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Background The national newborn blood spot (NBS) screening programme is an early detection tool for certain rare congenital health conditions in newborns. It enables early diagnosis and treatment before the disease causes irreversible damage, aiming to reduce long-term health complications, prevent severe disability and death, and improve quality of life. A high number of avoidable repeats were identified at Great Ormond Street Hospital (GOSH) in 2024. Avoidable repeats can cause diagnostic and treatment delays, potentially causing harm to the newborn and requiring a repeat blood sample. A quality improvement (QI) project started in February 2025 aiming to reduce the NBS avoidable repeat rate from 42% to 10-20% by October 2025.Methods We used QI methodology (Model for Improvement) to conduct this project. Nurses’ confidence scores were captured ( figure 1) in a hospital-wide survey (n = 156) and qualitative feedback was collected, which we themed to design interventions. The intervention includes three resources: a blood spot box, a buddy card to reduce missing information on the collection card, and a flowsheet providing a quick overview of the process (images 1, 2 and 3). These resources were first tested in May 2025 in the Neonatal Intensive Care Unit. The just-in-time education theory supports the intervention’s effectiveness. The wider educational offer is being improved as part of this work, including updating and modernising the local e-learning module.Results Since the project began, the avoidable repeat rate has reduced from 42% to 18.5% ( figure 2). Further validation of the interventions will be measured by repeating the nursing confidence survey. The project team will ensure the improvements are sustained before closing the project.Conclusion Targeted interventions and just-in-time education have significantly reduced avoidable repeats in NBS screening at GOSH. Continued testing and education will support sustained improvement, enhancing patient safety and care quality for newborns.Abstract 37 Figure 1Top 5 lowest-confidence tasksAbstract 37 Figure 2Newborn blood spot avoidable repeat rateAbstract 37 Image 1Abstract 37 Image 2Abstract 37 Image 3