EP-235 Improving working conditions of junior surgeons

Abstract Aims Significant exception reporting is reflective of difficult working conditions though well-recognised barriers exist to reporting which may reflect the culture within a unit. This study used exception reporting data to understand and improve the working conditions of juniors. Methods Junior surgeons were surveyed in December 2019 to evaluate additional hours worked, reasons for this work and whether exception reports were completed; where they were not, doctors were asked why. After data analysis, rota structures and surgical teams were changed and formal education about exception reporting given at departmental induction. The main changes involved greater opportunities to take leave and enhanced staffing on evenings and weekends. Surgical juniors were re-surveyed in September 2021. Results In December 2019, 49.2 additional hours were worked between 18 juniors. No exception reports were completed with the main reasons being a personal decision to stay late (for training opportunities), lack of understanding on how to report and cultural issues that made juniors unsure about how exception reports would be viewed. In September 2021, only 30 additional hours were worked between 17 respondents. Again, no exception reports were completed with over 95% of respondents citing a personal decision to stay late. Cultural issues within the department were no longer cited and knowledge of how to exception report was greatly increased. Conclusions A positive and open culture, where consultants and surgical leaders engage with juniors about rotas and working conditions can lead to a reduction in additional hours and improve the understanding of exception reporting.