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Objectives:To analyse the completeness and accuracy of the written handover in our ENT department, in line with Royal College of Surgeons of England guidance, and to improve standards.Setting:University Hospital, Cumberland Infirmary, Carlisle, UK.Methods and results:We prospectively analysed the written handover over two periods (of 30 and 18 days each). In the first period, the morning handover was present and complete on 77 per cent of days, present but incomplete or illegible on 6 per cent of days, and absent on 17 per cent of days; the evening handover was present and complete on 30 per cent of days, and absent on 67 per cent of days. To improve standards, we emphasised the importance of accurate handover to the ENT team and to junior doctors who cross-covered ENT. A reminder of the Royal College of Surgeons of England guidance was included in the handover book, and junior doctors received regular feedback.Conclusion:We demonstrated a substantial improvement in the quality and completeness of written handover, comparing the second and first audit periods. [ABSTRACT FROM PUBLISHER]