Hidden waits: the lasting impact of the pandemic on children’s services in the community

Posted: 5th April 2023

Key points

  • The COVID-19 pandemic has had a unique and significant impact on children and young people, particularly on social development, education and mental health. However, this impact has not been felt equally across society with some groups (particularly those from more disadvantaged backgrounds and those with disabilities) disproportionately affected.
  • Access to community health services for children and young people has been significantly affected by the pandemic. At points during the pandemic effort, community services staff were redeployed from some children and young people’s services to prioritise an urgent and timely response to the pandemic. While this may have been the right clinical prioritisation during a national crisis, its impact may be long lasting for some children and young people.
  • NHS England and NHS Improvement (NHSEI) data from January 2022 estimates that over 900,000 children and adults are waiting for services as part of a community services care backlog. For community children and young people’s services, the most significant waits are in speech and language therapy, community paediatrics, occupational therapy, physiotherapy and neuro-developmental assessments for those with suspected autism and attention deficit hyperactive disorder.
  • While not part of official backlog figures, a reduced service offer during the pandemic has had an impact on children and young people and their families. For instance, face-to-face health visiting can support early interventions and build important relationships with families. Some of these key windows of opportunity have been missed.
  • Community providers have been using data, digital tools and a health inequalities lens to tackle care backlogs in the sector, including for children and young people’s services. However, providers need more support to scale up this work.
  • Workforce pressures, including shortages of staff in some key services, make it difficult for community providers to increase delivery to address backlogs of care.
  • Complex commissioning and contracting arrangements, which are often based on historic agreements, also make it challenging to address the backlog of care in these services.
  • Backlogs of care and reduced offers in community children and young people’s services have negative and far-reaching impacts for individuals and families and in socio-economic terms. Delays to accessing these essential services can impact on social development and educational outcomes for individuals, and on wider society and the economy.
  • Colleagues in NHSEI and community providers are committed to radically improving the national dataset for community services to ensure prioritisation in national strategies and policy, but data to make the case for a greater focus on community provision remains inconsistent. Also, data submitted to the community services data set does not appear in national waiting list figures, which reduces the visibility of community backlogs and acts as a barrier to accessing dedicated, central funding.

Source: Hidden waits: the lasting impact of the pandemic on children’s services in the community | NHS Confederation

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