NHS waiting times for children is an unacceptable crisis

We cannot allow our young people to be failed by a system that is supposed to protect them, writes Dr Camilla Kingdon

It's an extremely disheartening time to be a paediatrician (PA Wire)

When the pandemic hit in 2020, we found ourselves having to adapt in ways that had never been asked of us previously. It was a monumental shift in how we lived our lives and how we, as healthcare professionals, delivered care.

During the first Covid-19 lockdown much of the child health workforce was redistributed, with almost half (46 per cent) of the community child health workforce redeployed to adult care, as well as up to 22 per cent of wider paediatric staff. Many key services such as health visiting and children’s community nursing, including complex care at home, were paused altogether. Children’s health and wellbeing took a backseat during this difficult period.

We always knew that post-pandemic recovery was going to be a challenge, but we did not anticipate a continued deprioritisation of children’s health and services. The latest data shows that over 400,000 children are now waiting for treatment – enough children to fill Wembley stadium four times over.

However, even this figure paints just part of the wider picture. The waiting lists only count the children waiting for elective consultant-led treatment, but there are many more children who are waiting for community care – such as autism assessments, speech and language therapy and mental health services – that are not counted.

We know this is often where the waiting times are longest, with many children waiting for well over a year for a first appointment. This is a hidden waiting list that continues to grow. This is a real crisis.

No paediatrician wants to see a child waiting over a year for treatment, and we are acutely aware of the negative impact that such long waits can have on a child's health and development. Waiting for 12 weeks can feel too long, so waiting for a year is wholly unacceptable.

Childhood is a crucial time in terms of health and wellbeing, and time spent waiting for treatment can seriously impede a child’s healthy development into adulthood. Treatment is usually timed carefully to align with a developmental milestone, or for simpler reasons like wanting to ensure a surgical procedure happens during school holidays to avoid disruption to education.

Child health teams know this, and are working tirelessly to tackle the backlog. We have some incredible examples of leadership and creative thinking, but without proper support teams are unable to make a meaningful dent in this mushrooming problem.

Considerable progress has been made in lowering wait times for adult treatment, yet the children's waiting lists continue to rise. This represents an unprecedented disparity in post-pandemic recovery.

It seems that the focus in the lead up to the next election is primarily on voting aged adult issues, and our patients are simply not a priority. The government's recent decisions to abandon the 10-year mental health plan, 10-year cancer plan, and the health disparities white paper, along with the delay in implementing vital policies to prevent obesity, has added to that concern.

As a paediatrician, I had hoped these plans would urgently address the unacceptable child health outcomes in England, which now lag behind our European partners in many cases. Instead, the Major Conditions Strategy, which replaced these plans, appears to primarily target older adults and frailty. This leaves a degree of uncertainty as to whether the needs of children and young people will be adequately addressed. The government must provide urgent clarity on its vision for children's health and the wider disease prevention agenda and outline concrete policies to bring this vision to life.

It's an extremely disheartening time to be a paediatrician. I speak for myself, but I know that every single committed member of the child health workforce feels the same. We are collectively committed to advocating for children in health, education, and social policy. We want to see urgent action taken to address the growing crisis in children's healthcare.

We keep being told that a workforce plan is due to be published. Well, where is it? Long-term, fully funded planning with a specific focus on the child health workforce is essential if we want to invest in our future society and the sustainability of the NHS. We are also calling on the UK government to produce a cross-departmental child health strategy, that puts children at the centre of its decision making, and includes a focus on inequalities, well-being, physical and mental health.

We cannot allow our children to be failed by a system that is supposed to protect them. It's time for the government to step up and take responsibility for the health and wellbeing of our children.

Dr Camilla Kingdon the president of The Royal College of Paediatrics and Child Health