Editor,—The article by Beverley et al was most interesting in clearly detailing the planning and implementation of a successful day assessment unit in a general paediatric unit.1 We agree that short stay observation wards staffed by paediatricians are an appropriate development, but the authors have not presented sufficient evidence to show that such development was associated with a reduction in the number of acute referrals that require an overnight stay. The presence of a day assessment unit may be associated with an increase in the number of acute paediatric referrals that do not require overnight admission without greatly affecting the numbers of children who require a longer stay—that is, the generation of a new daytime paediatric workload that may be unnecessary. The authors do not mention follow up care in the home environment through home care nursing staff or primary care physicians, which might reduce the need for overnight stay in hospital or re-attendance in hospital. In addition, the authors compare their figures on referrals not admitted overnight with figures on “inappropriate” admissions from other units, suggesting that all these …