A new report from the Royal College of Paediatrics and Child Health (RCPCH) Scotland warns that children and their families across Scotland are being let down by critical pressures in community paediatric services, a lack of reliable data, and workforce shortages.
Community paediatricians play a vital role in safeguarding vulnerable children, coordinating complex care, and working alongside families and multi-agency partners. Their roles include conducting clinics in various settings and developing local health strategies, safeguarding policies, and lifestyle programs to improve children’s health.
Despite the importance of community paediatric services, the report, titled ‘Collaborative Healthcare in Scotland: Delivering the services children need in the community’ reveals major challenges.
Key Findings:
- Data Deficiency: Accurate national data on community child health services is lacking. In a recent RCPCH Scotland survey, 81% of respondents said data collection needs improvement, and 76% believe better data would directly support their clinical work.
- Workforce Under Pressure: Health professionals are stretched thin. Concerns about staffing shortages, recruitment, and sustainability were echoed by multiple Royal Colleges and professional bodies. The RCPCH survey also revealed that 65% of paediatricians working with Allied Health Professionals (AHPs) believe that long waiting times are harming patient care.
- Inconsistent Access to Services: Children face a postcode lottery when accessing services. RCPCH members reported stark variations in provision, training, and capacity across NHS health boards.
- Poor Transitions to Adulthood: There is currently no statutory duty to support disabled children moving to adult services, putting many at risk of poor health outcomes during this vulnerable phase.
- Strained Neurodevelopmental Services: Rising demand, inadequate support for families, and insufficient national data have left neurodevelopmental (ND) services struggling to cope
RCPCH Scotland is urging the Scottish Government and health boards to take immediate action to strengthen community paediatric services. This includes improving national data collection and sharing, investing in a sustainable workforce, and ensuring timely access to care. Early intervention must be prioritised, and regional disparities addressed. In order to improve transitions to adult services, substantial investment, jointly planned services and better coordination are needed. Neurodevelopmental services also require urgent reform, including improved data collection and publication, greater public awareness of neurodiversity, and family support pre and post assessment.
You can read the report and the full recommendations here.
RCPCH Officer for Scotland, Dr Mairi Stark, said:
This report delves into the significant challenges faced by community child health services in delivering comprehensive care and support to children and their families. These challenges have been identified through feedback from our dedicated members. Our members have told us of long waiting lists and unsustainable demand for their services.
Unlike our Worried and Waiting report, community paediatric data is not published for all health boards on Public Health Scotland. Despite submitting FOIs to all health boards, we quickly uncovered a glaring inconsistency in data recording, preventing us from obtaining a clear picture of the need across Scotland. If we cannot grasp the full scale of the need, how can we possibly address it?
Community paediatrics is essential for children with the most complex needs, yet it remains under-supported and under-resourced. Without better data, strategic investment, and a sustainable workforce, we risk failing the children who rely on us most. RCPCH Scotland is urging the Scottish Government and health boards to act decisively to protect and improve these vital services.
Michelle Wilson, Head of Children Services at Children's Health Scotland, said:
Children's Health Scotland is proud to have engaged with our Health Rights Defenders to ensure that children and young people’s lived experiences and priorities take centre stage in this essential new RCPCH Scotland report. Children and young people’s insights, highlighted throughout this report, underscore the critical need for timely access to community child health services and collaborative care. CHS and RCPCH are dedicated to upholding the health rights of every child, empowering families, and fostering an environment where all children can thrive.
Nicola Killean, Children and Young People’s Commissioner Scotland, said:
Children have the right to the best possible physical and mental health, and that means getting the support they need, when they need it.
This powerful report highlights issues that children regularly raise with us and it’s vital that their voices are not only listened to but are acted upon. Much more needs to be done to address the postcode lottery of community-based healthcare and regional disparities to ensure that there is equal access to the right support and professionals at the right time. There is a real need for more investment in child community health including in early intervention, and resources to tackle the unmet need in relation to neurodevelopmental services.
There are strong and important recommendations in this report – decision-makers must take urgent action.