Facing the Future: A Briefing on the 5th Edition Standards for Children and Young People in Emergency Care

Executive Summary

This document provides a comprehensive briefing on the 5th Edition of the Facing the Future: Standards for children and young people in emergency care, published in October 2025. The standards serve as an evidence-based resource for driving improvements in the quality and provision of emergency care for all individuals under 18 years of age (1, 12). The new edition addresses the significant pressures on the paediatric emergency care system, including increased demand, insufficient resourcing post-COVID-19, and the need for a more integrated, whole-system approach to Urgent and Emergency Care (UEC) (4).

Key Takeaways for Emergency Department (ED) Clinicians:

Integrated Care and ED Crowding: The standards strongly advocate for a "whole pathway" approach, developing robust alternatives to ED attendance to protect capacity. Almost 40% of paediatric ED attendances are classified as "non-urgent" (22). EDs must have escalation policies to manage surges and crowding, recognised as a "whole system" issue requiring measures to manage patient input, throughput, and output (47, 48).
Critical Timelines and Assessments:
- Triage: A formal triage process, including a full set of vital signs for medically unwell or significantly injured patients, must be undertaken within 15 minutes of arrival. A rapid prioritisation system is required if this timeframe is breached.
- Full Assessment: A clinical decision maker must complete a full assessment within a median time of 60 minutes of arrival, prioritised by clinical urgency.
- Pain Management: Analgesia for moderate to severe pain must be dispensed within 20 minutes of arrival, with a pain score reassessed within 60 minutes.
Workforce and Wellbeing: The standards mandate specific staffing competencies, including a minimum of two registered children’s nurses on shift in EDs treating children and young people (CYP) (83). The importance of a multidisciplinary team (MDT), including play specialists and youth workers, is emphasised. Sustainable working practices and staff wellbeing are highlighted as critical for recruitment and retention, with a recommendation for every ED to have a lead for wellbeing (94).
Mental Health Crisis: Acknowledging a significant increase in CYP presenting with mental health crises (164, 166), the standards require EDs to have clear pathways for assessment and management. This includes creating a low-stimulation environment, parallel assessment of physical and mental health needs, and access to CAMHS or liaison psychiatry advice 24/7. Legal frameworks regarding consent, capacity, and restraint must be understood and applied correctly.
Safeguarding: EDs are a critical touchpoint for safeguarding. The standards mandate lead clinicians for child protection, 24/7 access to safeguarding advice, and robust systems for identifying frequent attenders and those on a Child Protection Plan/Register (30, 31, 32). Review by a senior decision maker is required prior to discharge for any CYP with safeguarding concerns or specific injury patterns in non-mobile infants (33).
CYP with Complex Needs: A needs-based approach is required, utilising Emergency Care Plans (ECPs) and Health Passports to facilitate care. Reasonable adjustments, tailored communication tools, and senior decision-maker review are mandated to prevent diagnostic overshadowing and ensure equitable care (49, 198).

1. Introduction and Core Principles

The 5th Edition of the Facing the Future standards, published in October 2025, serves as a contemporary reference point for improving the quality and provision of emergency care for Children and Young People (CYP) (9). The document is intended as a tool for healthcare professionals, managers, and service planners to plan, deliver, and quality-assure paediatric emergency services (10). It is endorsed by an intercollegiate committee including the Royal College of Emergency Medicine (RCEM), Royal College of Paediatrics and Child Health (RCPCH), Royal College of Nursing (RCN), and others.

1.1. Rights-Based Approach to Care

The standards are underpinned by the United Nations Convention on the Rights of the Child (UNCRC), which defines a child as anyone under 18 (12). This approach ensures that the physical, emotional, and psychological wellbeing of CYP is central to all healthcare procedures. It supports the rights of CYP to be listened to, respected, and involved in decisions that affect them (16, 17).

1.2. Scope and Setting

These standards apply to all Emergency Departments (EDs) seeing CYP, from large standalone paediatric EDs to smaller mixed EDs in district general hospitals (18). While acknowledging that smaller EDs may face challenges in meeting every standard, the document is intended to drive improvements across all settings and encourage a consistent quality of care for all CYP accessing emergency services.

2. An Integrated Urgent and Emergency Care System

A core theme of the standards is the need to move beyond siloed working towards a genuinely integrated UEC system. This requires collaboration between primary care, community services, ambulance services, and hospitals to ensure CYP receive coordinated care at the right time and in the right place (29, 30).

2.1. Managing Demand, Crowding, and Surge Capacity

ED crowding is an internationally recognised problem with adverse effects, including increased morbidity, clinical errors, and staff burnout (44, 45). The standards define crowding as a "whole system" issue and outline a tripartite approach to its prevention and management (47, 48).

Approach	Key Measures
Input Management	• Established criteria for redirection to alternative care settings like Urgent Treatment Centres (UTCs) (53).<br>• Co-working practices between UTCs and EDs to provide mutual support.
Throughput Management	• Adequate medical and nursing staff to cope with at least 80% of predicted maximum demand.<br>• Systems for rapid assessment and treatment (RAT) or 'team triage' models (50, 51).<br>• Access to point-of-care testing and rapid laboratory services.
Output Management	• Timely transfer of admitted patients to an inpatient ward within one hour of being clinically ready to proceed (52).<br>• Effective real-time hospital bed management and continuous flow systems.<br>• Access to ambulatory care models like clinical decision units or Hospital at Home services.

2.2. Alternatives to ED Attendance

To protect ED capacity, the development of robust alternative UEC services is essential. These include:

Digital First Approaches: Web-based or telephone decision support tools (e.g., NHS 111) and clinician-led Clinical Advisory Services (CAS) can support home management and appropriate service redirection (31).
Community-Based Services: Models like child health GP hubs, which facilitate closer working between GPs and consultant paediatricians, can reduce ED attendances (33). The expansion of mental health hubs and community diagnostic hubs also plays a key role (35).
Same Day Emergency Care (SDEC): Paediatric SDEC services provide an alternative to hospital admission by assessing, investigating, and diagnosing patients on the day of arrival (37, 38).

3. Workforce, Training, and Wellbeing

A skilled, resilient, and well-supported multidisciplinary workforce is fundamental to delivering high-quality paediatric emergency care.

3.1. Clinical Staffing and Competencies

Paediatric Emergency Medicine (PEM) Consultants: PEM consultants, trained via RCEM or RCPCH pathways, bring specialised expertise in undifferentiated paediatric presentations. Their distribution across the UK is uneven, and the standards call for this variation to be reduced to ensure equitable care (69). Job plans should reflect the intensity of the work, with a recommended minimum of two Programmed Activities (PAs) for Direct Clinical Care (DCC) in PEM (85).
Paediatric Emergency Nursing: Nurses, including Emergency Nurse Practitioners (ENPs) and Advanced Nurse Practitioners (ANPs), are integral to UEC. In mixed EDs, nurses caring for CYP must maintain competencies outlined in the RCN National Curriculum (70, 71).
Minimum Staffing Standards (Standard 11): All EDs treating CYP must always have staff on duty with paediatric competencies for managing critically ill and injured CYP. This includes:
- At least one senior clinician with Advanced Paediatric Life Support (APLS) or equivalent on duty at all times.
- At least one senior registered children’s nurse (Band 6 or above for larger units) with APLS or equivalent on each shift.
- A minimum of two registered children’s nurses on shift in any ED treating CYP (83).

3.2. The Multidisciplinary Team (MDT)

An effective MDT is crucial for delivering integrated care (74). Key roles highlighted include:

Play Specialists (Standard 17): Every ED caring for CYP must have access to a play specialist service. Their role includes providing distraction therapy, helping to create a child-friendly environment, and advising on the needs of CYP with complex conditions (76, 77).
Youth Workers: Embedding youth workers within the ED team facilitates a public health approach to complex issues like violence and substance abuse, as demonstrated by the Redthread program at King’s College Hospital (79, 80).

3.3. Staff Wellbeing

The high-pressure ED environment puts staff at risk of burnout and moral injury (94). The standards advocate for a working environment that actively promotes wellbeing.

Every ED should have a lead for wellbeing, with allocated time for the role.
Rota design should follow principles of sustainable working, particularly addressing the challenges of late and overnight working for senior staff (96).

4. Clinical Management of the Sick or Injured Child

This section outlines the core clinical standards for the assessment, treatment, and discharge of CYP in the ED.

4.1. Arrival and Initial Assessment

Observation: The arrivals area must be monitored to allow for rapid recognition of a seriously unwell child. All new arrivals must be kept in view while waiting (100).
Triage (Standard 18): A formal triage assessment by a trained professional with paediatric competence must occur within 15 minutes of arrival. For medically unwell CYP or those with significant trauma, this must include a full set of vital signs, weight, and a pain score (103).
Paediatric Early Warning System (PEWS): A PEWS should be used to detect deteriorating vital signs and identify CYP requiring escalation, such as those with potential sepsis (109). An ED National PEWS (NPEWS) is being rolled out across the UK. Abnormal vital signs at triage must be repeated within 60 minutes or sooner based on clinical need (Standard 21) (107).

4.2. Full Assessment and Treatment

Assessment Timing: A full assessment by a clinical decision maker with paediatric competence should be completed within a median time of 60 minutes across all presentations, or earlier depending on triage category (114).
Pain Management (Standard 25): For moderate and severe pain, analgesia must be dispensed within 20 minutes of arrival. The patient's pain score should be reassessed and acted upon within 60 minutes (111). Validated pain assessment tools, such as the FLACC (Face, Legs, Activity, Cry, Consolability) scale for children with cognitive impairment, should be used (205, 206).
Airway Management: Given that hypoxaemia and airway complications are frequent causes of cardiac arrest in CYP, EDs must have appropriately sized advanced airway equipment, including waveform capnography, and clear escalation pathways for anticipated difficult airways (123, 125, 126).

4.3. Safe Discharge

Senior Review (Standard 26): Policies must be in place to determine which CYP require review by a senior decision maker before discharge. Examples include:
- CYP with fever under 3 months of age.
- Those with persistently abnormal observations on a PEWS chart.
- CYP re-presenting with the same illness/injury.
- CYP with complex needs.
- Non-mobile infants (<12 months) with fractures, burns, or bruising.
- Any case with parental disagreement with the discharge plan or safeguarding concerns.
Safety Netting: CYP and their parents/carers must be provided with specific verbal and written safety netting advice in an accessible format, including when and where to seek further care (133).

5. Safeguarding in Emergency Care Settings

UEC settings are often the first point of contact for CYP at risk of abuse or neglect. All healthcare organisations have a statutory requirement to safeguard and promote the welfare of CYP (136).

5.1. Key Safeguarding Systems and Responsibilities

Leadership (Standard 29): All EDs must have a lead consultant and a lead nurse with shared responsibility for child protection.
Information Sharing (Standard 30): Information from a Child Protection Plan (England) or Register (other UK nations) must be available to relevant professionals 24/7. This is facilitated by systems like the Child Protection Information Sharing (CPIS) system in England (157).
Expert Advice (Standard 31): Staff must have 24/7 access to safeguarding advice from a paediatrician with adequate child protection expertise.
Frequent Attenders (Standard 32): Systems must be in place to identify and respond appropriately to CYP who attend UEC settings frequently. A two-tier trigger approach is suggested to identify both acute illness and longer-term safeguarding patterns.
High-Risk Presentations (Standard 33): CYP at risk of significant harm (e.g., those on a protection plan, non-mobile infants with injuries like bruising or fractures) must be reviewed by a senior decision maker before discharge.
Communication (Standard 34): GPs and other relevant community health team members must be informed of a CYP's attendance at a UEC setting.

5.2. Clinical Tools and Learning Aids

ICON: A charity and website providing advice to support parents and carers with infant crying. The mnemonic stands for: Infant crying is normal; Comforting methods can help; Ok to walk away; Never shake a baby.
Safeguarding Reflection Sessions: The practice example from Alder Hey Children’s Hospital highlights the value of monthly MDT reflection sessions to discuss challenging cases, share learning, and strengthen relationships between ED and safeguarding teams.

6. Mental Health in the Emergency Department

The standards address the escalating crisis in CYP mental health, with EDs increasingly managing patients with acute mental health concerns due to insufficient capacity in community and inpatient CAMHS (167, 176).

6.1. Challenges and System Pressures

Rising Demand: In 2023, 20% of CYP aged 8-16 had a probable mental disorder, up from 13% in 2017 (164). CAMHS saw a 53% increase in crisis presentations between 2020-2024 (166).
Long Waits in ED: Reports show many CYP wait over 12 hours in the ED to be seen by a mental health professional, with some waiting up to 5 days, due to a mismatch between demand and service capacity (177, 178).

6.2. ED Management Principles

Environment: EDs should provide a quiet, low-stimulation space for CYP in mental health crisis to minimise distress and manage risk. Audio-visual separation from the main department is recommended.
Parallel Assessment: Physical and mental health needs must be assessed and managed in parallel to prevent disjointed care. A full physical examination is required for first-time presentations to exclude organic pathology.
Self-Harm: CYP who have self-harmed require assessment by a trained professional to understand their needs and risks (129). Principles from the Children Act 1989 and Mental Health Act 2007, alongside Gillick competence, are critical (iii).
Restraint: De-escalation techniques should be used first. Pharmacological and physical restraint is a last resort, must be proportional, and conducted according to clear local guidelines by trained staff (186).
Legal Frameworks (Standard 45): ED staff must be trained in relevant legislation, including the Mental Health Act 1983 (and any subsequent updates), the Children Act 1989, and the Mental Capacity Act 2005.
Section 136 MHA: EDs must have a clear pathway for managing CYP brought in under a Section 136 order to an identified place of safety, in line with local policy (Standard 44) (188).

7. Care for CYP with Complex Needs

This chapter promotes a needs-based, rather than diagnosis-based, approach for CYP with medical complexity, learning disabilities, or neurodivergence.

Identification and Planning (Standard 48): Systems should be in place to "flag" CYP with complex needs. Staff must check for an Emergency Care Plan (ECP), which details specific medical management, or a Health Passport, which outlines communication and sensory needs.
Reasonable Adjustments (Standard 50): EDs must make reasonable adjustments to ensure equitable care (198). This includes providing accessible information and communication tools, such as tailored pain assessment tools, interpreters, and visual aids.
Senior Review (Standard 49): Systems must be in place to enable escalation for review by a senior decision maker when treating a CYP with complex needs.
Avoiding Diagnostic Overshadowing: Clinicians must be vigilant against attributing new signs and symptoms (e.g., behavioural changes) to a patient's underlying condition without seeking alternative diagnoses like pain or infection. Listening to parents and carers, who are experts in their child's baseline health, is paramount.
Training (Standard 52): All ED staff should receive training in managing CYP with complex needs, including the Oliver McGowan Mandatory Training on Learning Disability and Autism (208).

8. Health Improvement and Health Inequalities

The ED is a key setting for public health interventions, as it disproportionately serves CYP from deprived backgrounds who are 58% more likely to attend than their least deprived peers (213).

8.1. The ED Consultation as a Public Health Opportunity

Screening Tools: Biopsychosocial assessment tools like HEEADSSS (Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Suicide and Safety) or Not Just a Thought can be used to screen for risks. Web-based apps allow young people to complete these privately while waiting (232, 233).
Key Public Health Issues: Clinicians should be prepared to offer brief advice and signposting on:
- Disordered Eating: The obesity gap between the most and least deprived children is widening (Figure 1).
- Vaccinations: Rates of vaccine uptake have been falling, contributing to outbreaks of measles and pertussis (226).
- Violence Reduction: Refer young people affected by violence to Youth Navigator or support worker services (221).
CYPSAR: Children and young people seeking asylum and refugees (CYPSAR) are entitled to the same healthcare as UK nationals. EDs must have access to interpreters 24/7 and clear pathways for assessment and referral (234, 235).

9. Major Incidents, Transfers, and End-of-Life Care

9.1. Major Incidents

Planning (Standard 62): CYP must be specifically included in strategic and operational major incident plans, with adaptations for triage, clinical capacity, and mental health support (244). All hospitals should have a written major incident plan and use action cards to reduce cognitive load.
Training (Standard 63): All healthcare workers with a role in a major incident response must be involved in appropriate training and exercises. In-situ simulation is a valuable tool for testing plans.

9.2. Safe Transfers

Paediatric Critical Care Transport Service (PCCTS) (Standard 65 & 66): Each region must have a PCCTS with a dedicated 24-hour referral line for clinical advice and coordination of retrievals for critically ill or injured CYP.
Time-Critical Transfers (Standard 67): For conditions like severe head injury, local hospital staff may need to transfer the CYP to avoid delay. Such decisions require consultant-to-consultant discussion between the referring hospital and the PCCTS. Local facilities must have appropriate staff and equipment readily available.
Intra-Hospital Transfers (Standard 70): Admitted patients who are clinically ready should be transferred from the ED to a ward within one hour (52). Checklists and simulation exercises should be used to test intra-hospital transfer systems.

9.3. Death of a Child in the ED

Procedures (Standard 72 & 73): Clear, agreed local guidelines must be in place for managing the unexpected death of a CYP, covering procedures for resuscitation, police and coroner involvement, pathology sampling, and the child death review process (271, 278).
Family Support (Standard 75): Bereaved parents/carers must be supported sensitively and provided with an information pack before leaving the ED, including details on registering the death, the child death review process, and bereavement support services.
Adolescents: All processes and standards apply to CYP up to their 18th birthday, regardless of whether they are seen in a paediatric or adult ED.

10. Information Systems and Research

10.1. Information Systems and Data

Integrated Records: The standards advocate for integrated shared health records that communicate between EDs, primary care, and social services (294).
Data Disaggregation (Standard 80): All health organisations must collaborate with information programmes to disaggregate data for CYP, allowing for informed service planning. This is especially critical in mixed EDs.
Emergency Care Data Set (ECDS): EDs in England are required to provide reports compliant with the ECDS, a SNOMED-CT compliant dataset (298).

10.2. Research

PERUKI (Standard 81): The Paediatric Emergency Research in the UK and Ireland (PERUKI) network is highlighted as a key collaborator for developing high-quality, multicentre PEM research (313). EDs that are Paediatric Major Trauma Centres, are university-affiliated, or have a dedicated PEM consultant should be in good standing with PERUKI.
Knowledge Translation (Standard 82): All EDs treating CYP should review published research and consider how it can inform quality improvement and be implemented in practice.

Abbreviations

Abbreviation	Full Term
ANP	Advanced Nurse Practitioner
APLS	Advanced Paediatric Life Support
CAMHS	Child and Adolescent Mental Health Service
CPIS	Child Protection Information Sharing
CYP	Children and Young People
ECDS	Emergency Care Data Set
ECP	Emergency Care Plan
ED	Emergency Department
ENP	Emergency Nurse Practitioner
GIRFT	Getting It Right First Time
HEEADSSS	Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Suicide and Safety
ICB	Integrated Care Board
MDT	Multidisciplinary Team
MHA	Mental Health Act
MTC	Major Trauma Centre
PCCTS	Paediatric Critical Care Transport Service
PEM	Paediatric Emergency Medicine
PERUKI	Paediatric Emergency Research in the UK and Ireland
PEWS	Paediatric Early Warning System
RCEM	Royal College of Emergency Medicine
RCPCH	Royal College of Paediatrics and Child Health
RCN	Royal College of Nursing
SDEC	Same Day Emergency Care
UEC	Urgent and Emergency Care
UTC	Urgent Treatment Centre

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Information from a Child Protection Plan/Register is available to relevant professionals working in UEC settings 24/7, preferably through shared secure electronic information systems, or alternatively via a duty social worker
All staff working in UEC settings have access to safeguarding advice 24/7 from a paediatrician with adequate child protection expertise
Systems are in place to identify and respond appropriately to CYP who attend UEC settings frequently
CYP whose presentation indicates that they are at risk of significant harm (e.g. those on a Child Protection Plan/Register, non-mobile infants presenting with injuries such as bruising, burns or fractures, or perplexing presentations including potential Fabricated or Induced Illness) must be reviewed by a senior decision maker with the necessary competencies prior to discharge
GPs and other relevant members of the community child health team (midwife/ health visitor/school nurse/children’s community nurse/named social worker/ specialists) are informed of the attendance of a CYP (including care leavers) at a UEC setting within an agreed time frame
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Child and Adolescent Mental Health Services (CAMHS) saw a 53% increase from 2020-2024 in the number of CYP presenting in mental health crisis and needing emergency support166 [Reference in source text lacks full citation detail]
Patients are waiting for an average duration of five months after GP referral and, in the worst cases, almost two years for a community mental health service appointment168 [Reference in source text lacks full citation detail]
This has resulted in a rise in UEC attendances and hospital admissions for CYP with significant mental ill health, attempted suicide, self-harm, and eating disorders164.. [Reference in source text lacks full citation detail]
Reports show that many CYP are waiting over 12 hours from arrival before being seen by a mental health professional, with some reporting waits of up to 5 days177 [Reference in source text lacks full citation detail]
This increase in the length of wait from time of arrival in ED is due to a number of factors, including the lack of uniform provision of 24/7 mental health services for CYP, an increased complexity in presentations requiring multi-agency support, poor patient flow through hospitals and a significant mismatch between the demand for, and capacity to provide, mental health services. This subsequently manifests as prolonged waits for CAMHS assessment, a Mental Health Act assessment or the availability of a bed in a mental health ward178 [Reference in source text lacks full citation detail]
NICE. 2022. Self-harm: assessment, management and preventing recurrence. Available at: https://www.nice. org.uk/guidance/ng225
iii Healthcare professionals who have contact with CYP who have self-harmed should understand how to apply the principles of: -Children Act 1988 -Children and families Act 2014 -Mental Health Act 2007 (With regards to safeguarding children, capacity to consent/ Gillick Competence, Scope of Parental Responsibility & use of Section 5(2) or 5(4) based on ED setting/ Paediatric ward setting) [NICE. 2022. Guidelines: Self-harm: assessment, management and preventing recurrence. Available at: https://www.nice. org.uk/guidance/ng225)
Department of Health (Northern Ireland). 2023. Regional policy on the use of restrictive practices in health and social care settings. [online] Belfast: Department of Health. Available at: https://healthallianceni.com/ site/wp-content/uploads/2023/08/Regional-Policy-on-the-use-of-Restrictive-Practices-in-Health-and-Social-Care-Settings.pdf
Section 136 of the Mental Health Act 1983 (MHA 1983)188 applicable to England gives police the legal power to a) remove an individual to a place of safety... [Reference in source text lacks full citation detail]
NCMD. 2024. Learning from deaths: Children with a learning disability and autistic children aged 4 - 17 years. Available at: https://www.ncmd.info/wp-content/uploads/2024/07/NCMD-Learning-disability-and-autism-report_FINAL.pdf
The Oliver McGowan Mandatory Training on Learning Disability and Autism208 [Reference in source text lacks full citation detail]
Nuffeld Trust. Admissions of inequality: emergency hospital use for children and young people. 2017. Available at: https://www.nuffieldtrust.org.uk/research/admissions-of-inequality-emergency-hospital-use-for-children-and-young-people
Smyth, Walsh. 2024. Inside ‘HEEADSSS app’: what a psychosocial risk assessment tool can reveal and the importance of quality improvement initiatives in promoting its use. Available at: https://adc.bmj.com/ content/109/Suppl_1/A91.1
Iora, P., James, D., Patel, S. 2022. The HEEADSSS app: a service evaluation of the psychosocial screening app in young people. ADC. Available at: https://www.researchgate.net/publication/362756018_359_The_ HEEADSSS_app_a_service_evaluation_of_the_psychosocial_screening_app_in_young_people
UK Health Security Agency. 2019. Increasing vaccine uptake: Strategies for addressing barriers in primary care. Available at: https://ukhsa.blog.gov.uk/2019/05/16/increasing-vaccine-uptake-strategies-for-addressing-barriers-in-primary-care/
Youth Endowment Fund. 2025. A&E Navigators. Available at: https://youthendowmentfund.org.uk/toolkit/ae-navigators/
Refugee Council. 2025. Find a service. Available at: https://www.refugeecouncil.org.uk/get-support/services/
RCPCH. 2025. Children and young people seeking asylum and refugees - guidance for paediatricians. Available at: https://www.rcpch.ac.uk/resources/refugee-asylum-seeking-children-young-people-guidance-paediatricians#general-information
NHS England. 2022. NHS Emergency Preparedness Resilience and Response Framework. Available at: https://www.england.nhs.uk/wp-content/uploads/2022/07/B0900_emergency-preparedness-resilience-and-response-framework.pdf
All health care workers with a role in a major incident response must be involved in appropriate training and incident exercises
Each region has a Paediatric Critical Care Transport Service (PCCTS)
The regional PCCTS has a dedicated 24-hour critical care referral phone line providing clinical support and advice, and coordinating retrievals and transfers for critically ill or injured CYP
Local hospital facilities have appropriate staff and equipment readily available for time-critical inter-hospital transfers
All EDs should have appropriate guidelines and checklists in place to safely manage intra-hospital patient transfers
HM Government. 2018. Child death Statutory and Operational Guidance (England). Available at: https:// assets.publishing.service.gov.uk/media/637f759bd3bf7f154876adbd/child-death-review-statutory-and-operational-guidance-england.pdf
The Royal College of Pathologists and RCPCH. 2016. Sudden Unexpected Death in Infancy and Childhood. Available at: https://www.rcpath.org/static/874ae50e-c754-4933-995a804e0ef728a4/Sudden-unexpected-death-in-infancy-and-childhood-2e.pdf
Before leaving the ED, bereaved parents/carers should be provided with an information pack...
RCPCH. 2025. Available at: Putting child health at the centre of the Children’s Wellbeing and Schools Bill. Available at: https://www.rcpch.ac.uk/news-events/news/putting-child-health-centre-childrens-wellbeing-schools-bill
All health organisations providing UEC to CYP must collaborate with national or regional information programmes to disaggregate data for CYP...
NHS England. 2025. Emergency Care Data Set (ECDS). Available at: https://www.england.nhs.uk/ourwork/tsd/ ec-data-set/
Lyttle MD, O'Sullivan R, Hartshorn S, Bevan C, Cleugh F, Maconochie I. 2014. Pediatric Emergency Research in the UK and Ireland (PERUKI): developing a collaborative for multicentre research. Archives of Disease in Childhood. Available at: https://doi.org/10.1136/archdischild-2013-304998
All EDs that are Paediatric Major Trauma Centres, affiliated to a university or have at least one dedicated PEM consultant should be in good standing with PERUKI
All ED’s treating CYP should review published research and consider how it can inform quality improvement or be implemented in practice

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Emergency Care Standards for Children & Young People