My child has been referred to CATS

This page is designed to introduce you to the Children’s Acute Transport Service (CATS) and give you some practical information for what to expect during this stressful time.

What is CATS?

  • CATS is a specialised NHS service designed to make intensive care rapidly available to critically ill children in London and East Anglia, or all of the UK for certain illnesses.
  • We provide immediate telephone advice to hospitals and deploy an expert team to help stabilise and safely transfer children to PICU.
  • In this way, your child receives high quality intensive care throughout their journey.

CATS Philosophy

  • The Children’s Acute Transport service aims to provide the highest quality Paediatric Intensive Care for patients and their families, from the point of referral to the handover of care at the receiving Paediatric Intensive care Unit.

Referral Process

  • Paediatric intensive care (PICU) is provided only in a limited number of specialist hospitals in the UK.
  • When children become very ill, they are usually taken by ambulance to the nearest district general hospital, which may not have a PICU.
  • When children are critically unwell, the hospital your child is in will telephone the CATS team for advice and support. If ongoing Intensive Care is required, the CATS team will come to the hospital and transfer the child to a PICU.

When the CATS team arrive

  • The CATS team is made up of a Doctor/ Advanced Nurse Practitioner, Nurse and Ambulance Technician.
  • When the CATS team arrive, we will introduce ourselves to the family and the local team.
  • We will then get a full clinical handover and review and x-rays / scans.
  • We will then assess your child and start to change over the equipment and monitoring, to the transport equipment.
  • If your child needs help with breathing, a tube (Endotracheal or ET tube) will be passed through his or her mouth or nose into the windpipe and attached to a breathing machine (ventilator).
  • Your child will be given pain relief throughout, so this will not cause any discomfort.
  • During this time we will optimise the intensive care support your child requires.
  • We will update the family during this time, provide information about CATS to read and a comfort pack.


  • The Doctor/ANP will speak with the CATS Consultant prior to leaving.
  • The team will ensure your child and all equipment is safely secured.
  • The receiving PICU will be telephoned with a clinical update and an estimated time of arrival – this will ensure they are ready for when the CATS team arrive.
  • We have our own fully equipped ambulance.
  • If distance or time is a concern, we can also use an air ambulance.

Ambulance Safety

  • It is our policy to allow one or both parents to travel with their child.
  • If you do accompany your child:

–You must be seated, wearing a seatbelt at all times during the journey.

–Explanations of treatment for your child will only be given during the journey if the team are free to do so.

–You must not undo your seatbelt during the journey, unless otherwise instructed by the team.

  • Sometimes this will not be possible and we will ask you or the referring hospital to arrange transport
  • If you don’t accompany your child and decide to follow in your own vehicle, please do not tailgate the ambulance.

Arrival into PICU

  • We will bring you onto the PICU and introduce you to the team that will take over care of your child.
  • If there is limited room in the PICU bed space, our Ambulance technician will bring you to the family room, whilst we hand over
  • The CATS team then give a clinical handover to the PICU team and transfer the patient and equipment. This process can take up to 45 minutes.
  • Once your child has been transferred over to the PICU equipment, the PICU nurse will bring you through to see your child.