Royal College of Paediatrics and Child Health Wales (RCPCH) has published a seminal report, ‘Worried and waiting: A review of paediatric waiting times in Wales’. The report looks at data from 2016-2023 and highlights the grave state of paediatric waiting times in Wales.
The findings show that in November 2016 the total number of ongoing paediatric waits were 7,096. In November 2023 there were 11,514. This is a 62.3% increase. This compares to a 7% increase in waits for rheumatology, a 52.6% increase in trauma and orthopaedics and a 57.4% increase in Ears, Nose and Throat waits during the same timeframe.
The standard NHS target aims for 95% or more patients to wait less than 26 weeks to start treatment, however this target has not been met since February 2020. There has been limited progress in reducing the total number of children waiting this year, however waiting times hit a record high first and are still nowhere near pre-pandemic levels. In fact, waits over 36 weeks rose by 40.2% between November 2022 (858) and November 2023 (1,203). As of November 2023, there were 6,785 under 18-year-olds waiting over a year for treatment, and 1,229 waiting over 2 years.
Long waits also disproportionately affect the developing child, compared to adults, have a major impact on vulnerable families and exacerbate long term health inequalities. Delayed treatments may affect physical milestones, communication skills, social development, educational outcomes, confidence and resilience as well as their mental wellbeing. When asked about waiting times, one young person said: ‘I want to feel like they’re aware I’m waiting and not forgotten.’
Although a difficult read, the report also contains key policy recommendations which would ensure children and young people receive care in a timely manner, in the right place and by the right professional.
These recommendations include:
- Carry out a review of the entire child health workforce, including numbers working in child health settings, stage of their careers, place of work, demographics and working pattern.
- Develop and implement a bespoke child health workforce strategy that aims to attract and retain child health professionals.
- Improve the collection, sharing and utilisation of child health data when appropriate.
- To ensure the delivery of the Child Poverty Strategy is robust and transparent, the Welsh Government must promptly deliver a monitoring framework.
- Improve health outcomes for children currently living in poverty by developing a cross-government delivery plan for addressing child health inequalities.
RCPCH Officer for Wales, Dr Nick Wilkinson, said:
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 may endure for years or become irreversible. In recent months we’ve heard about children missing school, quitting sports, becoming isolated, and missing out on the important aspects of a healthy, happy childhood. Long waits are bad for children and bad for our society.
Paediatricians and the whole child health workforce are working immensely hard, but without further support the workforce will struggle to close these long delays. While there has been some positive progress near the end of 2023, current demands and pressures on services are unsustainable. Urgent investment across the entire children’s workforce such as improved access to child health data and a greater focus on prevention as a form of intervention is greatly needed. Any and all investments that support child health is high value - for a healthy child is more likely to become a healthy adult, and thus makes good economic sense for society.
Children’s Commissioner for Wales, Rocio Cifuentes, said:
I welcome this report and thank the Royal College for their work. The report paints a stark picture of the current state of child health services and of unacceptably long waiting times being endured by children.
I entirely support the recommendations made - we must use this report as a springboard for a renewed laser focus on child health in Wales.
While we have seen some recent improvement, this improvement must accelerate, and the disparities between health boards must be addressed. This can only be achieved with a dedicated plan for improving children and young people’s health, reducing child health inequalities and addressing workforce issues. I urge Welsh Government and Health Boards to respond positively and urgently to these recommendations. I stand ready to support action to improve the experience of children accessing our health service.