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What to expect working as a Paediatrician in the NHS

  • May 06, 2020

This blog article aims to provide insight into what working as a Paediatrician in the UK is like and more specifically aims to explain the different levels of Paediatrics and Neonatology.

What roles are there within Paediatrics?

As a Paediatrician, your job is to diagnose and treat health conditions that affect babies, children and young people. Paediatrics can be divided into 4 main areas:

  1. General Paediatrics – hospital role covering children up to the age of 16. All paediatricians will start their training in General Paediatrics and then some will choose to apply for a Paediatric subspecialty (also known as ‘Grid’).
  2. Neonatology – this role specialises in looking after newly born babies. This is usually based within an Intensive care unit and Doctors specifically look after premature babies or those with problems at birth
  3. Community Paediatrics – these doctors are based within the community and look after children with developmental, social and behavioural problems as well as those with a physical disability
  4. Paediatric Cardiology – This is a smaller area of Paediatrics whereby Doctors diagnose and treat children with heart conditions.

Whilst each of these 4 areas are profoundly different in their focus, your day-to-day duties as a Paediatrician working in any one of these, may include:

  • assessing children who are ill, injured or have disabilities
  • referring patients to specialist consultants for tests
  • prescribing medication, surgery or therapies
  • explaining diagnosis and treatment plans to parents and children
  • writing patient notes and producing medical reports for professionals
  • monitoring patient progress and responses to treatments
  • supervising and training junior medical staff

It is important to note that these four areas of Paediatrics can be further broken down into multiple sub-specialties (‘Grid’). At level 3 of training (ST6-8), paediatric trainees are eligible to sub-specialise and on completion of an approved programme, enter onto the GMC Specialist Register as a Paediatrician with sub-specialty. This process is called NTN Grid Recruitment. Paediatric sub-specialties include, but are not limited to:

  • Nephrology
  • Neurodisability
  • Neurology
  • Oncology
  • Intensive care
  • Respiratory
  • Mental Health
  • Emergency
  • Rheumatology
  • Inherited Metabolic
  • Diabetes and Endocrinology
  • Gastroenterology, hepatology and nutrition

Levels of Care

There are different levels or Tiers within Paediatrics, specifically Neonatology, and these are named depending on the level of specialist care they offer and provide.

As a simple breakdown, the Levels of care are as follows:

  • Level 1) Low level dependency
  • Level 2) Increased level of support and care for children who may need short-term intensive care
  • Level 3) Highest level of Support within Dependency Wards, Tertiary Centres and Intensive Care Units

More specifically, within Neonatology, the levels can be broken down further. Some Job Adverts may be listed as ‘Paediatrics with Level 1 Neonatology’ or Level 2 or 3. These levels correspond to the specific procedures and care provided within the department.

Level 1: Special Care Baby Unit (SCBU, sometimes called Low Dependency)

This is for babies who do not need intensive care and are often born after 32 week’s gestation. The role of a Doctor within this ward may include, but is not limited to:

  • Monitor babies breathing or heart rate
  • Give the baby more oxygen
  • Treat low body temperature
  • Treat low blog sugar
  • Helping baby feed, sometimes by using a tube
  • Helping babies who become unwell shortly after birth
  • Treatment of jaundice (sometimes treated in post-natal or transitional care units)

Level 2: Local Neonatal Unit (LNU)

This is for babies who need a higher level of medical and nursing support. If a baby has been or is due to be born between 28 and 32 weeks gestation, it may be transferred to an LNU. The role of a Doctor within this ward may include, but is not limited to:

  • Provide Breathing support given through their windpipe
  • Short-term intensive care
  • Care during short periods where baby stops breathing (apnoea)
  • Continuous positive airway pressure or high flow therapy for breathing support
  • Feeding through a drip in baby’s vein (parenteral nutrition)
  • Provide cooling treatment for babies who have had difficult births or are unwell soon after birth
  • Helping babies who become unwell shortly after birth

Level 3: Neonatal Intensive Care Unit (NICU)

This is for babies who need the highest level of medical and nursing support. Often these babies will have been born before 28 week’s gestation, or be very unwell after birth. Babies are cared for here when they:

  • Need breathing support
  • Have a severe respiratory disease
  • Need or have just had surgery

Relocating to the UK

If you are an international Paediatric doctor who would like to relocate to the UK , email your CV to [email protected] and we can support you in securing an NHS post and on your journey to relocate to the UK.

Are you a member of our Facebook group? When you join IMG Advisor, you join a community of doctors all looking to relocate to the UK and join the NHS. We post a series of blogs and vlogs to the group each day. We will also be on hand to answer all of your relocation queries.

Subscribe to our YouTube channel! We have over 60 videos covering everything you need to know about relocating to the UK and joining the NHS.

Listen to BDI Resourcing on the go with IMG Advisor the Podcast! You can listen to us on Apple Podcasts, Spotify, Stitcher and Buzzsprout. We have a number of episodes with tips and advice on relocating to the UK and the routes you can take to achieve this.

Finally, we have just launched our new Instagram, so if you are a member, feel free to follow us to view our posts and IGTV: @bdiresourcing


RCPCH. 2020. Sub-Specialty Training (NTN Grid) - Application Guidance. [online] Available at: [Accessed 5 May 2020].

RCPCH. 2020. Choose Paediatrics. [online] Available at: [Accessed 5 May 2020].

Health Careers. 2020. Paediatrics. [online] Available at: [Accessed 5 May 2020].

Bliss. 2020. What Are The Different Levels Of Neonatal Care? | Bliss. [online] Available at: [Accessed 5 May 2020].


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