There is a significant diversity of professional opinion over detailed recommendations in this area. This reflects the lack of reliable research evidence. The available evidence does not allow significant statements to be made about the best way to organise, staff and otherwise resource the care of critically ill children. Of particular note is the lack of British research in this area.
Changes should be informed by better information based upon comprehensive and accurate data collection. Units currently providing regular care for critically ill children should collect standard outcome and severity data. This will allow a more informed discussion of possible variations in the survival of children between units. Change in the care of critically ill children should be carried out in a controlled manner which can be evaluated and options for change should be subjected to critical scrutiny and be adequately costed.
The authors believe that while the BPA report is a useful source of information and summarises the views of a range of professional groups, it does not constitute sufficient basis for determining national or local policy for the care of critically ill children in Britain.