KCA Biobanking initiatives have led to the two large existing biobanks at Sydney Children’s Hospital with Children’s Cancer Institute and Children’s Hospital Westmead with Kids Research merging into a single governance structure and the banks adopting a new common IT system. The banks have harmonised the terminology used to code samples and increased the proportion of new diagnoses for whom samples have been collected. This has increased the total number of samples available to researchers, improved their access and paved the way for the future collection of matching germline DNA and serum samples on all patients. Moreover, analyses of our own banking techniques and international best practice has led to guidelines of benefit other initiatives in NSW. Under the leadership of Prof Jennifer Byrne these developments are now being applied to a national child health biobanking.