There is unprecedented demand for critical care services globally. In our region, there are approximately 119,000 admissions to 141 general intensive care units (ICUs) in Australia per year; this includes 5500 patient re-­admissions during the same hospital episode. In New Zealand, there are 18,000 admissions per year to 26 ICUs, including 500 re-admissions. Patients admitted to coronary care, paediatric or other specialty units not classified as a general ICU are not included in these figures, so the overall clinical activity for 'critical care' is much higher ( e.g. there were also 5500 paediatric admissions to PICUs).1 Importantly, critical care treatment is a high-expense component of hospital care; one conservative estimate of cost exceeded $A2600 per day, with more than two-thirds going to staff costs, one fifth to clinical consumables and the rest to clinical support and capital expenditure.'