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50% of children waiting over 18 weeks for community health services compared to just 15% of adults

The current state of children’s community health services is unsustainable, says Royal College of Paediatrics and Child Health (RCPCH) with new data showing children are waiting far longer than adults for care.
Man and woman, with toddler, smiling, meet with a doctor

Latest NHS performance data shows 270,156 children currently waiting for community health services in England. Alarmingly, 49.5% of children are waiting more than 18 weeks for care, compared to just 15% of adults waiting over 18 weeks. Of the 270,156 children on waiting lists, over 16% (44,066) are waiting over a year to be seen. The College is calling on the government to address these shocking figures.

Community paediatricians and health professionals play a vital role in improving the health of all children and young people including some of the most vulnerable. These clinicians specialise in a variety of areas, relating to childhood development – such as concerns over physical and social development including speech and language; neurodiversity assessments and support; chronic illnesses, and child protection. 

Long waits for care are unacceptable for any patient but are even more harmful for children, where delays may lead to irreparable harm if care is not initiated before a particular developmental window closes, with lifelong impact on speech, mobility, physical and social development, and missed learning. 

Many children will be out of school while they wait, missing vital education and putting a strain on their parents and carers who may have to miss work as a result. Long-wait times for community care also places strain on the wider health system, with many families reaching out for help repeatedly to GPs and Emergency Departments while waiting in limbo. 

RCPCH is urgently calling for an NHS that equitably considers the needs of children and young people in hospital and community settings. They urge the government to: 

  • Outline the steps they are taking to improve waiting times for community health services 
  • Urgently address the current long waiting times in community child health services as a core part of recovery plans, before progress can be made on the 10-year plan. 
  • Set a waiting times standard and offer dedicated support and guidance to health systems to tackle long waits.
  • Introduce a Children's Health Investment Standard to address the investment gap between child and adult health services.

Today RCPCH has written to Health Secretary, Wes Streeting, in light of the government’s recent announcement on ending hospital backlogs the NHS standard on 18 weeks and to urge that any plans sitting behind this adequately addresses the needs of children.  

RCPCH Officer for Health Services, Dr Ronny Cheung, said:

It’s wholly unacceptable that 50% of children are not being seen by the 18-week target set out by the NHS, and even more shocking to see that 44 thousand children are waiting more than a year to get the care they need. I’m deeply concerned about what this persistent figure means for our children and their future. The impact for a young child of waiting over a year for a neurodevelopmental assessment, or waiting two years for speech and language therapy, can affect them for the rest of their lives.

No child should be waiting over 18 weeks for health care. Children’s community services provide children with the help and treatment they need to live full and happy lives and are the bedrock of how we care for our most vulnerable children and young people. Despite this, children’s community services have been overlooked in the recovery agenda so far. 

We welcome the Government’s focus on the current NHS waiting lists, but previous experience shows that unless plans specifically reference children’s services or allocate ringfenced funding, these services lose out in favour of adult care. Ahead of the publication of the 10-Year Plan we’re asking the Health Secretary to actively consider the unique needs of children and young people and ask for clarity on the steps they intend to take to improve over-stretched community health services.

Community Paediatrician and Co-Founder of ADHD UK, Dr Max Davie, said: 

Children and their families have been severely impacted by spiralling wait times, leading to more school exclusion, lost opportunities for learning and socialisation, and worsening mental health. 
We hear heartbreaking stories every day at ADHDUK about children suffering due to lack of assessment and treatment. The difficulties are compounded by the fragmented way that community health services are commissioned - for instance, in many areas, the closely related conditions ASD and ADHD are commissioned from completely different organisations, creating duplication and compounding the difficulties with access. We need to refocus on holistic support through a new commissioning framework for neurodevelopmental difficulties.


Royal College of Speech and Language Therapists’ Director of Policy and Public Affairs Derek Munn said: 

There are far too many children stuck on long waiting lists for community health services, with around a quarter of them waiting to see a speech and language therapist. Communication skills are central to children’s development, their ability to make friends and get on in school, and their opportunities later in life.

The earlier we can get in and support children the better. We urgently need more investment in children’s community health services to improve access and early intervention. This must be accompanied by a clear message that child health is a priority in the upcoming Ten Year Plan.