There are now more and more advertisements for ambulatory paediatricians. Ambulatory care is one of the popular new catch phrases within the National Health Service (NHS). Both the Tomlinson report and the King’s Fund document on health care in the capital, advocated the development of ambulatory services.1 2 A British Paediatric Association discussion document introduced ambulatory paediatrics as an option for future development.3 This document gave a broad definition of ambulatory paediatrics as being everything that is non-inpatient, and so included such diverse areas as community paediatrics, child guidance and counselling services, specialist clinic care, and primary care paediatrics. Ambulatory paediatrics is not a specialty but a philosophy and, to a large extent, many paediatricians are already operating an ambulatory service.4 In practice, however, what does ambulatory paediatrics mean, what is the role of an ambulatory paediatrician, and does ambulatory paediatrics make any difference?

I was appointed in 1993 as an ambulatory paediatrician. Working from a hospital base in a district general hospital setting, I share with my colleagues the inpatient load on the general wards and the special care baby unit, as well as the outpatient load. However, my prime responsibility is the development of the ambulatory service, which I have approached in the following way.