Plans to ingrain exception reporting into the workplace

The BMA is set to participate in an ambitious, collaborative initiative to bolster workplace safety mechanisms for junior doctors.

The association is among almost half a dozen health bodies that will be working with NHS Improvement as part of a review into the use and enhancement of exception reporting.

Organisations taking part in the working group include the Academy of Medical Royal Colleges, Health Education England, NHS Employers, the GMC and the Care quality Commission, with the central focus of the review being how data from reports can be standardised.

A joint statement published today by the group emphasised how exception reporting was a ‘valuable instrument’ to safeguarding patient safety and to promoting good-quality training, accurately reflected pay and morale among junior staff.

BMA junior doctor committee terms and conditions of service subcommittee lead for exception reporting Mairi Reid said that she was hopeful that the group would be able to gain a greater understanding of the reporting process, and take steps to further ingrain it into workplace culture, as well as improving its effectiveness and functionality for trainees.

She said: ‘The exception reporting system, secured during contract negotiations two years ago, is vital in ensuring doctors are encouraged and feel able to highlight times when their working hours and shift patterns are non-compliant and – ultimately – unsafe.

‘It also seeks to guarantee that doctors are able to obtain the full amount of educational experience required to progress through their training programme competently.

‘When this works properly, it can be highly effective and prompt trusts to take immediate and necessary action to ensure staff and patients are protected from future incidents, and doctors do not miss training opportunities.

‘However, this is not always the case due to a number of systematic limitations.

‘Through the creation of this group, we hope to standardise the exception reporting process across England, and ensure that it is effective and easy to engage with. Further, we will put pressure on trusts who do not support the process, noting with real concern reports that some trainees feel actively discouraged from raising concerns about their rotas.

‘Alongside the other organisations in this group, the BMA believes it can ensure this important system becomes ingrained in the workplace culture across England and leads to a marked improvement in wellbeing for all junior doctors.’

In conducting its review, the working group will seek to follow a series of six key principles.

These include a collective effort to reducing the burden of the exception reporting process to trainees and employers, and a commitment to exploring opportunities to further streamline the reporting process.

It also calls for report data to be collected on a qualitative as well as quantitative basis, and that data should be made to be more shareable to enable comparisons across individual trusts and grades.

As well as seeking ways to standardise data collection, the group’s review may also examine ways in which cultural issues in the workplace can limit exception reporting, and how safe working guardians can be better supported in their roles.

Additional to its role in improving exception reporting effectiveness and data collection, the BMA will continue to support junior doctors across England and the devolved nations, using the monitoring and banding arrangements of the 2002 contract.

In doing so, it will ensure working hours and pay remain safe and fair for these members of staff.

BMA teams working at local levels are also working with the GMC, to establish how processes for rota management and monitoring can be further improved to promote and protect the quality and safety of the training environment.

Read the group’s statement

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