Health leaders fear children’s development will be delayed due to long waits for community care

Health leaders are warning that children and young people are being put at risk due to long waits for community health services.

Of the 65 community provider leaders who took part in the survey, all (100%) said they were either moderately or extremely concerned about the impact of long waits for community care.

Almost nine in 10 (88%) said current wait times for assessments and treatment have increased compared to pre-pandemic, and this is having an impact on children’s social development, education and communication.

Key services experiencing the longest assessment delays are:

• neuro-developmental pathways (average: 40 week wait)
• community paediatrics (average: 33 week wait)
• speech and language therapy (average: 20 week wait)
• occupational therapy (average: 20 week wait)
• physiotherapy (average: 13 week wait).

Mental health school teams and school nursing had the shortest waits at 3.4 weeks and 3.3 weeks respectively.

Treatment delays were the most pronounced in all the key service areas listed above, with the addition of child and adolescent mental health services, which had an average treatment wait time of 20 weeks.

The respondents also noted several more specific key areas in which waiting and treatment times were particularly pronounced. This included ADHD and autism pathways, dietetics, eating disorders, special educational needs and learning disabilities, enuresis, orthodontics and dysphagia assessments.

Long waits for treatment exacerbate health inequalities

As well as delays in development, education, and communication, health leaders are particularly concerned about the impact on the individual’s mental health and the stress incurred by families while they wait for assessment and/or treatment.

Respondents particularly highlighted the impact on those children presenting with more complex or specialist needs. They said that deterioration in conditions over time could lead to increased needs when the individual is seen, as well as more children presenting at A&E or in crisis.

The NHS Confederation says 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.

Community care backlog must be prioritised

Community providers are now calling for greater investment in early intervention, support for the workforce required and more co-ordinated action in support of children and young people across government. They want to see:

• Increased investment in prevention and early intervention
• Access to additional national funding
• Support to increase numbers of staff with the right skills mix
• Simplified commissioning and contracting structures for children and young people.

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.”