If you ask most people how doctors’ working hours are regulated in the UK, they’d probably assume there are strict rules in place to ensure medics aren’t run into the ground. And, in theory, they’d be right. The NHS follows working time regulations that cap shifts and mandate rest periods. But what happens when the reality on the ground doesn’t match up to those rules? That’s where exception reports come in. These reports allow junior doctors to flag when their actual hours, working conditions, or training opportunities deviate from what’s contractually agreed. It’s a safety net, yet when you see how many of these reports are being filed, it starts to look less like a safety net and more like a distress signal.
Every two years, we conduct a Freedom of Information survey to get a clearer picture of the strain junior doctors are under. We ask NHS trusts how many exception reports have been filed and request the full, unedited notes left by medics. That way, we’re not just looking at numbers; we’re seeing exactly what doctors are up against in their own words. The latest results were published in the Sunday Express on February 9, 2025. This year’s results highlight just how many junior doctors are raising concerns about their working conditions.
Take this from North West Anglia Trust: a doctor missed a patient who then went into cardiac arrest, had to be resuscitated, and was moved to intensive care.
The medic in question wrote into the NHS’s exception reporting system: “I still feel guilty for my actions… but I really do feel the pressure and staffing is not well supported.”
In 2023, the stories were just as troubling—like the East Kent Hospitals NHS Trust doctor who worked through the night in A&E, clocked 24 hours without a single break, and ended up crying in front of four consultants due to sheer exhaustion. Then there was the East Sussex Healthcare Trust doctor who worked 13 hours straight without a single break for food. In 2021, our survey uncovered the story of a Royal Cornwall Hospital doctor who pulled a 21-hour shift. During that time, he treated multiple patients, including a stabbing victim whose ear had been sliced off. He worked from 8am to 9pm but was twice recalled to treat more patients and didn’t get home until 5:15am.
And then there’s the numbers. In 2021, we had 801 reports. In 2025, despite only 90 out of 136 major trusts responding, that number has shot up to 2,500—a more than 200% increase in four years.
Below, you can explore our exception report clippings from 2023, 2021, and 2019 to see just how much has changed (and how much hasn’t).
