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Emergency care for children—the next steps
  1. M W Cooke,
  2. K G G M Alberti
  1. Department of Health, London, UK
  1. Correspondence to:
    Professor M W Cooke
    Warwick Medical School, Coventry CV4 7AL, UK; m.w.cooke{at}

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Recommended steps for improved medical services to children and those needing urgent medical attention

In a typical year, around 25% of calls to National Health Service (NHS) Direct will be about a child; a pre-school child will see his or her general practitioner about six times; a child of school age will see his or her general practitioner two or three times; approximately 10% of walk-in centre attendances will be children; up to half of infants aged <12 months and one quarter of children over one year old will attend an emergency department (accounting for about one quarter of emergency department attendances); 1 in 11 children will be referred to an outpatients clinic; and 1 in 15 children will be admitted to hospital. Emergency care has undergone massive change in the past few years. Recent emphasis has been on reducing delays for patients, particularly in emergency departments of acute hospitals. At present, the focus is changing to wider issues of quality.

In June 1999, an intercollegiate working party of the Royal College of Paediatrics and Child Health, British Association of Accident and Emergency Medicine, British Association of Paediatric Surgeons, Faculty of Accident and Emergency Medicine, Royal College of Nursing and Royal College of General Practitioners was established. The terms of reference were to review emergency services for children and to make recommendations for future provision of these services. The subsequent report—Accident and emergency services for children—made 32 recommendations (representing minimum levels of care), which were to be implemented …

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  • Competing interests: None declared.

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