Abstract
All hospitals that provide care for children should have arrangements in place for high dependency care. These arrangements will vary between a district general hospital and a tertiary centre but thoughtful planning in developing the unit is crucial. The high dependency unit will often act as a ‘step-up’ or ‘step-down’ unit between the general ward and paediatric intensive care so good communication is essential. It can be argued that the general paediatrician is the ideal candidate to be the lead clinician in high dependency care. It is important to maintain a high level of training for all staff, including paediatric life support and have 24 h medical cover. High dependency units may have some costs benefits, but the main aim is to improve the care of acutely ill children.
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