Facing the Future: Standards for Acute General Paediatric Services

Facing the Future report cover

Facing the Future provides a vision of how paediatric care can be delivered to provide a safe and sustainable, high-quality service that meets the health needs of every child and young person.

On this page:

On other pages:

Facing the Future Audit 2017

This summer the RCPCH is auditing the updated Standards for Acute General Paediatrics Services. If your hospital has not received an invitation to join the audit, or if you would like to share practice examples where you are meeting standards particularly well, please contact us via facingthefuture@rcpch.ac.uk. The deadline for data collection is Monday 10th July 2017.

Facing the Future: Standards for Acute General Paediatric Services – 2015

Five years on from their original publication and in light of national health policy changes, changes to the way that healthcare professionals work and new research and evidence, the RCPCH has revised the standards. 

This report sets out ten standards for high quality, safe and sustainable acute general paediatric services. It is essential that paediatrics is a 24 hours a day, seven days a week specialty; with the most experienced doctors present at the busiest times.

The RCPCH believes that these standards will bring a level of consistency to what is currently quite a variable pattern of practice. The intention is to ensure that every child is seen in a timely manner by a suitably experienced doctor.

Facing the Future: Standards for Acute General Paediatric Services 2015 (PDF, 948KB, 25 pages)

Implementation plan

The standards cannot be met with the current workforce and the current number of inpatient units.

The five key recommendations made in the original report are even more crucial with these revisions to the standards:

  1. Reduce the number of inpatient sites
  2. Increase the number of consultants
  3. Expand significantly the number of registered children’s nurses
  4. Expand the number of GPs trained in paediatrics
  5. Decrease the number of paediatric trainees

The RCPCH has developed an implementation plan to support the implementation of the standards across the UK by:

  • Supporting and equipping members with the information and skills to influence at a local level
  • Supporting services to implement the standards
  • Encouraging services to work together in regional networks to implement the standards
  • Continuing discussions and negotiation between the RCPCH and key stakeholders at a national policy level

Facing the Future: Standards for Acute General Paediatric Services Implementation Plan 2015 (PDF, 134KB, 5 pages)

Facing the Future Audit

The College plans to carry out an audit of the standards across the UK in 2016/17. 

Facing the Future: Making standards a reality event

In November 2016, child health professionals from the College and NHS England came together to discuss the challenges and successes of implementing the standards - view the presentations.

Workforce implications

Facing the Future: Standards for Acute General Paediatric Services Workforce Implications (2015) (PDF, KB, pages) 

2013 report: Back to Facing the Future

Key findings:

  • Over three quarters (77%) of children see a paediatrician on middle or consultant grade rotas within four hours of admission - just under a quarter do not.
  • 88% of children or young people admitted to a paediatric department with an acute medical problem are seen by a consultant paediatrician (or equicalent) within the first 24 hours.
  • There is a disparity between care delivered during the day - just 11% (26% of self reported peak times) had a presence during the evening. During peak times at weekends consultant presence was just 6% (20% at self reported peak times).
  • Immediate telephone advice is not always available across some specialties - and arrangements are often informal.
  • There is a shortfall of staff across all rotas when measured against the Facing the Future standards.

To deal with the challenges facing the service, the College called for urgent service reconfiguration. Paediatric services needed to look at more innovative models of service provision, such as providing more care in the community, to deliver the best possible care to children and young people.

Back to Facing the Future: Executive summary (2013) (PDF, 1.06MB, 6 pages)

Back to Facing the Future: An audit of standards for acute paediatric care (2013) (PDF, 1.95MB, 69 pages)

2011 reports: Facing the Future

Facing the Future: Standards for Paediatric Services (2011) (PDF, 322KB, 13 pages) - Outlines 10 minimum standards for acute, general paediatric care. These standards are intended to support a safe and sustainable quality paediatric service for children and young people. Each standard is accompanied by an explanation of what the standard aims to achieve, and how the standard was agreed.

Facing the Future: A Review of Paediatric Services (2011) (PDF, 371KB, 50 pages) - Models the potential implications of these standards for paediatric services in the UK. It maps the current acute service configuration in the UK, which inadequately serves the current and future needs of children and young people.Facing the Future proposes possible solutions to these problems, and imagines three possible scenarios for the configuration of inpatient units.

The workforce implications of these scenarios are also explored and concludes that in order to deliver safe and sustainable services the current UK consultant workforce needs to expand from 3,084 WTE consultants to between 4,488 and 4,853 WTE consultants depending on which reconfiguration model is adopted. It also recommends the increased involvement of children’s nurses and GP trainees in some aspects of care. 

Quality and Safety Standards for Small and Remote Paediatric Units (2011) (PDF, 259KB, 8 pages) - Remote and rural areas account for over four fifths of the UK land mass and include up to a quarter of the UK population. Children and young people represent 22 percent of total rural populations. Due to distance and scattered populations, such areas face a diverse range of problems in the delivery of health services. RCPCH proposed the following standards to ensure the quality and safety of small and remote (S&R) paediatric units within the NHS. These have been developed by a working group of paediatricians for use locally and to support NHS commissioners in the provision of safe local health services for children and young people.


For more information about any of the publications on this page, please email: facingthefuture@rcpch.ac.uk