What’s next for children and young people’s services?

Health is a lifelong journey. Over time, problems left unchecked can grow until they become unmanageable – creating a butterfly effect. The longer an issue goes unresolved, the greater the consequences may be.

Nowhere is this more apparent than in children and young people’s (CYP) health. Intervening early can prevent an individual from being plagued by a lifetime of physical and mental ill-health, as well as allowing the patient and their family to grow up as happily as possible and achieve their potential in life. Yet at present, Britain’s CYP are faced with a health crisis, with NHS services struggling to manage, let alone resolve, increasingly complex needs from an ever-growing proportion of under-25s. 

If not reversed, this trend will result in hundreds of thousands of today’s children and young people suffering a lifetime of bad health, with serious and negative consequences for their future wellbeing, including their educational prospects, employability and capacity to form stable relationships. 

Universal pressures, lifelong impacts

The NHS Long Term Plan’s vision for CYP services in 2019 was disrupted by the COVID-19 pandemic. Now, over 400,000 children and young people are waiting for care. With the upcoming ten-year plan offering the chance of a fresh start for the NHS, the needs of children and young people should be a core strategic priority. 

Rising demand, including a wave of unmet need revealed during the pandemic, has highlighted the true scale of the health crisis affecting the under-25s. Physical, mental and neurodevelopmental services alike are struggling to keep pace, while young patients and their families are suffering as a result. Small wonder, therefore, that Britain’s children are among the most unhappy in Europe.

Even where children and young people are able to access a referral to treatment, long waits are causing significant developmental challenges. The uniform methods by which waiting lists are often managed – taking into account the risks of morbidity and mortality to the patient – struggle to also capture the potential for lifelong impacts to speech, behaviour, or growth that long waits can cause for children.

Innovation not despair

Yet against this backdrop, NHS leaders and partners from across a range of sectors are finding new answers to the problems facing CYP services. In the face of the sector’s challenges, innovation undertaken at a local level is paving the way ahead for the whole system.

"Instead of tinkering around the edges, some services are undertaking wholesale transformation and reaping the benefits."

Instead of tinkering around the edges, some services are undertaking wholesale transformation and reaping the benefits. For example, partnership working in Portsmouth has virtually eliminated its waiting lists for neurodevelopmental assessments amongst children. Rather than simply seeking to grow capacity incrementally, a whole new paradigm of care is being explored to meet young patients’ needs and allow them to succeed in education even if still awaiting a diagnosis. 

Empowering families is another way in which CYP services are being reshaped, in the process fundamentally reforming the relationship between the NHS and those it serves. By giving parents the tools to assess their child’s health, unnecessary GP visits and ED attendances can be avoided. Meanwhile, the growth of paediatric virtual wards is keeping families together, as young patients receive treatment at home that would once have required long weeks of separation during an inpatient stay.

What needs to happen next

In Lord Darzi’s words: “Childhood is precious because it is brief; too many children are spending too much of it waiting for care.” With a new government pledging to create the ‘healthiest generation of children in our history’, CYP services will have to overcome both the challenges of today and adapt to meet the needs of tomorrow. 

Whilst the landscape remains challenging, leaders are demonstrating the ambition, hope and optimism that drove so many of those working across CYP services. Instead of accepting managed decline, the response of pioneering leaders has been to innovate and rethink, using scarce resources wisely and above all remaining focused on the needs of the youngest in our society.

The government must now seize upon that ingenuity and positivity. By setting out a way forward for CYP services as the NHS plans for its future, we are being offered a once-in-a-generation opportunity. Investing in children and young people now will allow us all to reap the benefits for decades to come.

Antony Tucker is policy and engagement adviser for out of hospital care at the NHS Confederation. You can follow Antony on LinkedIn.