Paediatric accident & emergency services. Are we meeting the need?

Paediatric Casualty has evolved into a blend of true Accident and Emergency and Primary Care Services. With the impending redevelopment of the Accident and Emergency Department at the Camperdown Children's Hospital a survey of families utilising the service was conducted to assess their perceptions of the services provided. It emerged that although many families travelled long distances to the Hospital and had to contend with long waits, they perceived the trip as worthwhile with most finding the quality of care satisfactory (95%) and friendly (90%), coming away with a good understanding of their child's problem (94%), the investigations performed and management prescribed (97%), and arrangements made for follow up (89%). A large percentage (51%) came to the hospital seeking a second opinion for which they had already consulted another agency. Nineteen percent were directly referred, with the remainder seeking a second opinion on their own initiative. This high referral rate necessitates a staffing formula that provides appropriate expertise and supervision. As the demand on hospitals to provide primary care facilities is likely to remain, recommendations are made for improvement in the services provided as well as making more use in forward planning of available expertise and supervision.