paediatric nurse talking to patient

Children face growing delays in NHS community care

growing by 58% since 2022, according to a new briefing from the Nuffield Trust, published as part of its QualityWatch programme with the Health Foundation.

The analysis reveals that almost 1 in 4 children wait over a year for care, and 1 in 15 wait over two years, compared to just 1 in 100 adults. These delays affect access to vital services such as community paediatrics, autism and ADHD diagnosis, and speech and language therapy – with serious implications for children’s health and future life chances.

Key findings include:

  • 55% of children on the waiting list are waiting for community paediatric services
  • 21% are waiting for speech and language therapy
  • The overall community care waiting list stands at 1.2 million
  • Weight management services for adults saw a 512% increase in demand
  • Musculoskeletal services account for 44% of adult community care waits

The report highlights regional variation, with some providers reporting zero long waits, while others – such as University Hospitals Dorset NHS Foundation Trust – have over 90% of children waiting more than 18 weeks.

The briefing also reveals that community staffing levels have lagged behind hospitals. Between 2010 and 2025, the number of community nurses has increased by only 1%, adult hospital nurses rose by 42%, and children’s hospital nurses went up by 93%.

Jessica Morris, Nuffield Trust Fellow and briefing author, said:

“Children across the country are waiting far too long for the community care they desperately need. For the families affected it can feel like life is on hold while they’re stuck waiting for support. To take just one example, many children on the list are in urgent need of lifechanging speech and language therapy because of difficulties with communicating or swallowing.

“The increasing number of people living with long-term conditions together with our ageing population mean that more and more people are likely to need support from community health services in the coming years. The government’s health plans recognise the importance of community services and include laudable aims to expand them, but our analysis shows how difficult realising that goal will be when existing community services are already on their knees.”

Nuffield report QUOTE

The Nuffield Trust warns that without realistic workforce and service plans, the government’s ambition to shift care from hospitals to communities under the 10 Year Health Plan will falter.

The report has called for:

  • A national waiting time target for community services
  • A dedicated strategy to tackle children’s community care delays
  • A rebalancing of resources to support “neighbourhood health”
  • Investment in staffing and infrastructure where delays are most severe

As the government prioritises community care, the Nuffield Trust urges policymakers to ensure that children and families are not left behind in the shift to more localised healthcare.

In response to the report, NHS Providers’ Chief Executive Daniel Elkeles commented:

"This report underlines NHS trusts leaders’ worries that a forgotten generation’s life chances are being harmed due to delays accessing care.

"Preventing ill health among children and young people is central to ensuring the next generation are able to live well, thrive and contribute to society and the economy.

"We have highlighted great examples of trusts working in new and innovative ways to improve services for young people, and the lessons they have drawn.

"These include the need for a wholesale shift at a national level which puts them at the heart of policy making.”

 

Image credit: iStock

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