Children waiting for community health services risk being ‘overshadowed’ as health leaders call for cross-government action

• Children at risk of poorer outcomes if development windows are missed
• Not enough joined-up support for prevention and early intervention
• A need for more co-ordinated action across government and commissioning for children and young people’s services.

The health and well-being of children and young people is being put at risk as vital community services struggle to keep pace with demand, health leaders have warned.

With some children and young people facing long waits for essential speech and language therapy, autism diagnoses and community paediatric services, community service leaders are calling urgently for more co-ordinated investment in early intervention and support to grow workforce capacity to address waiting times.

Health leaders we surveyed warn that the pressure on these services, made worse by the disruption of the pandemic, is extraordinary.

Long waits can often impact outcomes for children more severely than adults because  delays in assessment and treatment have a knock-on effect on communication skills, social development and educational outcomes as well as their mental wellbeing. Long waits are  also exacerbating health inequalities and disproportionately impacting vulnerable families, many of whom cannot afford to pay for quicker private treatment. As well as taking a toll on the life chances of individual children, this has ramifications for the economy, with parents often struggling to work full-time alongside caring responsibilities and wider society.

Health leaders are doing all they can to tackle long waits for these key services. But community providers have today called for greater investment in early intervention, support for the workforce required to respond to growing demand and more co-ordinated action in support of children and young people across government.  

Matthew Taylor, chief executive of the NHS Confederation, said: “Expecting a child and their family to have to wait - sometimes for years - for diagnosis, let alone treatment, is completely unacceptable. No one should endure waits this long, let alone a child whose development and maturity could be severely delayed as a result.

“We know that leaders and teams in community services are doing all they can to drive down waits and see, diagnose and treat as many children and young people as possible, but they can only do so much.

“Children and young people’s community services are now under extraordinary pressure , and we must see them  given the same level of priority as the elective backlog, coupled with action from across government.”

Miriam Deakin, director of policy and strategy of NHS Providers said: “Leaders in community providers are committed to doing all they can to reduce long waits for children and young people’s services.  But our survey paints a worrying picture, laying bare the scale of the challenge, the impact of long waits for particular services on children’s development, the strain for families and the pressure on NHS staff in a context of constrained resources.

“More investment, co-ordinated support and a more coherent national policy framework, is needed for these vital community services. Without it, too many children and young people will continue to miss the window for the right care when they need it most.”

Siobhan Melia, chief executive of Sussex Community NHS Foundation Trust and chair of the Community Network, which is hosted by the NHS Confederation and NHS Providers, said: “There is a clear need for investment in prevention and early intervention to reduce the demand for these services, and leaders are understandably anxious to access additional national funding. But as well as this, the government should be looking to increase numbers of staff with the right skills mix in these services.

“Nearly all community health leaders told us that they were concerned about the impact these kinds of waits were having on staff morale, but in order to get these waits down, we need more staff. Children and young people’s community services must not be forgotten by the government in the workforce plan.”

Alongside due focus for children awaiting hospital operations and mental health support, leaders from community providers say the government must not overlook children and young people's community health services.

The top things that health leaders said would help cut waiting times were:

• More government investment in prevention and early intervention (69 per cent)
• More national funding similar to the Elective Recovery Fund (52 per cent)
• Support for more staff with the right skills mix (52 per cent)
• More co-ordinated commissioning and support for children and young people’s services across government

Since the survey was started in March 2023, NHS England has published regular data on community waiting lists including for children and young people’s community services. The figures show that whilst the number of adults waiting for community services has increased by 3.2% since October 2022, wait lists for children and young people’s services have increased by 10.2% over the same period to 227,490. The proportion of children and young people waiting from 18-52 weeks for treatment far outstrips the proportion of adults waiting the same amount of time.

This was echoed by our respondents with almost nine in ten (88%) reporting that current waiting times for children and young people to access initial assessment and treatment for community services have increased either significantly (48%) or moderately (39%) compared to pre-pandemic figures.

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We are the membership organisation that brings together, supports and speaks for the whole healthcare system in England, Wales and Northern Ireland. The members we represent employ 1.5 million staff, care for more than 1 million patients a day and control £150 billion of public expenditure. We promote collaboration and partnership working as the key to improving population health, delivering high-quality care and reducing health inequalities.