A report from the Royal College of Paediatrics and Child Health (RCPCH) highlights the devastating consequences of prolonged underinvestment in community healthcare, and the growing waiting lists faced by children and young people as a result.
The report, ‘Collaborative Healthcare in Wales: Delivering the Services Children Need in the Community’, lays bare the scale of crisis facing community child health services across the country, with data provided by each Welsh health board and key insights from community paediatricians.
Community child health services provide care for children with the greatest needs in our communities. Often lead by community paediatricians, these services diagnose conditions, assess safeguarding concerns and support children with complex medical needs outside of hospital settings. Working in clinics, schools and community hubs community paediatric services focus on long term care and coordination across services.
The analysis of data obtained from Freedom of Information request (FOI) between March-May 2025 from health boards across Wales reveals dramatic increases in waiting times:
- Aneurin Bevan: waiting lists for community paediatrics increased 117% from 150 in 2015 to 326 by 2024.
- Betsi: community paediatric waits have increased from 805 in 2018 to 8,986 in 2025. The equivalent of a 1016% increase.
- Cardiff: community paediatric waiting lists have grown by 302% since 2018, from 1239 to 4,990. Number of community paediatricians decreased by 8% during this time.
- Cwm Taf: The number of children waiting for a community paediatric service fell from 141(2023) to 135 (2025). The number of under 18s waiting for neurodevelopmental services rose from 2,173 in 2023 to 3,391 by the 1 January 2025. A rise of 56%
- Hywel Dda: The number of children waiting for community paediatric services has increased by 4.1% between 2018- 2025, rising from 1,477 to 1,538. The number waiting for an Autism Spectrum Disorder assessment has risen by 781% since 2018 and the number waiting for an ADHD assessment have risen by 331% since 2018.
- Powys: The Health Board employs three community paediatricians, and has 119 children waiting for community paediatric services and 1,109 for ND services a rise of 112% (2022-2025).
- Swansea: Number of children waiting for community paediatric services increased by 112% since 2020, from 597 to 1,271. The average number of weeks risen from 36 weeks to 80.
[The data from these FOI responses are not comparable across health boards as they lack uniformity, and at times are inconsistent or incomplete. Instead, the data displayed in this report will provide a spotlight on each health board using the individual FOI responses, where available. This data should not be compared across health boards, nor totalled as an overall figure.]
The current situation for Welsh community health services is unsustainable. RCPCH call on the Welsh Government to deliver on its long-standing ambition of care closer to home by investing in early years support and ensuring adequate staffing across disciplines like community paediatrics, speech and language therapy, and mental health.
Read the full report and recommendations
RCPCH Officer for Wales, Dr Nick Wilkinson, said:
Children and young people are too often overlooked, with services focused on adult pressures. Despite the Welsh Government’s aim to deliver care closer to home, community child health remains underfunded — with too few health visitors, continence nurses and speech and language therapists. These gaps have serious consequences, from poor school readiness to long-term health issues and we’re seeing the impact of this on all our services
Early intervention is vital, yet growing waiting lists and delays are leaving children without the timely care they need. The Welsh Government must act now to prioritise and invest in children’s services — before more young lives are impacted.
Children’s Commissioner for Wales, Rocio Cifuentes, MBE, said:
The importance of early intervention in children’s health can’t be overstated, yet the startling waiting times outlined in the report show that children are missing out on a range of vital interventions—and alarmingly, at a growing rate. The wider themes raised in the report are issues my office has consistently raised over the years, like poor transitions to adult care, a system that can be complex to navigate, and care being reliant on assessments rather than need. These deficiencies must be a priority for the Welsh Government. Failure to act will risk health problems worsening over time and having a significant impact well into adulthood, as well as placing more and more pressure on public services.
Dr Lizzy Nickerson, Chair of the Wales Community Child Health Network & Consultant Community Paediatrician, said:
This report puts the spotlight on the part of the iceberg that has been ignored for too long. Political priorities now need to focus on the long-term consequences of neglecting the cohort of children with neurodivergence and complex needs, taking a multi-agency, holistic and need-based approach to early intervention and the vital importance of early years.
For so long we have heard how parents and carers are struggling, and this is very evident in the long waiting lists, increased safeguarding concerns and the rising need for community paediatric services. We must end the over-reliance on the good will of NHS practitioners working in an under-resourced system. These children are tomorrow's adults and without the investment into their needs and the workforce who cares for them, the socioeconomic future is bleak.