A new report from the Royal College of Paediatrics and Child Health (RCPCH) warns that children and young people are at risk, facing ‘significant’ challenges waiting for NHS care, with doctors calling for urgent action.

Scottish paediatricians report that over the past 11 years, the pressures experienced by staff across services has risen, resulting in a greater number of children and young people waiting longer.

The ‘Worried and Waiting: A Review of Paediatric Waiting Times in Scotland’ report looks at data on waiting times between October 2012 and September 2023, revealing increasing burdens on services and staff.

Waiting lists for paediatric services, excluding mental health, cardiology, surgical and ear nose and throat, have more than doubled in this time to 10,512.

The RCPCH Scotland says the government must undertake a full review of the child health workforce to ensure the workforce is ‘sufficiently resourced and funded’ to tackle waiting times.

The college is also asking for improvements to be made to the collection and use of child health data, and to improve funding for, and access, to primary and community care support.

These three key recommendations follow consultation with young people and the College’s members.

RCPCH Officer for Scotland, Dr Mairi Stark says the information gathered represents only the “tip of the iceberg” and more must be done to ensure services meet demand:

“An 114% increase in outpatient waiting times over the past 11 years signifies a clear failure to prioritise the health and wellbeing of our children.

“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 can be irreversible.

“What’s more, the shocking data in this report is just the very tip of the iceberg. We know that there are exceptionally long waits for other services children and young people access, such as surgical, mental health and ear, nose and throat (ENT) services.

“Paediatric services need to match the existing need, and enhanced data collection can be a key tool to understanding where the backlogs are and how to direct resource.”

RCPCH Scotland says improving access and funding to primary care and cross-sectoral, community-based services, resources and advice for children and families is vital to support their health and mental wellbeing.

“Unacceptable waits”

One RCPCH member said that parents have shared that they feel “overwhelmed and isolated” while waiting for appointments and are unsure where to turn for support.

Dr Stark says those working in the NHS and more broadly must be better supported to meet the needs of children and young people:

“We need to give the child health workforce the support it needs to care for the children and young people of Scotland.

“We urge the government heed our advice and implement our recommendations. Only by tackling long waiting times can we provide the appropriate, holistic care that children need. Healthy children grow up to be healthy adults, so the time to act is now.”

Missed targets

The standard waiting times target for Scotland states that 95% of new outpatients should wait no longer than 12 weeks from referral stage to the point of being seen.

However, almost half of all young people and children waiting to be seen had to wait more than 12 weeks for an outpatient appointment in 2023 – rising from just 1% of total waits in 2012 to 48.9% last year.

One emergency department consultant told RCPCH this is “incredibly concerning”, adding that they “regularly see the impact” of these waits, with families resorting to bringing their children to the emergency department for support instead.

The longest waiting lists and the highest proportion of waits over 12 weeks was seen in NHS Lothian, with 69.1% of all waits over the 12-week target.

Michelle Wilson, Head of Children and Young People’s Health and Wellbeing Services at Children's Health Scotland, says the report reveals the day-to-day experience of people across Scotland:

“It highlights what children, young people and those that love and care for them have also been telling CHS: “Waiting for appointments takes too long”.

The report not only highlights issues of concern but carries strong recommendations that will help Scotland realise its Promise to all our children – in order that they feel loved, safe and respected and have the opportunity to be the best they can be.”

Read more: Funding boost to support new parents' mental health; Medics warn pollution is risking children's health; Children's health not improving despite good policy; Psychiatrists in ‘disbelief' over cut funding; Health poverty hits children halfway through pregnancy; Regulation key to reducing obesity

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