Which way forward for the care of critically ill children?


In January 1994 an Executive Letter (EL(94)10) was issued which referred to a report of a working party on the Care of Critically Ill Children convened by the British Paediatric Association (BPA). This report recommended several major changes including an increase in the number of Paediatric Intensive Care facilities, larger units, and more specialist trained nurses.

In December 1993 CRD was asked by the Department of Health to review the BPA report in the light of the available research evidence.


There is a significant diversity of professional opinion over detailed recommendations in this area. This reflects the lack of reliable research evidence. The available evidence does not allow significant statements to be made about the best way to organize, staff and otherwise resource the care of critically ill children. Of particular note is the lack of British research in this area.

Change should be informed by better information based upon comprehensive and accurate data collection. Units currently providing regular care for critically ill children should collect standard outcome and severity data. This will allow a more informed discussion of possible variations in the survival of children between units. Change in the care of critically ill children should be carried out in a controlled manner which can be evaluated and options for change should be subjected to critical scrutiny and be adequately costed. It is our view that, while the BPA report is a useful source of information and summarises the views of a range of professional groups, it does not constitute sufficient basis for determining national or local policy for the care of critically ill children in Britain.

Conducted by: CRD


NHS Centre for Reviews and Dissemination. Which way forward for the care of critically ill children? CRD Report 1. York: University of York. 1995


Commissioned by the NHS Executive