As a tertiary heart transplant centre the use of mechanical devices to bridge children to heart transplantation is logical and necessary service. However the use of such a device has challenges for the team, the family and the child. With increased pressures for cost savings, service provision and quality of care, what environment should these children be cared and who should provide that care.

Aims

· To meet cost pressures, service provision and quality of care
· To assess which environment is optimal for these children
· To decide who can provide their daily care

This presentation addresses the issues raised to effect this transition.