What can be exception reported
The parties agree that the terms and conditions of service should provide greater clarity on the types of activity that can be exception reported. While it is not possible to outline an exhaustive list within the contract, there are a number of overarching principles and examples of activities that will provide a useful steer to trainees and employers, which will be included as set out below.
Exception reporting is the mechanism by which trainees can guarantee compensation for all work performed and uphold agreed educational opportunities, this includes but is not limited to:
- All scheduled NHS work under this contract (eg any patient facing and non-patient facing activities that your team or supervisor requires you to do as part of your employment).
- Any activities required for the successful completion of Annual Review of Competency Progression (ARCP) and any additional educational or development activities explicitly set out in the agreed personalised work schedule.
- Activities that are agreed between the doctor and their employer, such as quality improvement or patient safety tasks directly serving a department or wider employing organisation, or their doctors (eg attending a JDF, activities related to rota management, delivering teaching, or setting up training programmes).
- All professional activities that doctors are required to fulfil by their employer (eportfolio, induction, e-learning, quality improvement and quality assurance projects, audits, mandatory training/courses).
Unless required by your employer or agreed with the educational supervisor, this does not include occasions where an individual may choose to undertake educational activities for personal development or career enhancing purposes, which are outside of contractual requirements, the agreed personalised work schedule or are not an essential activity to pass ARCP.
Reviewal process for exception reports
Since the adoption and roll out of exception reporting, some organisations have adopted different processes for who reviews exception reports further to agreement with their trainees. This has resulted in individuals other than the educational supervisor being nominated as the reviewer/actioner for certain types of exception report.
To reflect this existing practice, the reviewal process for exception reports should be a locally agreed process, which is jointly agreed by; the guardian, the Junior Doctor Forum, and the Joint Local Negotiating Committee. Regardless of the process that is agreed, all reports should be copied to a trainee’s educational supervisor, irrespective of whether the educational supervisor is required to action all types of report.
Response time for educational supervisors
The terms and conditions of service will mirror the response times referenced in the exception reporting flowcharts produced by NHS Employers and the BMA. In line with this, the educational supervisor (or other nominated reviewer) must respond to exception reports within seven days of a report being submitted in order to review the report and discuss the reasons with the trainee and progress to agreeing an appropriate outcome.
The guardian of safe working will have the authority to action any exception reports that have not been responded to.
Pre-authorisation for additional hours of work
Doctors in their professional judgement may consider that it is necessary to work beyond the hours set out in their work schedule, in order to secure patient safety. The parties acknowledge that doctors will endeavour to seek approval for this with their clinical manager before or during the event, but recognise that this will not always be possible and fully support that doctors should be empowered to exception report whenever pre-authorisation is not possible.
Once an exception report has been submitted it will continue to be subsequently validated by the clinical manager, and an outcome agreed within sevent days, to allow for payment for the additional hours worked.
Payment for exception reports
Payment must be made for approved exception reports within a month, or within the next available payroll, of a report being approved for payment and agreed by all parties. There should be no additional administrative burden, such as submitting additional forms outside of the exception reporting process, to receive payment for an approved exception report.
Conversion of untaken time off in lieu (TOIL) into pay
Where TOIL is agreed by all parties as the outcome of an exception report, there will be a four-week window from the outcome being agreed for the trainee and rota manager to discuss and allocate the TOIL to a future shift in their working pattern before the end of that placement.
In the instances where this does not occur, the TOIL should automatically be converted to pay after that four-week period. At the end of a placement, any untaken TOIL will be converted into pay.
Automatic acceptance of exception reporting outcomes
To ensure prompt payment, the doctor should formally accept the exception reporting outcome presented by the employer as soon as is practicable. Where agreed outcomes are not formally closed on the system following discussion with the relevant supervisor, these will automatically be accepted and closed at the end of the trainee’s rotation.
Exception reports for trainees with extenuating circumstances will automatically be accepted and closed at four weeks. The parties will produce supporting guidance for trainees and employing organisations to assist in defining examples of extenuating circumstances, such as long-term sickness or maternity leave.