In England, the rate of emergency department (ED) attendance in the first year of life is greater than at any other age, amounting to 122 visits per 100 000 population.1 Children aged 0–16 accounted for 23% of ED attendances (more than 5.4 million children) in 2022/2023, with children aged 0–4 accounting for 11%. Paediatric emergency medicine (PEM) was first recognised in the UK in 2001 with all doctors required to have a parent specialty—emergency medicine (EM) or paediatrics.

A 2013 census2 by the Royal College of Emergency Medicine found variation across the UK in PEM provision and that the intercollegiate gold3 standard of at least one PEM consultant in any department seeing>16 000 children was not being met. This standard was updated in 20184 to recommend that all EDs treating children should have a PEM consultant. Audit data published in 2022 demonstrated that 41% of departments did not meet this standard.5

Growth of the subspecialty is …