Introduction A 7-day NHS service is proven to achieve greatest benefits for patients as published by recent evidence based review. Despite the limitation of NHS resources, healthcare professionals should aim to provide the best quality of care to patients at all times.

Concerns about weekend ward cover, especially for medical patients on outlier wards, were raised through emails and verbal feedback from doctors and nursing teams. This project aims to improve clinical effectiveness for medical patients over the weekend.

Methods Qualitative data was collected through verbal and written feedbacks from wards, managers and medical teams.

A new poster with up-to-date bleep numbers for medical doctors over the weekend was designed, and a morning weekend handover was established together with collection of bleeps in a designated area. These changes were communicated to doctors, site managers, nursing and administrative staff and switchboard.

Results Numerous factors which were contributing to the problem have been identified:

1. Incorrect bleep numbers were recorded on the switchboard system

2. The use of bleeps were inconsistent amongst doctors

3. The ward staffs were unaware of the bleep numbers that were carried by the doctors

4. Uncertainty of which doctors are on–call

Conclusion Several implementations have been introduced as a result to improve communication between ward staffs and on-call doctors.

1. Designated buddying outlier wards for specific medical wards.

2. Designated bleeps numbers for doctors covering specific wards, all bleeps need to be returned to EAU office at the end of the shift.

3. Up–to–date on–call board on EAU

4. Laminated A4 medical on–call bleep sheet on every ward to guide ward staffs to bleep the accurate doctors.

5. Up–to–date list of bleeps with switchboard

6. Emails to all medical consultants, trainees, ward team and site managers with updates of the implementation.