ArticleBMJ paediatrics open2025
Exploring the provision and structure of paediatric critical care outreach teams (PCCOTs) in the UK and Ireland: a national questionnaire study.
Article in BMJ paediatrics open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
backgroundFailure to recognise and respond to early signs of critical illness contributes to preventable deaths in the UK, particularly among medically complex children. Critical care outreach teams (CCOTs) are multidisciplinary teams that manage deteriorating patients and support early care escalation. While well-established in adult services, Paediatric CCOTs (PCCOTs) remain under-researched. This study presents the first national evaluation of PCCOT provision and characteristics across tertiary paediatric centres in the UK and Ireland.
methodsA cross-sectional questionnaire, developed from literature, patient and public involvement and peer-reviewed for validity, was distributed via Bristol Online Survey to healthcare professionals in 29 tertiary paediatric centres. Recruitment used convenience sampling through social media and professional networks. Eligible participants gave electronic consent. Data was collected over 7 weeks (August-October 2022) and used descriptive analysis. Ethical approval was obtained from the University of Birmingham.
resultsThe response rate was 93% (27/29 centres). Of these, 41% reported having a PCCOT, predominantly nurse-led with notable growth since 2013. Team composition, size, funding models and training varied widely. Education and formal competencies were inconsistent, and many PCCOTs operated within incomplete governance systems often lacking process improvement functions. Commonly collected metrics included cardiorespiratory arrest rates, inpatient mortality and unplanned paediatric intensive care unit admissions.
conclusionsPCCOTs remain underdeveloped, with limited 24/7 coverage, inconsistent training and fragmented governance in comparison with adult CCOTs. Despite their critical role, most lack sustainable funding and robust evaluation frameworks. Newly developed paediatric-specific education standards now require implementation and impact assessment. National leadership, investment and standardisation are needed to ensure PCCOTs can deliver safe, effective and equitable care across the UK and Ireland.
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