Children's doctors raise alarm on ‘out of control’ paediatric waits in Northern Ireland

Between June 2016 and June 2023 Northen Ireland saw an increase of 172.6% in paediatric outpatient waiting lists.

Royal College of Paediatrics and Child Health (RCPCH) Ireland has published a watershed report on the endless waiting lists for paediatric outpatient appointments in Northern Ireland. The report ‘Worried and Waiting: A review of paediatric waiting times in Northern Ireland’ outlines the shocking rise in waiting times for children and young people in Northern Ireland from summer 2016 to summer 2023.

During this period there has been an increase of 172.6% in overall outpatient waits for children, with the number of children waiting at a record high of 22,272. This figure represents a staggering 22.5% increase from the year previous. RCPCH’s report also highlights the deeply concerning number of children and young people waiting over a year for treatment. There were 578 ongoing waits over 52 weeks in June 2016 and 6,326 in June 2023. When looking at over 52 weeks waits between June 2022 (4,743) and June 2023, there was a 33.4% increase.

The consequences of such long waiting times are profoundly damaging for children. Many treatments and interventions must be administered within specific age or developmental stages, making the irrevocable effects of such delays even more pronounced. Prolonged waits not only impair children's mental and physical development but also have a detrimental impact on their education and overall wellbeing. Feedback from children and families has illustrated their worry and discontent with the impact of long waits.

This year RCPCH has published reports in both Wales and Scotland noting extremely long waits for children. However, the longest waiting times for children are found in Northern Ireland. Furthermore, while Scotland and Wales have seen minor reductions to outpatient waiting times in 2023, waiting times in Northern Ireland have continued to grow.

Although a harrowing read, the report also contains key policy recommendations which would ensure children and young people receive care in a timely manner, in the right place and by the right professional. RCPCH recommendations include:

  • Taking a ‘whole child’ approach to service configuration, starting with a full review of the child health system to ensure that health and social care reform is based on a clear understanding of need and improving integration. Attention should also be paid to reducing poverty and subsequent health inequalities within the nation.
  • Stronger workforce planning, including the development of a bespoke whole child health workforce strategy with an integrated approach including numbers working in child all health settings, career stage, demographics and working patterns.
  • Better data collection as limited data availability in the nation remains a barrier to understanding need and appropriate commissioning. The Department of Health, Public Health Agency and HSC Trusts should improve the collection, sharing and utilisation of child health data.

You can read the report and RCPCH’s recommendations here.

Dr Ray Nethercott, RCPCH Officer for Ireland said:

We know that for all age groups Northern Ireland has some of the worst waiting times in the UK, but we also know that for of children, time is felt relatively. A year long wait for a child does not compare with that of an adult in the grand scheme of their lives. Long waits are also more dangerous for children and young people, with many treatments need to be given by a specific age or developmental stage. Often if you miss the right window to treat a child or wait too long the consequences can be irreversible.

An 172% increase in paediatric waiting times since 2016 is nothing short of a catastrophe. Not only are these out of control numbers unsustainable, but they also represent a failure to prioritise children’s health. We have seen exceptionally long waits in Scotland and Wales also, not to the same extent as Northern Ireland. As a paediatrician I am deeply frustrated to see Northern Irish children bearing the greatest burden when accessing health services.

Northern Ireland currently has the lowest spend on children of any other UK country overall. We cannot ignore the fact that our children are being let down. But we can begin reversing this devastating trend by taking a ‘whole child’ approach to service provision, workforce planning and in reducing poverty. The child health workforce is working hard to match the demand put on services, but without further support and resourcing they will never make a meaningful dent. Our new Assembly gives us the perfect opportunity to fix these issues and invest in our future by investing in our children.

Chris Quinn, Commissioner for Children and Young People Northern Ireland, said

I welcome the RCPCH Northern Ireland publication "Worried and waiting: A review of paediatric waiting times in Northern Ireland", and I am pleased to support the recommendations it proposes to address the worrying situation of increased waiting times for paediatric services.

I am concerned by the findings of the report regarding the steady increase in waiting times, as behind each statistic are children who are facing barriers and delays in treatment and care, which can have a significant impact on their daily lives and wellbeing.

This report is an important intervention in the discussion on the waiting list crisis in NI, and it is critical that any measures taken to address waiting lists actively includes provision to support paediatric services, and the staff working to ensure their operation.

I have been concerned by the limited consideration of paediatric waiting lists in the devolved institutions since their return, and this report demonstrates that children cannot be left waiting for political action.

Notes to editors:

  1. The report looks at first outpatient appointment waits for paediatric medical specialties only, excluding community paediatrics and those children’s specialities under other Royal Medical Colleges such as CAMHs, paediatric cardiology and paediatric surgical specialties.
  2. The report does not include the most recent quarterly outpatient’s data set due the unavailability of figures from the South-Eastern Trust on 31 December 2023 due to transitioning to Encompass. Therefore, data used for this report stops at quarterly release in September 2023.