Paediatricians call on government to take action as children’s waiting lists soar to 350,000 for the first time

NHS England published referral to treatment waiting times for April 2022 on 16 June 2022. For the first time, we have a full year of consultant-led paediatric waiting lists data.
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•    According to figures released today by NHS England, there are now 100,000 more children  waiting to be seen by a consultant than there were a year ago.  The number of children and young people in the queue for care and treatment has soared to more than 350,000, the highest on record. 

•    Long waits for care are particularly harmful for children as they can impair their mental and physical development at a critical time of life. Paediatricians and child health teams are working hard to bring the longest waits down but they work within a system that does not prioritise children’s needs. As a College, we are dismayed that more than 12,000 children have been waiting over a year for treatment. 

Tables are below, but the monthly dataset is for April 2022, and shows:  

  • The number of children waiting to start treatment with a consultant at the end of April 2022 is 350,969. This is the highest number since records began. 
  • The waiting list has grown by over 100,000 in the year from April 21 – April 22. 
  • The size of the waiting list is growing more rapidly, with a rise of 50,000 between November and April.  
  • Half of all children are waiting more than 12 weeks for treatment.  
  • 65.4% of patients were seen within 18 weeks where the NHS target is 92%.
  • The average waiting time for children and young people is nearly three months (11.8 weeks)
  • Regional variation is high with NHS Oxfordshire seeing waits per 100,000 of 230.1 children whereas NHS Sheffield CCG has a waiting list per 100,000 children of 5,491.5

President of the Royal College of Paediatrics and Child Health, Dr Camilla Kingdon said:  

It is very disturbing that in the past 12 months, more than 100,000 more children have been added to the NHS waiting list. With more than 350,000 children and young people waiting for care, we have to find a way of addressing this immense need for them and their families, and we need to start prioritising them so that they can have the prospect of a healthy childhood.  

It’s important to bear in mind that these are just the number on the list who are recorded and counted. There are a series of hidden waiting times for community care. Paediatricians are working extremely hard to see as many children and young people as possible but the pandemic has carried in its wake a burden of young need that we cannot address. Ministers must now take urgent steps to prioritise their care and capitalise on every opportunity to innovate and transform care. Lengthy waits are unacceptable for any patient but for children and young people waits can be catastrophic as many treatments need to be given by a specific age or developmental stage. It is not the same as for adults. If you miss the right window to treat a child or wait too long the consequences can be irrevocable.    

If the government is serious about levelling up Britain and giving every child the best start in life, we need a proper response including a child health action plan, combined with a clear plan to ensure we have a strong child health workforce to provide the right care for those at the start of their lives. This is the mark of any decent society. Many children and young people have suffered a great deal as a result of the impact of successive lockdowns and should not be expected to wait for months and years to receive treatments which could have a lasting impact on their lives.  

RCPCH Vice President for Policy, Dr Mike McKean said:  

Long delays cause serious issues for children and young people, but delays also spark secondary consequences which can be stark for children and their families.  

In recent times I’ve been made aware of a child with vulnerable breathing and spinal scoliosis. She deteriorated through the pandemic to the point she could no longer sit down, or go to school. To improve her quality of life and get her back to school a major surgery was required, but while waiting, the surgery was cancelled four times – and was all down to the recurrent pressures on intensive care.  

In this case she had already missed more school than was necessary, setting her back in her education and struggling to catch up. The delay also meant her parents missed time off work, and her sibling’s mental health was impacted, also leading to their missing school.

Paediatricians are working immensely hard, but without further support the workforce will struggle to close these long delays. This will impact Britain for the long haul. We urgently need roll out and full funding of the 15 year NHS work force strategy announced by the Secretary of State yesterday with specific inclusions around paediatrics and child health to protect children, young people and their families from lasting consequences. 

As a College we are calling for:  

  • Enhanced data collection to understand where the backlogs are building up, and where Government, the NHS and others should direct resource  
  • Monthly data collation for paediatric community health services, so that data can be monitored and those current waiting lists tackled 
  • Government to produce a cross-departmental child health strategy, that puts children at the centre of its decision making, and includes a focus on inequalities, wellbeing, physical and mental health.  
  • A long term and evidence-based workforce plan to map the staff shortages and start tackling them so that we can offer the best care for children throughout the country  

As we continue to bear witness to the impact of lockdown on children’s lives these actions matter more than ever. 

Notes to editors:  

Analysis extracted from Consultant-led Referral to Treatment Waiting Times Data 2021-22.  & 2022-23

Month Number on waiting list Difference to previous month Percentage change Not seen in 52 weeks
Apr-21 245,699  n/a n/a 17,800
May-21 257,407 11,708 5% Unknown
Jun-21 267,256 9,839 4% 13,854
Jul-21 277,642 10,386 4% 12,681
Aug-21 283,301 5,656 2% 12,173
Sep-21 288,030  4,729  2% 11,914 
Oct-21 298,151  10,121  4% 11,808 
Nov-21 300,465  2,314  1% 11,237 
Dec-21 310,441  9,976  3% 11,290 
Jan-21 315,738  5,297  2% 11,154 
Feb-21 324,804  9,066  3% 10,719 
Mar-21 340,240  15,436  5% 10,996  
Apr-22 350,969  10,729  3% 12,022

April data – taken from NHS’s England’s RTT waiting times by hospital trust 

Regional break down by number waiting per 100,000 taken from an NHS waiting list tracker.

Rank CCG Total number of pathways for 100,00 population waiting to start treatment  
1 NHS Oxfordshire CCG 230.1
2 NHS Cheshire CCG 462.5
3 NHS Portsmouth CCG 673
4 NHS Hampshire, Southampton and Isle of Wight CCG 699.2
5 NHS Bristol, North Somerset and South Gloucestershire CCG 739.4
102 NHS Leicester City CCG 4,389.5
103 NHS Manchester CCG 4,533.1
104 NHS Salford CCG 4,636.9
105 NHS Brighton and Hove CCG 5,110.3
106 NHS Sheffield CCG 5,491.5