A national survey of tracheostomy care policy was undertaken. Information was gathered from 127 acute hospital trusts in England. 103 of these trusts care for patients with tracheostomies. Of these 15 (14.6%) have no tracheostomy care policy in place. The remaining trusts use external guidelines. 88% of trusts arrange for staff to attend tracheostomy study days. Advice on tracheostomy care comes from a variety of sources including ENT surgeons, ENT nurses, speech therapists and ITU staff, however only one quarter of trusts have a designated tracheostomy nurse specialist. Although 31% of trusts surveyed have a tracheostomy care team, the composition of such teams varies considerably. Members include nurse specialists, physiotherapists, speech therapists and consultant anaesthetists but few consultant ENT surgeons (12.5%).