G393(P) Managing the winter-pressure registrar rota: our experience

Introduction Our DGH secured funding for a winter-pressure (WP) registrar locum shift to cover CAU for 8-hours overnight from October 2018 to March 2019. Managing the WP-rota was taken up by a paediatric registrar (overseen by a consultant) as a management and leadership QI project. We aimed to evaluate trends in how locum shifts are booked and to see if a mobile messaging application (WhatsApp) administrated by a trainee could lead to improved uptake of locum bookings. Methods Utilising our network of current and previous trainees a WhatsApp ‘WP group’ was created to advertise and book WP–shifts (alongside medical staffing advertising via their e–mailing lists). Shifts were also open to level–1 trainees with full MRCPCH membership. We managed at standardised NHS–P rate. There were flexible start times: 10pm, 11pm or midnight. The paediatric registrar administrator was the direct clinical contact and liaised with medical staffing to organise bookings. Results 96% (N=174) of WP–shifts were booked. 91% (N=160) of WP–shifts were booked via direct communication with the registrar administrator through WhatsApp. 9% (N=14) of WP–shifts were booked as a result of medical staffing emailing advertisements alone. 57% (N=99) of WP–shifts were booked with more than 4 weeks’ notice. 19 doctors booked shifts. 100% of doctors booked more than one shift. Informal feedback from registrars was collected; both local trainees and locums felt the WP–rota made the department feel safer and had improved staff morale. Take Home Messages Anecdotally locums liked the flexibility and convenience of choosing their start time. Good communication with a personal touch is key. Using a mobile chat application is an efficient way to advertise shifts, answer queries and confirm bookings. The locums valued the ease of communication with a clinical contact who would liaise and book shifts with medical staffing on their behalf. Locum doctors and local trainees appreciated a clinical person who could relate to them overseeing the WP–rota. Co–ordinating the WP–rota takes commitment and personal time for the trainee lead – we suggest allocating 4 hours’ admin time each fortnight for this. Taking on this role improves a trainee’s leadership and management experience.