Dear Q,

Within my current role I am working on several improvement initiatives within my local trust, one of which is developing a hospital-at-night or bleep-triage system. Such systems have a tangible benefit to juniors doctors working in acute centres out-of-hours (OOH) in reducing unnecessary calls/bleeps and allowing them to respond more flexibly to medical emergencies.

The background to this is that survey data collected from juniors within the trust, suggests only 4.4% are able to access their full break entitlement when working OOH. Additionally, an audit of the requests received OOH showed in excess of 40% were inappropriate for the clinician receiving them. FY1’s were the worst affected by this, with bleeps during the night ranging from warfarin prescribing and routine bloods to requests to fix the fax machine(?!).

Within other trusts I have visited, one of the key requirements for this system is the presence of a central coordinator to receive, triage and delegate bleeps and jobs to medics. In the systems I have observed, this person is typically a clinically trained individual such as a band 6+ nurse or paramedic.

This project was almost completely ready for implementation. However, funding is no longer available for the central coordinator role.

I wanted to tap into some of the experience at Q and ask if anyone was aware of any alternative solutions such as software packages or otherwise which have been utilised in any organisations across the country?

Any advice or recommendations would be greatly appreciated.

Joe