Hospital at Night SOS

We are looking at implementing Hospital at Night, where should we start?

• Do an audit of current workload and workforce to find out what is going on
• Get stakeholders together to decide what competences are required (including all relevant medical and support staff groups such as porters and cleaners etc)
• Ask four fundamental questions:

1. What work needs to be done only by a doctor and which band of doctor?
2. What can be done by another type of practitioner eg nurse AHP?
3. What can be done by a non registered clinical practitioner eg clinical support worker, medical technical/assistant?
4. What work doesn’t need to be done at all, or shouldn’t be done at that time, ie left over from the day?

• Make sure you have a clear handover policy in place and have a process to hand back to incoming morning teams.

• Train the site nurse practitioners who have been identified as the leaders of the HaN team to lead difficult meetings with difficult people. Also, train them how to lead people and how to persuade people to do things that are culturally very different to what they had done before
• Have a named consultant responsible for the HaN way of working
• Consider the option of going ‘big bang’ and implement the method 24:7.
• We have implemented HaN but there is no medical leadership, what can we do?
• Senior management backing is essential. The message about Hospital at Night has to be right
• A top down approach works when the chief executive and clinical leads realise that they don’t want adverse publicity from serious incidents due to lack of medical buy in.

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