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Background/Aim General anaesthesia (GA) is often necessary for paediatric procedures but carries risks, particularly with repeated exposures, which also place a burden on families. At Great Ormond Street Hospital (GOSH), ‘piggybacking’ - where dental teams join other specialty GA lists to combine procedures - offers a way to reduce these risks and deliver more joined-up, family-centred care. This project evaluated missed and completed piggybacking opportunities and explored how to improve efficiency.Methods A retrospective analysis was undertaken from January to December 2024, using hospital electronic records, theatre logs, and clinical communications. Data included children on the dental waiting list who underwent other GA procedures, as well as planned and completed piggybacked cases, procedure types, cancellations, and specialties involved.Results Among 146 children on the dental waiting list who required another GA, 31 (21%) were genuine missed opportunities, largely due to lack of awareness or consultant availability. During the same period, 49 piggybacked procedures were planned, with 32 successfully completed. These prevented 32 additional dental GA episodes - the equivalent of eight separate dental lists. Patients ranged from 2-17 years (ASA 1-4), with ENT being the most frequent collaborating specialty. Seventeen planned cases were cancelled due to parental withdrawal, patient illness, or lack of beds.Conclusion Piggybacking reduces GA exposure, improves service efficiency, and eases the burden on children and families. However, barriers remain, including limited consultant cover and communication gaps between specialties. Optimising this model requires improved flagging systems, stronger interdepartmental coordination, and increased dental staffing. Piggybacking demonstrates a practical and patient-centred approach to embedding safer, more coordinated care for children with complex healthcare needs.