A new report from RCPCH Ireland: ‘Collaborative Healthcare in Northern Ireland: Delivering the services children need in the community’ lays bare the scale of crisis facing community child health services across the country, with data obtained through freedom of information requests (FOIs) and research conducted with paediatricians working across the nation.
Community paediatricians are doctors who specialise in caring for children with the greatest needs in our communities. They work in clinics, schools, or community health centres, focusing on long-term care and coordination across services. Their roles include diagnosing conditions such as autism, ADHD, developmental delays, assessing safeguarding concerns and supporting children with complex medical needs outside of hospital settings.
The report found that since from September 2020 to September 2023, the waiting list for outpatient community paediatrics grew from 5397 to 10,035, a staggering 85.9% rise. On top of this dramatic rise, research shows that 88% of community paediatricians surveyed in Northern Ireland reported staffing shortages in their services, whilst 100% of survey respondents reported that long-term demand was outstripping capacity.
In order to alleviate the pressure in community care, RCPCH Ireland has put forth a series of recommendations, including:
- Developing and deliver a community paediatrics regional action plan.
- Conducting a scoping review of the current community child health workforce, including paediatrician per Trust and per capita.
- The Northern Ireland Executive should support the Department of Health to invest in the community child health workforce. This includes addressing workforce gaps for community paediatricians, Allied Health Professionals, nursing and beyond.
- Mandatory data reporting from all Trusts to ensure a full and accurate picture of the number of children on waiting lists.
- Implement the draft Children’s and Young People’s Emotional Wellbeing Framework in order to develop a roadmap for the delivery of uniform neurodiversity pathways and support services for children prior to any diagnosis.
RCPCH Officer for Ireland, Dr Thomas Bourke, said:
Community care is the bedrock of NHS services, especially for children and young people. Yet the current surge in demand has laid bare just how massively overstretched and under-resourced our community paediatric services have become. Community paediatricians are on the front line of supporting children with the most complex and lifelong needs, but they cannot do this vital work without proper investment. These dedicated professionals deserve the time, staffing and infrastructure to deliver the care our children urgently need. Without it, we are failing our most vulnerable children.
Interim Chief Executive of the NI Commissioner for Children and Young People, Alex Tennant, said:
I welcome RCPCH’s report, which highlights the significant rise in demand for community paediatric services, and the challenges of meeting this demand.
We in NICCY know about the vital impact that community child health services have on children and young people and highly commend the valuable work of community paediatricians in schools, communities, and health centres. However, we also see how children are waiting too long to access these essential services, and the impact, not only on their health and well-being, but the knock-on impacts of stress, school absence, and social exclusion. Parents and carers are also affected, as they anxiously await hospital appointments and treatment for their children.
This report is a very thoughtful and practical response to these challenges, making concrete recommendations that would improve the capacity of paediatric services to meet the needs of children across Northern Ireland. We commend it to the Executive and ask that they act on behalf of the thousands of children struggling to access these critical services.