The numbers of children coming to A&E have steadily increased over the last 5 years, and are continuing to increase. This puts a large burden on NHS staff. However, the reasons behind this increase are not entirely clear. Parents may be bringing children who are less sick because they struggle to get emergency appointments with their GP, or because they cannot access other out-of-hours services. Alternatively, more children who really are sick may being sent to A&E by services like the NHS-111 telephone line. To manage limited NHS resources better, we want to understand more about which groups of children are coming to A&E more and more, and particularly how infections may be contributing. We plan to investigate how numbers of A&E attendances are changing over time by various factors including (i) registered GP surgery (ii) time of day, day of week, (iii) reasons for attending, (iv) underlying illness (assess using blood test requests and results, and whether the child was admitted to hospital from A&E), (v) antibiotics prescribed. If we can identify key subgroups of children, we may be able to introduce ways to manage paediatric A&E better, including better information for parents or different systems in A&E.