Record high: Over 400,000 children waiting for treatment amidst child health crisis

Disturbingly, 17,991 of these children have been waiting for more than a year for essential treatments. During this period, we have seen considerable progress made in shrinking the adult backlog, but the children’s list continues to rise at an unprecedented rate. Our children are not being prioritised.

These numbers, already too high, only represent the recorded and counted cases, failing to capture the true extent of the issue. Hidden waiting times for community care continue to grow, exacerbating the situation. Paediatricians are utterly focussed on delivering care for children, but the overwhelming rise in child waiting times has left them devastated - no medical professional wants to see a patient waiting for over a year for treatment, but especially not a child.

The consequences of such long waiting times are particularly 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.

RCPCH is deeply concerned with the de-prioritisation of children and young people in current health policy and in the wider political agenda. Children, who cannot vote and have no strong voice in these matters, are all too often left behind. The College is calling on Health Secretary, Steve Barclay, to put children at the heart of policy making by including ringfenced funding for children’s service recovery at all levels (community, elective, and urgent care), and by publishing the long promised long-term, fully costed NHS workforce plan immediately.  

RCPCH President Dr Camilla Kingdon said:  

It is a national scandal that over 400,000 children are stuck in limbo on a list, waiting for treatment. These children could fill Wembley stadium four times over. Of this number, 17,991 of them have been waiting for more than a year. NHS England has a zero-tolerance policy for 52-week waits, so it is deeply concerning that these targets are being missed. The clear regional variation in size of waiting lists, also means that this is an equity issue for children and their families.  Child health teams are working tirelessly to address the growing backlogs, but without proper support, their efforts are unable to make a meaningful dent in the problem.   

We fear that children are being left behind again in health policy and the wider political agenda. While there has been considerable progress in reducing wait times for adult treatment in recent months, children's waiting lists continue to grow. The recent focus on adult service recovery through the elective recovery plan has further deprioritized children's health in national and local policies, raising alarming questions about the commitment to children's well-being. 

The government's recent decisions to abandon the 10-year mental health plan, 10-year cancer plan, and the health disparities white paper, along with the delay in implementing vital policies to prevent obesity, has added to our concern. Paediatricians had hoped these plans would urgently address the unacceptable child health outcomes in England. Unfortunately, the Major Conditions Strategy, which replaced these plans, appears to primarily target older adults and frailty, leaving uncertainty as to whether the needs of children and young people will be adequately addressed. The government must provide urgent clarity on its vision for children's health and the wider disease prevention agenda and outline concrete policies to bring this vision to life. 

As committed paediatricians, we are unwavering in our advocacy for children in health, education, and social policy. It is imperative that immediate action be taken to alleviate waiting times and ensure the well-being of our nation's children. 

RCPCH Officer for Health Services, Dr Ronny Cheung said:  

It’s clear now that the voices of children are not being heard. It seems that the focus in the lead up to the next election is primarily on voting-aged adult issues. The health of our children is simply not a priority.  

400,000 children waiting for treatment is a damning indictment of how the UK is treating its most vulnerable. Lengthy waits are unacceptable for any patient but for children and young people the 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 irreversible. In recent months we’ve heard about children missing school, quitting sports, and missing out on the important aspects of a healthy, happy childhood. This is not a trivial matter.  

We need to start investing in our future and that means investing in children’s health. We are calling on the UK 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, well-being, physical and mental health. We also need the publication of 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.  

RCPCH analysis of NHS England’s RTT dataset  for 'other paediatrics'

Tables are below, but the monthly dataset is for March 2023, and shows:    

• Waiting list March 2023: 403,955  
  • This is the highest list since records began  
  • The waiting list has grown by 158,256 between April 2021 and March 2023.   
  • This is a 39% increase in just two years  
  • This figure do not represent the children waiting for other treatment specialisms, or indeed in community care where no data is recorded.   
• 59.8% of paediatric patients were seen within 18 weeks where the NHS target is 92%.  
• The average waiting time for children and young people is well over the three month target – at 13.5 weeks.  
• Total waiting more than 52 weeks: 17,991  
• Total waiting more than 78 weeks: 452   
• The total waiting list is 7,282 more than the previous month.    
• There are 642 more children who have been waiting longer than year for treatment in March than February. So the year long waiting list is rising