Abstract The delivery of the highest quality anaesthetic services to children depends on many factors. All staff should be adequately trained and have appropriate continuing experience. Though facilities should be as accessible as possible, they must conform to nationally recognized standards. These cover not only the skills of surgeons, anaesthetists, nursing and ancillary staff but also the provision of paediatric medical support, emergency treatment and intensive care. Standards have also been set in relation to day-care and inpatient facilities, perioperative care, acute pain management and resuscitation services. Where possible, children's surgery should be performed on dedicated operating lists, where it may be easier to create a child-orientated environment and where teaching can be effective. There should be effective links with the nearest tertiary paediatric centre and appropriate arrangements for interhospital transfer. Most children's surgery will continue to be carried out in District Hospitals, where a multidisciplinary team should agree local practice and devise protocols based on national guidelines. The concept of acceptable continuing experience should be applied flexibly, using criteria based on children's age, number of cases performed by an individual per year and case mix. In this age of risk management, professional self-regulation and clinical governance, those providing surgical services for children must be able to justify their policies.