Objective To assess the workload of, and referral patterns to, paediatric cardiology outreach clinics to provide data for future planning.

Design Descriptive study of outpatient attendance during 1991 and 1996.

Setting Five district general hospitals with unchanged local demographics and referral patterns during the study period.

Results The number of outpatients increased by 61%, with a consequent increase in the number of clinics held and patients seen in each clinic. The number of patients aged between 10 and 15 years doubled.

Conclusion These data confirm the impression that demands for paediatric cardiology services are increasing. The increased need for attendance at outreach clinics has inevitable consequences for the clinical, teaching, and research activities of specialists in tertiary centres. An increase in the number of paediatric cardiologists, or development of local expertise (general paediatricians with an interest in cardiology), will be required. Furthermore, the increasingly large cohort of older teenagers and young adults with congenital heart disease underscores the need for the development of specialist facilities.