Resident doctors in England have agreed reforms to additional hours worked and safe working practices in NHS hospitals, bringing to an end a dispute with Government over lack of progress with this part of last year’s pay deal.

Reform to ‘exception reporting’, the process resident doctors use to accurately record their working hours, identify unsafe staffing levels, and protect patients, had been a key part of the deal that had seen too little progress up to January of this year. 

However, after extensive negotiations over the last six months with the Department for Health and Social Care, NHS Employers, and NHS England, the BMA’s resident doctors committee (RDC) has determined that the Government and Employers have agreed enough substantive reforms to end the dispute.  

The exception reporting system as it currently functions is not fit for purpose, with many resident doctors simply not reporting exceptions in their hospitals due to inaccessible systems, time consuming processes, and sometimes the fear of repercussions for identifying problems. This not only means doctors don’t get the pay and training opportunities they deserve but also means that NHS hospitals are missing out on crucial information about how they are functioning.  

Such a lack of reporting reduces NHS productivity and can even put patient safety in jeopardy, as resident doctors exceed safe working hours without their hospital knowing. 

Co-chairs of RDC, Dr Melissa Ryan and Dr Ross Nieuwoudt, said: 

“This is a win-win outcome for doctors, the Government and the NHS. Doctors should never feel intimidated into not reporting their overtime, not pointing out where they are missing out on training, not raising the alarm over staffing shortages. The current system has left many feeling gaslit and let down such that many don’t even bother using the system. This needed to change and we feel confident we are now making enough progress in doing so. 

“But this is also something the Government and health service can celebrate. Ministers have talked about how they want to boost NHS productivity – but hospitals first need information about what is going wrong to do that. Exception reporting highlights flaws in rotas, patient safety concerns, and inefficiencies right across a hospital. With the data coming in from an exception reporting system that everyone believes in, the NHS will have the localised and up-to-date information stream it needs to fix problems and keep patients safe. Bad work cultures mean inefficient workplaces – better reporting is good for everyone.  

“This outcome shows what can be achieved by productive negotiations, where there is trust on both sides. Doctors have stood up for what they deserve and everyone has benefitted as a result. As we look ahead to this year’s pay award and the pressing need to move forward with the promised journey to pay restoration, we hope this episode reminds the Government that with the right spirit it is possible to end disputes before they even cause an hour’s disruption.” 

Ends 

Notes to editors

The agreed reforms include: 

• Moving responsibility for handling exception reporting from medical supervisors to hospital HR departments 

• Improved accessibility of the exception reporting process 

• Minimum expected ER requirements for employers enforced by fines 

• A new system for ensuring confidence in the confidentiality of the process 

The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.