Background The last decade has seen dramatic changes in the training needs and number of junior doctors in NNUs in the UK alongside the restriction of working hours – European Working Time Directive (EWTD). Consequently RCHT has introduced ANNPs working on the junior medical rota.

Methods 2 ANNPs replaced the two year 2 Foundation doctors (F2) releasing them for general paediatric experience. 2 further ANNPs then replaced the General Practitioner (GP) trainees. Tier 1 rota is now provided by a combination of three 1st or 2nd year paediatric speciality trainees (ST) along side the 4 ANNPs.

Results Junior doctors now comply with EWTD. The Royal College of General Practitioner (RCGP) guidance that GP trainees should not be working in NNUs is facilitated.

ANNPs have bridged the gap between the neonatal nurses and the medical staff with education, governance, and management roles.

ANNPs lead bedside education sessions for the medical students alongside developing a medical quiz and ‘Newborn Examination’ booklet that has been adapted by other medical schools. The ANNPs provide a unique ‘buddy’ system for ST trainees starting on the neonatal unit. They lead on the neonatal Simulation scenarios, and take part in the regional ‘Step up to Registrar’ neonatal simulation workshops.

The lead ANNP has been awarded the RCHT 2013 ‘Excellence and Innovation’ award.

Conclusion The advanced skills, knowledge and practice of the ANNPs has improved the quality of service provision along side enhancing the teaching and training of medical students and paediatric ST trainees.