This ED is split between Resus/majors, urgent care centre(mixed in with minor injuries) and paediatrics. This department also heavily relies on locum doctors (FY3+) and without these locums, this ED would simply collapse and not cope. There's hardly any training doctors at middle grade, only 1-2 ST regs and the rest of the "regs" are either SAS or promoted without actually doing a training programme....i wonder why..Lots of junior doctors from abroad work here too and sad to say, their clinical acumen is also not great. The locums are given a lot of responsibility to deal with resus patients on their own and to be fair are more competent than some of the seniors in this dept. Resus/majors is always busy, lots of interesting casemix but also a lot of timewasters and frustratingly, lots of patients who can't speak english. Senior clinical acumen overall is poor and I wouldn't trust a lot of them with my relatives. Triaging is a bit of a mess and consultants don't see patients and decision making from a lot of the seniors is highly questionable to the point where many of my junior colleagues and I will avoid certain people to discuss cases with. Some of the sisters in charge are also a pain to work with as they can be rude and moan about breaches to the doctors. They don't care about patient safety, just about the 4 hour target. Urgent care centre is also busy and is staffed with doctors and ENPs. The ENPs are great with minor injuries and minor ailments. Again, lots of dinosaurs in this department who I would not trust to discuss a case with. Overnight, support is very poor and mainly staffed with F2s and GPST1s overnight. Paediatrics. Staffed with ANPs mostly with doctors coming in to help when the dept is overwhelmed. The nurses and ANPs are good and experienced however. Royal blackburn hospital is also associated with burnley urgent care centre which i will just say to avoid completely. Too many seniors there just don't care and waiting times are a joke. Overall, the staff are friendly and even though there are some drama amongst the staff, there is a family feel to it. However, my points above stand and after working in several other ED depts in the north west, I will never come back to work here again.