ObjectivesIn the 2013 RCPCH overview of child deaths, 71% of children who died had a chronic condition, most frequently neurological.1 Our aim was to review & improve the quality of care provided to children with a chronic neuro-disability, using cerebral palsy (CP) as an example of chronic neuro-disabling condition.MethodsUsing the NCEPOD audit tool, we reviewed 5 areas of clinical care: clinical recording, emergency care planning, respiratory compromise, clinical standards, and transition.2 Within these 5 areas, we focused on 21 recommendations set out from the NCEPOD ‘Each and Every Need’ guideline and NICE guideline for patients aged 0–25years with CP.3 30 patients with CP (GMFCS I-V) from 2 trusts were randomly selected and their clinical letters reviewed from the preceding 12months, to include correspondence from the paediatric MDT.Results93% of patient’s motor impairment and tone description were documented and 100% of patients had a local paediatrician to coordinate care with a recent assessment of pain, feeding and other medical needs. 100% of patients had care plans distributed to families, GPs and the MDT. 43% of patients were ‘GMFCS IV/V’, of which only one had documentation of being offered the opportunity to develop an Emergency health care plan (EHCP). Of the relevant patients, 38% had their respiratory risk assessed by a lead respiratory clinician. Of the 2 children who were over 14years, neither had documentation of transition planning.Based on the results, recommendations were made regionally to the MDT including ensuring detailing GMFCS level, annual dental review, annual consideration of an EHCP and at least annual assessment of nutritional status.ConclusionsDuring busy consultations, it is very difficult to assess all health aspects of a child with CP. To improve overall care quality, an annual medical review checklist for children with CP has been created and implemented regionally for the paediatric MDT, based on the NICE guideline.3 The checklist includes QR code access to additional information from the regional ‘Cerebral Palsy Toolkit’ as well as information on managing respiratory risk for user friendly access. Using PDSA methodology, adaptations have been made to update the checklist based on user feedback, as well as implementation of evidenced techniques for successful imbedding of checklists into standard care.4 5Referenceshttps://www.rcpch.ac.uk/sites/default/files/CHR-UK_-_Retrospective_Epidemiological_Review_of_All-cause_Mortality_in_CYP.pdfEachAndEveryNeed_FullReport.pdf (ncepod.org.uk)https://www.nice.org.uk/guidance/ng62Thomassen Ø, Espeland A, Søfteland E, et al. Implementation of checklists in health care; learning from high-reliability organisations. Scand J Trauma Resusc Emerg Med 2011;19, 53.