – and has specifically pointed to occupational health nurses and physiotherapists.
The thinking behind this is practical. At the moment, an employee already assessed by an occupational health professional may still have to make a separate GP appointment purely so that a doctor can confirm the diagnosis for RIDDOR purposes. Broadening who can diagnose would remove that duplication, ease pressure on GPs, and make better use of the specialist expertise that already sits within occupational health. For most employers it would mean a faster, less convoluted route from identifying a work-related condition to meeting their reporting duty – and one less appointment for the employee to chase.
Work-related stress and suicide stay out, for now
Some had expected the HSE to use this reform to make work-related stress reportable. It has decided not to. Its reasoning is that work-related stress is difficult to define in a way that allows consistent, reliable reporting across very different sectors, and that it is better addressed through other regulatory and policy tools.
Work-related suicide will also remain outside RIDDOR. Decisions about the cause of a death rest with coroners in England and Wales, and with the Procurator Fiscal – and, where one is held, a Fatal Accident Inquiry – in Scotland. The HSE's view is that requiring an employer to attribute a death by suicide to work and report it would pre-empt those established investigations, and force employers to make judgements they are not equipped to make, including on matters such as access to a person's medical records. Anyone affected by these issues can find support from organisations such as Samaritans, free on 116 123.
Definitions, dangerous occurrences and a simpler form
Beyond the disease list, the consultation proposes tightening several definitions in the regulations – terms such as "work-related" and "significant" – where uncertainty has led to inconsistent reporting, including a large volume of over-reported cases. It also proposes revising the list of reportable dangerous occurrences to reflect modern risks, and simplifying the online reporting form. The overall aim is to cut both under-reporting and over-reporting, so the data the HSE holds is more complete and more useful.
What employers should do now
There is no need to change anything today, but a little preparation will pay off if the proposals become law:
- Identify which of the proposed conditions could realistically affect your workforce, particularly if you operate in construction, manufacturing, agriculture, healthcare or heavy industry.
- Check that your health surveillance is set up to catch the early signs of noise, vibration, respiratory and skin conditions – exactly the diseases the reforms would capture.
- Review how you currently identify and report occupational disease, and who makes the diagnosis.
- Keep clear, retrievable records: a wider reporting net raises the risk of inadvertent non-compliance, and RIDDOR breaches can carry significant fines.
- Watch for the HSE's response to the consultation and any timetable for implementation.
In practice: A manufacturer running annual audiometry as part of its health surveillance picks up early noise-induced hearing loss in a long-serving machine operator. Under the current rules that case would not be RIDDOR-reportable; under the proposals it would be – and the same surveillance that flags it also gives the employer the evidence to act on the underlying noise exposure before anyone else is affected.
Where occupational health fits
Occupational health runs through most of these proposals. Most of the conditions being added or reintroduced – noise-induced hearing loss, hand-arm vibration syndrome, respiratory and skin disease – are detected early through structured health surveillance, which is both how employers protect their people and how many reportable cases first come to light. The proposal to let occupational health nurses and other registered practitioners make the formal diagnosis simply recognises the part occupational health teams already play.
Medwyn's health surveillance programmes and clinical team help employers spot these conditions early, advise on the workplace measures that prevent them, and support accurate reporting when it is needed. Getting the groundwork right now – knowing your risks, running the right surveillance, keeping good records – means that if the rules do change, you are already most of the way there.
This article is general guidance, not a substitute for tailored occupational health or legal advice. For help with a specific situation, contact Medwyn Occupational Health.
This article is general guidance for employers and is not individual medical or legal advice. If you are unsure how it applies to your organisation, contact our team.