The on-call anaesthetic cover at PRH is as follows: The first on-call cover the CEPOD theatres, attend resuscitation calls and support the second on call in ITU patient care. The CEPOD theatres at PRH predominantly cater for gynaecological, paediatric, head and neck, trauma, and maxillofacial emergencies. The second on-call is provided by the STs, specialty doctors and specialists, working full shifts primarily for ITU. There is an obstetric anaesthetic on-call rota with specialist obstetric anaesthetists covering the labour ward out of hours. Currently 1:8. There are two consultants who prove support to the resident tiers. Consultant 1 covers CEPOD and Obstetrics, Consultant 2 covers ITU and paediatric resuscitation. Currently there are Emergency departments and Intensive Care units at both the Royal Shrewsbury Hospital and the Princess Royal Hospital. The medical acute take and acute Orthopaedics is split between both Hospitals. The CEPOD theatres at RSH cater for adult general surgery, urology, vascular and ophthalmic emergencies. Head injured adults needing Surgery or admission to a Neurosurgical unit are generally transferred to Stoke -on -Trents Neurosurgical Unit or to the University Hospital in Birmingham. Paediatric patients requiring intensive care are stabilised by a MDT comprising paediatric and anaesthetic staff and are transferred to PICUs in Stoke- on- Trent or Birmingham and are coordinated by the KIDS and Neonatal transfer service.