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Hospital at Night



Hospital at Night (H@N) is a multiprofessional approach to delivering care at night and during the out of hours period, with the aim of providing safe and effective care to our patients.

A national initiative, initially devised as a new way of working to manage out of hours care in response to the reduction in junior doctors’ hours required by the European Working time directives. The H@N team at Russell’s Hall Hospital, remains a fairly new concept, having been established in August 2019.

After working in the Trust for in excess of 30 years, I am honoured to be part of this fantastic initiative, ensuring the delivery of safe effective care to our patients during the out of hours period.

Donna Bissell
Advanced Clinical Practitioner
Hospital at Night Team

Hospital at Night


The team currently consists of;

Eight senior members of staff from a variety of  multiprofessional backgrounds, including nursing and paramedic science. The team primarily provides cover to adult inpatient clinical areas.  Working 12-hour shifts.

The team provides clinical cover from 17:00 to 07:30 Monday to Friday, and from17;00 on Friday. Cover is available 24 hours per day through to 07:30am Monday morning. 

Additionally, the team provides 24-hour cover during all public holidays. Ideally there will be a minimum of two team members on duty overnight and one member during weekend days and public holidays.

Hospital at Night


The role requires the team members to undertake a 3-year programme of study at Masters level in advanced clinical practice. The team members are therefore at varying stages along the advanced clinical practice programme.

Those undertaking the MSc are referred to as trainee Advanced Clinical Practitioners (tACP’s) and those who have completed the course are referred to as Advanced Clinical Practitioners (ACP’s).

The team led by the Director of Medical Education and also has a team lead. The team remains accountable to the Medical Director. Whilst the team consists of eight senior staff members, seven tACP’s and an ACP, there are plans to recruit a further two team members imminently.

The team are contactable via the nerve-centre messaging service


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  • The tACP/ACP will work closely with junior and senior medical, allied healthcare professionals and nursing staff out of hours.

  • Undertake advanced clinical assessment, determine clinical diagnosis, decision making and treatment of in-patients and acutely unwell or deteriorating patients.

  • The team members are Advanced Life Support (ALS) providers and are members of the Medical Emergency team (MET) out of hours (OOH).
  • Work alongside the Multi-disciplinary team (MDT) to ensure onward referrals/pathways are managed appropriately.

  • Facilitate and support management of deteriorating patients, working closely with Critical Care Outreach Team (CCOT).

  • To identify and review information available to determine and plan the patient’s clinical management, providing advice and reassurance to nursing staff on duty.
  • Take an integral role in the medical handover at night, during weekends and public holidays.
  • Participate in quality improvement strategies in support of evidence-based practices.

  • Assist with challenging clinical tasks when ward staff encounter difficulties ie, venepuncture, cannulation, naso-gastric tube insertion, catheterisation of male and female patients.

  • Undertake other clinical tasks including ABG, Verification of death and prescribing of medication (Upon completion of Non-Medical Prescribing course).


Further information and resources about the Hospital at Night Team

Below are some useful website links.

Hospital at Night: A organisational design that provides safer care at night. 

Multi-professional framework for advanced clinical practice in England

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