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Background Sedation in paediatric diagnostic imaging is often essential to ensure good image quality and reduce anxiety or movement that may interfere with scan results. The Nurse-led Sedation Service (NLSS) was set up at Great Ormond Street Hospital (GOSH) in 1999 and was the first of its kind in the UK. To-date it remains the only UK paediatric sedation service to be fully Nurse-led. The NLSS offers a safer, lower-risk alternative to general anaesthetic (GA) for radiological imaging. As we know, paediatric health conditions have become ever-more complex in this time, leading to an increased number of children requiring surveillance or diagnostic imaging. Hence, a higher demand on the service.Aim Our objective was to increase the efficiency of the sedation lists, whilst maintaining patient safety, to allow more children to be offered a sedation slot rather than GA for their scans.Results To help increase efficiency we trialled new ways of utilising staff. Such as, staff members recovering more patients at once, and increasing the number of Nurse prescribers in the department to allow for multiple lists to be carried out simultaneously. We collected data from the previous 5 years and found a 58% increase in the number of sedated MRI scans carried out, a 37% increase in sedated CT scans, and a 31% increase in additional procedures such as lumbar punctures and auditory brainstem response testing. Overall, the figures demonstrate a 54% increase in the overall number of patients seen by the NLSS from 2019 to 2024. This change comes alongside just a 4% increase in staffing, equivalent to 0.5 WTE.Conclusion This demonstrates that with more effective use of staffing, the team were able to offer sedation to more patients with minimal impact on staffing levels, meaning the efficiency of the NLSS was successfully increased.