Workforce pressures this winter - supporting paediatrics in local settings

We will continue to call on national governments to support paediatrics and child health this winter (2022-23). Some of you may wish to raise these issues in your local settings and may find the points below useful. We have also pulled together a range of resources to support you and colleagues on the ground.
Last modified
2 December 2022

Thank you to everyone working across paediatrics for your colossal and continuous hard work to support children and young people.


We are in no doubt that we are set for an extremely challenging and busy time through to next spring. The General Medical Council (GMC) has sent a letter to services across the UK in recognition of the tough environment that NHS staff are working in and expressing their thanks for all you have done and continue to do for patients, the public, and all those receiving care. As a College, we are working with senior partners across the UK to amplify concerns from our members about the pressures so many of you are facing, and to advocate for the needs of children, young people and their families.

Our calls to Governments are of course national by nature and overarching across paediatrics.  We fully recognise that in every country across the UK, paediatric wards and emergency departments in trusts and health boards will be seeing patients presenting with a variety of concerns and potential complexities.  We appreciate you will know far more about your own local situation and therefore, we know in parallel to our national advocacy you may wish to raise concerns on the ground that reflect your local environment.

The information presented here is designed to support you in discussions with your trust, health board or local system representatives.

Our national facing calls to governments across the UK

As you are only too aware, the UK health systems are facing substantial pressures. We are seeing more children and young people presenting at emergency departments with respiratory infections, acute mental health need and, increasingly, complex health needs.This is set against the backdrop of rising waiting times and an ever-increasing backlog of routine and elective work, as well as the incalculable effect the cost of living crisis is having on our nations’ health. Of course, children and young people from socially vulnerable backgrounds continue to fall at the sharp end.

Across the board – these issues are impacting services and, of course, the health and wellbeing of paediatricians and the allied clinical professionals in the team.

We are calling on governments across the UK to take action now, and in the long term, to:

  • Support paediatric and child health workforce recruitment and retention by implementing a workforce plan that is fully costed and evidence-based. This should include investment in staff wellbeing and create inclusive and compassionate workplaces
  • Introduce a clear and fully funded cross-departmental strategy to address health inequalities with measurable goals and resourcing for collecting data to support these. Prioritise public health, prevention and early intervention: preventative measures will reverse current trends and ensure healthy children become healthy adults.

Support for you and colleagues

We have brought together a number of tools we hope will support you and colleagues on the ground, including your own wellbeing.

It is so important to take care of yourself as well as your patients. College members have written blogs on wellbeing and provided links to support services.

Our winter pressures guidance and case studies help you make a compelling and evidence-based case for children's healthcare when services are under immense pressure.

In September 2022 we hosted a meeting to address concerns regarding increased clinical pressures in UK Paediatric Emergency Departments ahead of winter and to share and discuss some potential solutions. You can watch a recording or read a summary of the meeting

NHS England and Health Education Improvement, alongside the Paediatric Critical Care Society, has created a programme to support respiratory surge in children. This aims to support the cross-skilling of the NHS workforce to manage existing demand, potential future spikes of respiratory illnesses including RSV, and in the longer term, increasing paediatric acuity and demand in children.

Our guidance for the management of children in hospital with viral respiratory tract infections (updated in 2022) helps support planning in partnership with local infection prevention control teams and is in continuous review.

The General Medical Council’s position still stands that when concerns are raised, the factors relevant to the environment in which the professional is working will always be considered on the specific facts of the case. Its letter on 11 November 2022 alongside the Chief Medical Officers, mentioned above, underlines this point again.

NHS England published a letter in October 2022 thanking staff and teams for their ongoing hard work, as well as outlining more information on winter resilience planning, including staff vaccination, oversight and incident management arrangements, and further actions ahead of winter.

Our health inequalities toolkit, launched in September 2022, provides background evidence on how poverty drives child health outcomes within the UK context, and provides paediatricians with the skills to talk with families.

If you are based in England, you can now write to your MP and encourage them to raise the need for action on child health inequalities and poverty in Parliament.