title: A re-audit of paediatric ENT services in England and Wales.
abstract: OBJECTIVE
  ENT has a high paediatric workload. National recommendations for provision of paediatric surgical services are provided by three key documents produced by the Department of Health and Royal Colleges of Surgeons and Anaesthetists. This second cycle audit assesses the current state of paediatric services in ENT departments in England and Wales based on these recommendations and whether progress has been made since the first audit in 2003.
  
  
  METHODS
  A hyperlinked web-based questionnaire was e-mailed to ENT consultants in 164 ENT departments. The questionnaire addressed key areas recommended in the guidelines - theatre and anaesthetic provisions, inpatient/outpatients facilities and staff training. The responses were categorised according to hospital type - teaching hospitals, large or small district general hospitals and specialist stand-alone hospitals.
  
  
  RESULTS
  An overall response rate of 56% was achieved. Children's ward facilities remained high across all types of hospitals, with most having dedicated paediatric medical cover and specialised staff. There was an improvement in the number of staff qualified to provide paediatric life support. The level of anaesthetic supervision and expertise in theatres improved, as did the overall level of post-operative management. However, the provision of acute pain services remained relatively low.
  
  
  CONCLUSIONS
  Overall there has been an improvement in the provision of paediatric surgical services in accordance with the guidelines but there remains variability in some aspects relating to the size of the hospital.
authors.affiliation: James Cook University Hospital, Marton Road, Middlesbrough, Cleveland TS4 3BW, United Kingdom. Electronic address: lakhpabla@doctors.org.uk.
authors.forename: L
authors.initials: L
authors.lastname: Pabla
authors.affiliation: James Cook University Hospital, Marton Road, Middlesbrough, Cleveland TS4 3BW, United Kingdom.
authors.forename: P
authors.initials: P
authors.lastname: Finn
authors.affiliation: James Cook University Hospital, Marton Road, Middlesbrough, Cleveland TS4 3BW, United Kingdom.
authors.forename: K J
authors.initials: KJ
authors.lastname: Blackmore
authors.affiliation: James Cook University Hospital, Marton Road, Middlesbrough, Cleveland TS4 3BW, United Kingdom.
authors.forename: D A
authors.initials: DA
authors.lastname: Bosman
mesh_terms: D002648:Child; D002662:Child Health Services / Q000592:standards / Q000706:statistics & numerical data*; D003695:Delivery of Health Care / Q000592:standards / Q000706:statistics & numerical data*; D004739:England; D006801:Humans; D008485:Medical Audit; D010036:Otolaryngology / Q000592:standards / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000592:standards / Q000706:statistics & numerical data*; D010820:Physicians; D011795:Surveys and Questionnaires; D014852:Wales
keywords: Guidelines; Otolaryngology; Paediatric; Questionnaire