Outpatient services for children

Most patient contacts with hospital services are as outpatients and paediatricians spend a great deal of their working lives in outpatient clinics. Yet this work has a low profile in comparison to other areas of clinical practice, is usually poorly organised and managed, and is often provided in outdated and unsuitable facilities. As a consequence it attracts poor support in terms of clinical and other staV. Since 1991, new appointments in the NHS have increased overall by 4.8% per year and in paediatrics the rise is greater than this. A new report from the Clinical Standards Advisory Group (CSAG), Services for outpatients, 1 has identified current problems and suggests ways of tackling them. The report considers the whole range of outpatient services for adults and children-medical, surgical, and specialist-but has important implications for the provision of children's outpatient services.