Exception reporting in 2018: how often is it happening?

Abstract

Background Exception reporting is the main process in England to resolve issues related to junior doctor working hours. Concerns have been raised regarding variable report submission, but no significant exploration has occurred. This study assesses frequency of exception reporting and correlates it with frequency of working beyond rostered hours and overall satisfaction. Methods National training survey (NTS) scores for 'Overall Satisfaction' and frequency of working beyond rostered hours was obtained for 26 randomly identified trusts throughout England and correlated with exception reporting frequency from guardian of safe working (guardian) quarterly reports covering April 2018. Results Guardian reports were obtained for 24 trusts. NTS data suggest trainees worked beyond their rostered hours 12.1 times per quarter (interquartile range (IQR) 10.0-12.9) whereas guardian reports show they exception reported 0.15 times per quarter (IQR 0.084-0.25). Trainees exception report 1.2% of the time they work beyond rostered hours (IQR 0.8-2.4%). Frequency of exception reporting correlates poorly with the frequency with which trainees work beyond rostered hours (coefficient-0.22) and with a marker of overall satisfaction (coefficient-0.21). Conclusion The current exception reporting process significantly under-reports trainee working hours although there is regional variation.