Exception reporting in 2018: how often is it happening?

Area of Science:

• Medical Education
• Healthcare Management
• Workforce Analytics

Background:

• Exception reporting is a key process for addressing junior doctor working hour issues in England.
• Concerns exist regarding inconsistent exception report submissions, necessitating further investigation.
• This study examines exception reporting frequency in relation to working beyond rostered hours and overall job satisfaction.

Purpose of the Study:

• To assess the frequency of exception reporting among junior doctors in England.
• To correlate exception reporting frequency with the incidence of working beyond rostered hours.
• To evaluate the relationship between exception reporting and junior doctor overall satisfaction.

Main Methods:

• Data from the National Training Survey (NTS) on overall satisfaction and working beyond hours were collected for 26 trusts.
• Exception reporting data were obtained from quarterly reports by guardians of safe working for these trusts.
• Statistical correlation analysis was performed between exception reporting frequency and NTS data.

Main Results:

• Data from 24 trusts indicated trainees worked beyond hours 12.1 times/quarter, but exception reported only 0.15 times/quarter.
• Trainees exception reported only 1.2% of the time they worked beyond rostered hours.
• Exception reporting frequency showed a poor negative correlation with both working beyond hours (r=-0.22) and overall satisfaction (r=-0.21).

Conclusions:

• The current exception reporting system significantly under-reports actual junior doctor working hours.
• There is considerable regional variation in the under-reporting of working hours.
• Improvements to the exception reporting process may be needed to accurately capture working time and address trainee concerns.