Sick children’s health worsening as record numbers wait for NHS care in England

Sick children’s health problems are getting worse as record numbers wait up to 18 months for NHS care, doctors treating them have warned.

The number of under-18s on the waiting list for paediatric care in England has soared to 423,500, the highest on record. Of those, 23,396 have been forced to wait over a year for their appointment.

Delays facing children and young people are now so common that Dr Jeanette Dickson, the chair of the Academy of Medical Royal Colleges, the body representing all UK doctors professionally, warned that children are “the forgotten casualties of the NHS’s waiting list crisis”.

Fewer than three-fifths (57%) of children are now seen within 18 weeks, even though NHS treatment targets say that 92% should be. The number on the waiting list has jumped by 52% since 2021.

“As a paediatrician, I’ve seen first hand the damaging impact that long waiting times have on children, on their education and overall wellbeing, and of course on their families,” said Dr Camilla Kingdon, the president of the Royal College of Paediatrics and Child Health (RCPCH).

The figures came from the RCPCH’s analysis of official performance data recently published by NHS England.

The health of some children was deteriorating while they languished on the waiting list because their illness and age meant they needed to have their treatment fast, Kingdon added. “Many treatments and interventions must be administered within specific age or developmental stages. No one wants to wait for treatment, but children’s care is frequently time-critical.”

She cited the example of children with serious hearing problems being harmed as a result of being forced to wait to have surgery to receive cochlear implants. “It’s critical for language development to get them in around a year of age,” she said.

“Waiting lists for radiology – because you usually need a general anaesthetic for good-quality pictures – mean that the pre-op work up is often delayed for months, plus surgery can be delayed by 10 to 12 months. So instead of doing it at 10 months of age, it’s done at 18-20 months. That’s a massive difference developmentally in terms of speech and language development.”

Under-18s were also facing long delays for community-based services, not just hospital care, added Kingdon, a consultant paediatrician in London. “I had a baby with an evolving cerebral palsy who desperately needed a special occupational therapy chair. This was a bright little boy of eight months who had every potential of making very good progress.

“Because he [was in] a neighbouring borough with very long therapy waiting lists, there was a six-month delay for getting the chair. Six months’ delay when you’re eight months old and wanting to sit but needing the extra support is an absolute disaster.”

A Department of Health and Social Care spokesperson said: “Cutting waiting lists is one of the government’s top five priorities and despite disruption from strikes, we have virtually eliminated 18-month waits and are taking immediate action to bring down long waits.

“We are improving support for children, young people, and their families by providing around £300m to fund a three-year Family Hubs and Start for Life programme, in 75 local authorities in England, and they are already making a difference by bringing together services and support for families with babies and children of all ages.”

Dickson and Kingdon voiced their fears as the academy published a new report into children’s health that criticised the government for ignoring young people’s needs when devising key health policies.

“All medical Royal College leaders are genuinely horrified at the current lack of emphasis on the health of children and young people. It’s as if they don’t exist,” said Dickson.

The report highlights the government’s controversial decision to publish a strategy covering a large number of major conditions, instead of having specific plans for each one. Although the strategy will replace several key child health plans, it mainly focuses on adult health.

The academy also criticises ministers for abandoning plans to tackle obesity, despite the growing number of school-age children who are dangerously overweight, and also for delaying publication of a vaccination strategy, even though take-up has declined across 13 of the 14 routine childhood vaccinations.

The report urges Rishi Sunak to create a cabinet-level minister for children and young people, offer free school meals to all primary school pupils, ramp up vaccination efforts, and expand mental health services for under-18s as part of a renewed drive to improve child health and prevent illness.