Aims and Objectives Children 0-16 accounted for 23% of all ED attendances in 2022/3 with the rate of attendance in the first year of life greater than at any other age at 122.3 visits per 100,000 population.

A 2013 census found variation across the UK in PEM provision and audit data published in 2022 suggested that 41% of departments did not meet the intercollegiate gold-standard of one PEM consultant in every department treating children. We report here the growth in PEM trained doctors from 2006-present.

Method and Design We approached the GMC with a FOI request to determine the number of doctors with a subspecialty of PEM from either college from 2006 onwards. We looked at the growth in numbers; overall, by college and by area of the UK, and mapped this to the numbers of children under the age of 16 in each region (ONS data 2022).

Results and Conclusion By 2023 there were 565 doctors registered with subspecialty PEM. This represents a 17.6-fold increase since 2006. In 2023 there were 5.4 million ED attendances by children, equating overall to 1 PEM doctor per 9,500 attendances UK wide. 384 (68%) had a primary specialty of EM and 181 (32%) Paediatrics. (Figure 1) In 2023 >11% of all EM licenced CCT holders (384/3304) were dual accredited in PEM.

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Abstract 2631 Figure 1

In 2023 areas had an average of 4 PEM doctors/100,00 children under the age of 16. The Northeast, and Southwest appear as positive outliers with >5 PEM consultants/100000, whilst the East of England has <2.

This survey only looked at raw numbers of PEM specialists. What we do not know is the number of these doctors actively practicing PEM, the setting in which they practice, and the spread of job-planned time and activities this entails. Next steps would be to undertake a more detailed workforce census to understand this further.