EXCLUSIVE
“SYSTEMIC staffing pressures” have been revealed by a report into doctors’ working hours – which exposed a 13-hour shift breach, and an “immediate safety concern” regarding a single junior doctor covering over 30 patients.
Dated from June 2024 to June 2025, The Guardian of Safe Working Hours Annual Report – which was only made public following a request under the freedom of information law by this newspaper – highlighted rota gaps and an overreliance on locum and bank staff.
More than £3,000 in fines have been imposed on hospital departments for breaches of safe working hours during this period – but a dedicated fund has not yet been created to reinvest that money in doctor welfare.
The majority of the violations (68%) were within the surgical department, and all were for breaching the maximum shift length of 13 hours.
The report explained that “the surgical care group has experienced particular pressures due to the loss of a clinical fellow”, with a formal safety concern raised in the department.
Exception reports – which are official records submitted by junior doctors when their working hours or rest breaks do not match what was agreed in their schedule – have started to increase.
Most reports were from first year foundation doctors in general medicine (159 reports – 52%) and first year foundation doctors in surgery (84 reports – 28%).
The report attributed the increase to a “change in culture”, stating that the 303 exception reports “represent appropriate use of the reporting system, with the increase reflecting positive cultural change rather than deteriorating conditions”.
The report recommended reopening “bank-only” contracts for local doctors, which were previously withdrawn. A bank-only contract allows a doctor to work shifts on a flexible, as-needed basis – similar to zero-hour or casual contracts in other sectors – but within the hospital’s internal staff bank, rather than through expensive external agencies.
The report warned that staff is “limited sometimes due to the removal of bank only contracts”, warning that the removal may have forced further reliance on more expensive locums.
The document recommended that bank-only contracts should be reintroduced, stating that it would “enable local doctors to provide additional cover, particularly for weekend and evening shifts where breaches are most common”.
It also recommended that a separate budget should be established for the fine monies to ensure the fund are exclusively used to benefit the education, training and working environment of resident doctors.
Health’s response
Responding to the report, deputy medical director John McInerney said: “Health and Care Jersey takes patient safety extremely seriously. We maintain robust oversight of medical staffing and rota compliance, and steps have already been taken to address the issues raised in the Guardian of Safe Working Hours Annual Report.
“We currently have a full complement of foundation doctors, supported by two fixed-term locums, and almost 100% coverage of clinical fellows. Minor vacancies in medicine and obstetrics/gynaecology are being actively recruited to, following internal promotions. Overall, resident doctor staffing across HCJ remains strong.”
He added: “While the recommended shift length for resident doctors is capped at 13 hours, there are rare occasions (such as critically ill patients or operational pressures) where this may be exceeded. These instances are logged, investigated, and monitored through our exemption reporting system. The average extension beyond the 13-hour threshold is 1.5 hours .
“We have no concerns regarding recruitment or retention of resident doctors or clinical fellows. Health and Care Jersey consistently ranks among the top three training environments in annual Wessex Deanery surveys, reflecting the quality of our medical education and support.
“Islanders can be reassured that patient safety remains our highest priority, and we are committed to maintaining safe, supported care across all services.”
