Exception reporting for junior doctors

Exception reporting for junior doctors in England. Find out when to flag up work that varies from your agreed work schedule, who should be on the receiving end of your reports, how to submit an exception report, and at what stage.

Location: England
Audience: Junior doctors
Updated: Monday 7 September 2020
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What you should exception report

Exception reporting will allow you to quickly and easily flag up if your actual work has varied from your agreed work schedule (the plan for your work and training including the rota template).

You should exception report issues as they arise, which can include:

  • differences in the total hours worked from what was set out in the work schedule, including the prospective estimate of hours actually worked while non-resident on-call
  • rest breaks not taken (at least one 30-minute paid break for a shift rostered to last more than five hours, and a second 30-minute paid break for a shift rostered to last more than nine hours)
  • educational or training opportunities missed
  • levels of support available during service commitments

This will facilitate timely adjustments to be made to your working patterns where needed, as well as getting sign off for either time off in lieu or additional pay if you've been required to work beyond your scheduled hours.

Exception reporting is every trainee’s right and responsibility. There are no restrictions on what should be reported or indeed how many reports can be submitted. Furthermore, there is no pre-authorisation or sign-off process required before an exception report can be submitted.

Exception reporting is the mechanism to ensure that training can be safeguarded, workloads kept manageable and safeguards maintained both for your health and the safety of the patients you look after.


Who to submit an exception report to

Exception reports should be sent to your educational supervisor. In addition, the reports should copy in the guardian of safe working for issues related to safe working practices or the director of medical education (DME) for issues related to training, in some cases it may be both.

Where it is deemed to be of benefit to trainees, an educational supervisor may elect to nominate a clinical supervisor to receive exception reports on their behalf, due to their knowledge of the department and rota. However, this should only be agreed in accordance with local negotiating policy and with consent from the junior doctors affected.

Any such arrangement should be explained to trainees in advance, and the educational supervisor retains overall accountability for the process.


How to submit an exception report

Exception reports must be sent electronically.

There may be variation between employers in the exception reporting tools used, such as email, mobile or desktop apps, or other technology. However, employers must have a system in place – paper forms are not a permitted mechanism.

If the exception reporting software your employer has in place is faulty or not accessible at the time, you should still submit an exception report through other means, for example by email as a temporary solution until software problems are resolved. Software problems should not be used as an excuse not to exception report.

Training on the local exception reporting technology must be provided by your employer and should take place during working hours.


When to submit an exception report

Any variation from the planned working hours or training opportunities in your work schedule should trigger an exception report.

You should submit the exception report as soon as possible after the exception takes place, this should be done within a maximum of 14 days (or 7 days when making a claim for payment).

When you are required to work additional hours, ideally you would seek authorisation for this beforehand from your manager, but this isn’t always possible. If that is the case, submit an exception report and the extra hours can be authorised retrospectively. As outlined above, the claim should be submitted within 7 days of the event, and your manager must deal with it within 7 days of submission.

In circumstances where the additional hours you were required to work result in a breach of rest requirements (the required 11 hours’ continuous rest between rostered shifts is reduced to less than 8 hours) this should be highlighted in the exception report and marked as urgent, so that all practicable steps can be taken to ensure that time off in lieu can be authorised within the 24 hours after the shift.

Circumstances concerning an immediate and substantive risk to the safety of patients or the trainee making the report are outlined in the next topic page of this overview.