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Background Oxygen is a medication in the children’s British National Formulary (cBNF) requiring a prescription from a qualified health professional, outside of an emergency. A prescription specifies target oxygen saturations, delivery device, and the flow for the patient‘s condition. Oxygen treatment when stopped, should be discontinued on the prescribing/electronic platform. Local training, education, audit and a governance framework, support local practice & patient safety. The recent OxyPICU study (Peters et al 2024) suggests conservative oxygenation targets in critical care benefit patient outcomes.Aim Audit a snape shot oxygen prescriptions, tertiary level children’s hospitals, ward and intensive cares.Method Five questions directly or called by phone, 2-day period in September 2025.Do you have patients on oxygen therapy?If yes, is there an oxygen prescription?If yes, is there a target range of oxygen saturations, type of delivery device, flow for the patient‘s condition?If no prescription – why? Obstacles to practice?Do you have an oxygen prescribing policy with training?Results Critical care areas, had no oxygen prescriptions, despite 100% of the patients receiving oxygen therapy. However, it was noted that other gases, nitric oxide & Entonox were prescribed. NICU areas were able to state greater emphasis on local guidance & training but did not meet 100% of accurate prescriptions. Ward areas it was evident that oxygen prescriptions were either based on professional group or the support of a local policy with training.Outcome This initial scoping exercise suggests that there is wide variability on the prescription of oxygen therapy across trusts and clinical arenas, with little or no compliance with national guidance. Concerned raised by a wide range of professionals interviewed around local standards and training, peer and senior support for practice change with legal requirements.References Peters MJ, Carla T, et al. Conservative versus liberal oxygenation targets in critically ill children (Oxy-PICU): a UK multicentre, open, parallel-group, randomised clinical trial. The Lancet 403(10424):355–364.2. Oxygen | Treatment summaries | BNFC | NICE