In Wales, we pride ourselves on our commitment to giving every child the best start in life. The Wellbeing of Future Generations (Wales) Act 2015 is a pioneering piece of legislation that has helped shift the focus of government and public bodies towards the needs of the next generation. But the reality is that our health system doesn’t always reflect that ambition. As a paediatrician and RCPCH’s Deputy Officer for Wales, I see every day how children’s health services are under-prioritised and under-funded in a system largely designed around adult care.
That’s why transforming child health services is one of the core themes of Putting Children First: Prioritising Wales’s Future – our manifesto for the 2026 Senedd election. We’re calling on the next Welsh Government to put children’s health, happiness and wellbeing at the heart of NHS planning, funding and delivery.
Right now, the NHS in Wales allocates a disproportionate share of resources to adult services. Not because children’s needs are less important, but because the system hasn’t been designed with them in mind. The result? Overstretched child health teams, and delayed access to care for babies, children and young people that can have lifelong consequences.
We need a fairer, needs-based approach to service planning and investment – one that recognises that children’s care must be tailored, timely, and fully resourced. Is it really too much to ask that services available for adults, such as fatigue and pain management pathways, are also available for children?
Scaling up what works
Transformation isn’t just about funding. It’s about embracing children’s rights, tackling the root causes of poverty and inequalities which hamper the development and prospects of too many of our young people, and scaling up projects that have been proven to work. Across Wales, there are promising examples of child health transformation that deserve attention, investment and scale-up support. Examples include:
- The QuickChange project in Cardiff and the Vale of Glamorgan, which is helping to tackle increasing rates of obesity and inactivity by using podiatric expertise to create classroom-friendly animations with age-appropriate motor skills, stretching, and strengthening exercises. Piloted in five primary schools, it’s now being adapted for early years settings across the health board area - showing how small, targeted interventions can promote lifelong health and wellbeing.
- In Neath Port Talbot, integrated occupational therapy models have reduced school-based referrals by 60%, improving children’s wellbeing and school attendance, while easing pressure on secondary services.
- Betsi Cadwaladr UHB’s specialist eating disorder (SpeED) service embeds Band 4 healthcare assistants in schools across North Wales to support children and young people with eating disorders, improving access, engagement and outcomes. The service was the first in Wales to embed paediatrics at the start of a patient’s journey and the first in the UK to recruit a specialist cardiologist for dedicated paediatric cardiology care for eating disorder patients. The model is being scaled and shared with teams across Wales.
Together, these examples show that innovation in child health services is already happening across Wales - and it’s making a difference. From improving patient safety and reducing harm, to helping children access support earlier and avoid long-term complications, these initiatives are delivering better outcomes. They also help to ease pressure on acute and secondary services by reducing unnecessary referrals and enabling care to be delivered closer to home and in a more timely manner, making the system more efficient and responsive. With the right investment and leadership, these models can be scaled to benefit even more children across Wales.
The road ahead
Despite the really positive examples out there transformation in child health services, there is still a long way to go. Every delayed diagnosis, every postponed appointment, every pound diverted from prevention increases the risk of poorer outcomes. Children are missing school, families are facing mounting stress, and manageable conditions are becoming chronic. This is unacceptable.
We need a system that sees children, values children, and plans for their needs from the outset. That means child health voices at every level of decision-making. It means measuring and reporting on child-specific outcomes. And it means shifting NHS resources to address the investment gap between child and adult health services.
We need to embed Value-Based Healthcare (VBHC) principles into child health transformation. That means focusing on outcomes that matter to children and families, rather than tick boxes. It means using tools like Patient Reported Outcome Measures (PROMs) and Patient Report Experience Measures (PREMs) consistently to measure impact, and applying VBHC templates to guide investment decisions that deliver long-term value.
Collaboration is, of course, key. RCPCH Wales’s own National Specialist Advisory Group (NSAG) offers a vital platform to drive and evaluate change, bringing together clinicians and policymakers to advocate and design for services that work for children. We want to work with the next Welsh Government and NHS Performance and Improvement to reshape child health services so that babies, children and young people get the care and support they need, when they need it.
Your voice matters
We’re not just asking the Welsh Government to act - we’re asking you, our members and partners, to champion this cause with us. Speak out about the gaps in your services, share examples of innovation and good practice, and engage with your health board and local candidates ahead of the Senedd election so they are clear that children’s health must be more than an afterthought.
Transforming child health services isn’t a luxury. It’s a necessity. Let’s make sure that, come May 2026, our political representatives are left in no doubt that putting children first is not only the right choice, but also the smart choice for a stronger, healthier and fairer Wales.
Dr Dana Beasley
RCPCH Deputy Officer for Wales