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No matter how effective medication regimens are, if children and parents do not follow instructions then healthcare is compromised. Here we outline strategies to improve adherence.

assistants' understanding of other HCPs' roles highlighted the need for further education in this area. Conclusions Whilst rehabilitation is not new to palliative care, the findings suggest this approach is going through a developmental and formalisation process. Increased interdisciplinary team working and further training in rehabilitative palliative care for hospice staff would be beneficial to embedding this approach in hospices. The findings show that healthcare assistants, who provide a large proportion of patient 'hands on care', would particularly benefit from additional training to incorporate rehabilitative palliative care into their practice.

Background: Paediatric antimicrobial stewardship (PAS) networks exist in the USA and Australia but not in the UK. We sought to capture a snapshot of the current PAS landscape across UK children’s hospitals. Methods: A survey of PAS activities was conducted in tertiary children’s hospitals. Results: Infectious disease or microbiology consultants responded to the survey (n=15). All hospitals had neonatal, paediatric intensive care and surgical patients.All centres provided a PAS education programme for doctors, 7 for nurses and 9 for pharmacists as well. All centres had empirical antimicrobial prescribing guidelines. All centres with a paediatric infectious diseases (PID) team (11/15) used “audit and feedback” rounds, although their frequency and coverage varied. The PAS teams mostly included a PID consultant and/or microbiology consultants and a pharmacist. Three centres also had a nurse covering also the paediatric out-patient antibiotic treatment programme. Funding for PAS were inconsistent: Great Ormond Street Hospital had secured a dedicated full-time paediatric microbiologist, antimicrobial pharmacist and PID consultant with a ratio of 1/453 in-patient beds. 9 centres did not have dedicated funding for a paediatric antimicrobial pharmacist, 7 did not have funding for a paediatric infectious disease consultant. Only 2 hospitals had microbiology consultant time for paediatric audit and feedback. Conclusion: PAS programmes in the UK are limited, funding is inconsistent and their set up is variable, even in tertiary children’s hospitals with a strong interest in infectious diseases. We propose a national PAS network to advocate for more consistency and research into the implementation of PAS programmes.

Despite the majority of infections being viral and self‐limiting, children are still frequently prescribed antibiotics for upper respiratory tract infections (URTIs) and acute otitis media. This article discusses how to assess whether an antibiotic is appropriate and when referral to secondary care may be necessary.