Prior to 2011, paediatric critical care consisted of time-critical resuscitation and rapid transfer to Melbourne. In response to increasing clinical demand we have now deliberately integrated paediatric clinical care in the core business of the ICU. Two bed spaces have been modified to suit this purpose, backed up by expanded stores of paediatric specific equipment, in-room teleconference capability, and augmented staff training and education programs. We collaborate closely with our colleagues in General Paediatrics and the Emergency Department and liaise with PIPER at the Royal Children’s Hospital Melbourne whenever patient acuity or complexity require it. Barwon Health’s ICU coordinates high level educational programs including Paediatric BASIC and High-SPAEDS courses, and is collaborating with Adelaide Women’s and Children’s Hospital in developing a bespoke PICU nursing transition course. Barwon Health’s paediatric ICU data is submitted to ANZPICR for regular audit.