Summary•Emergency nurse practitioners (ENPs) formally developed in accident and emergency (A&E) departments as a direct response to waiting times for the walking wounded, the need to reduce junior doctors hours and changes in nursing practice.•ENPs existed informally for many years in minor injuries units and specialist ophthalmic departments.•This study aimed to examine whether or not the role of ENP could be applied to the specialist service of a paediatric casualty department.•The results showed that 3% of patients could be seen and treated to conclusion by a children's ENP, and some patients could have their care accelerated by a children's ENP.•The introduction of children's ENPs would have an impact on waiting times, junior doctors work‐load and the quality of p