Minimal to no support in hours, worse out of hours. One of the busiest acute takes in the NW, frequently >30 patients referred to medics to clerk in ED. SHO holds the met bleep. Registrar is often too busy to assist unless it’s a cardiac arrest call. Consultants do not provide daily input on to wards (maximum 1/ week). Have been to about 3 clinics all year. No ward cover SHO therefore FY1s left alone to try to manage wards out of hours. Silver lining is the education department who organises local teaching- have about 1 day per month of local teaching which is very good quality with excellent SIM and theory teaching and the only asset to whiston hospital.