Secondly, participants queried the heterogeneity in absence reporting across professions and working groups within the hospital. Nurses often had independent reporting systems to higher level health professionals and described experiences where the absence of doctors had been noticed only hours after they were due to attend work, if at all. They stated that often, there was a complete lack of structure in absence reporting among senior staff. With regular use of bank, temporary and contract staff, an accurate overview of absentee levels and reasons for absence within the hospital was deemed challenging.