Spotlight on local innovation: on-call ward allocations in Blackpool

When I first started working at Blackpool Victoria Hospital, one thing quickly became clear: the sheer size and layout of the hospital posed a real challenge during on-call shifts. With three floors, long corridors and multiple branches, getting from one end to the other could feel like a marathon – especially when patients needed urgent reviews.

Previously, ward allocations for on-call resident doctors weren’t arranged geographically. This meant that during a busy evening, a doctor could be called to review a patient on one side of the hospital, only to be needed moments later at the opposite end. Time-sensitive jobs, like falls reviews, were often delayed and some tasks had to be handed over to the night team because priorities elsewhere took precedence. It wasn’t ideal for patient care, and it certainly wasn’t efficient.

I wanted to take a closer look at how we could improve this system. The idea was simple: what if we split the wards geographically? That way, each doctor would cover patients in a defined area, reducing wasted time spent walking and allowing us to respond faster to urgent jobs.

But it wasn’t just about dividing the hospital into neat sections. I also considered which wards had higher acuity patients, which were busiest out of hours and where outliers tended to be placed. Using feedback from colleagues and my own experience, I created a new allocation system that grouped wards logically and shared outlier wards more evenly between bleeps.

The results spoke for themselves. After trialling the new system, 17 out of 20 colleagues said the new ward groupings were an improvement and 16 out of 20 felt the splitting of outlier wards was better. With such positive feedback, the changes were adopted as a formal part of our on-call arrangements.

Improving these processes was essential for patient safety and staff wellbeing. When systems are clear and reliable, the risk of clinical errors decreases, communication improves and patients receive safer, higher-quality care. At the same time, staff feel supported and less stressed, which boosts morale and retention.

This project reminded me how small changes can make a big difference – not just for us as clinicians, but for the patients we care for. By reducing time spent walking and improving response times, we’ve made on-call shifts more efficient and safer for everyone.

Lessons learned

• Engage people early: involving clinicians, administrative teams and support staff from the start ensures practical solutions and strong buy-in.
• Start small: piloting changes before full rollout helps identify issues and refine processes.
• Communicate clearly and often: regular updates maintain momentum and address concerns quickly.
• Balance safety and wellbeing: improvements should enhance patient care while supporting staff experience.
• Use data to guide decisions: monitor outcomes and feedback to demonstrate impact and adjust as needed.
• Celebrate success: recognising achievements motivates teams and reinforces the value of change.

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