INTRODUCTION The Liverpool Heart and Chest Hospital provides medical and surgical adult cardiothoracic services to the people of Merseyside, North Wales, Isle of Man, parts of Lancashire and Cheshire. This catchment area has a population of over 2.8 million people. The hospital is one of the largest of its kind in the country and performs around 2000 major cardiac procedures and 700 major thoracic procedures per annum. The full range of services for adult cardiothoracic surgical patients (with the exception of transplantation) is provided and this includes an expanding service for adult congenital, major aortic surgery, with minimally invasive robotic cardiac and thoracic surgery. The trust also performs over 150 transcatheter aortic valve insertion procedures per year. The hospital has seen a great deal of development in the last few years. As a result of major capital investment, we are able to provide: 184 medical and surgical beds: 25 day case beds 12 bed cystic fibrosis ward 30 Critical care beds 9 dedicated cardiothoracic surgical operating theatres Endoscopy suite Recovery room X-ray department with a multi-channel spiral CT Scanner and MRI scanner Pulmonary function and oesophageal laboratory 7 cardiac catheterisation laboratories One dedicated pacing theatre and a shared pacing/aneurysm theatre Newly refurbished research laboratories Hospital electronic patient record system (EPR) Da Vinci Robotic surgery