title: Review of paediatric cardiology services in district general hospitals in the United Kingdom.
abstract: Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals.
  
  
  OBJECTIVE
  To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom.
  
  
  METHODS
  An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone.
  
  
  RESULTS
  The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly.
  
  
  CONCLUSIONS
  There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.
authors.affiliation: 1Birmingham University Medical School,Birmingham,United Kingdom.
authors.forename: Hannah
authors.initials: H
authors.lastname: Andrews
authors.affiliation: 2Addenbrooke's Hospital,Cambridge University Hospitals NHS Foundation Trust,Cambridge,United Kingdom.
authors.forename: Yogen
authors.initials: Y
authors.lastname: Singh
mesh_terms: D002309:Cardiology; D004452:Echocardiography; D004562:Electrocardiography; D006769:Hospitals, General / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D000072143:Pediatricians / Q000600:supply & distribution*; D010372:Pediatrics; D011795:Surveys and Questionnaires; D017216:Telemedicine; D006113:United Kingdom; D000078329:Workforce
keywords: Paediatric cardiology services in district general hospitals; echocardiography; paediatricians with expertise in cardiology