This piece of qualitative research looks into the attitudes of managers, consultants and junior doctors towards the exception reporting process that was introduced as part of the new junior doctors’ contract in December 2016.

The qualitative interviews, conducted in both structured and semi-structured format, provide a range of themes that lead to numerous recommendations for consideration by central government and lobbyists such as the British Medical Association (BMA) as to how the process could be improved.

The major themes that were identified by the interviews are; apathy, cultural issues, safety, stigma, junior-led process, training and practical issues. These are explored in some detail in the paper, with direct quotes evidencing each provided, together with a commentary.

The main recommendations include; an England-wide campaign on exception reporting to address cultural issues and stigma, more active involvement of consultants in the process, treating exception reports as a ‘near miss’ event from a safety perspective, lengthening timelines and introducing penalties for breaching such timelines, allowing for doctors to claim for training opportunities and address practical issues around reporting such as provision of a username and password that is the same as other IT systems in the Trusts.

Further areas of research recommended is an England-wide survey based on the themes that were elicited by the interviews, as well as the facility for further free-text comments from individuals in a survey format in order to collect quantitative data and confirm the themes with further qualitative input.