Children are facing unacceptably long waits for NHS community
services that deliver care closer to home, including for
paediatric services that help children with developmental
problems or disabilities. Almost 1 in 4 children spend over a
year on the waiting list and 1 in 15 wait over two years. In
comparison, 1 in 100 adults wait over a year for community care.
These long waits for essential healthcare can not only impact
children's health but also their future life chances.
That's according to a new briefing on growing
waits for community care by the Nuffield Trust, published today
as part of their joint QualityWatch programme with the Health
Foundation. The analysis found that the size of the community
care waiting list for children has increased by 58% since data
began in 2022, compared with a 23% increase for adults. Over half
of children and young people on the waiting list are waiting for
community paediatric services (55%) – that includes support for
developmental problems and diagnosing and managing conditions
like autism and ADHD – and 21% are waiting for speech and
language therapy services.
Government targets have focused on reducing long waits for
hospital treatment, but the overall community care list – which
stands at almost 1.2 million – has received much less attention.
As part of the 10 Year Health Plan, the government has big
ambitions to shift more care from hospitals into communities, but
the QualityWatch analysis reveals how existing community services
are already struggling to keep up with demand.
Further findings from the analysis include:
- There is large and concerning variation in waiting times
across the country for NHS community services. In July 2025, (of
those that submit data) the care provider with the highest
proportion of long waits for paediatric services was the
University Hospitals Dorset NHS Foundation Trust, with over 90%
of children waiting more than 18 weeks. In contrast, seven
providers – including Sherwood Forest Hospitals Foundations Trust
– reported zero waits of over 18 weeks.
- For adults, 44% of those on the community waiting list are
waiting for musculoskeletal services which assess and treat
conditions relating to bone, joint or muscle pain. This raises
concerns about services in the NHS not keeping up with the ageing
and increasingly obese population.
- The largest percentage increase of any community service
since 2022 occurred in weight management services for adults
(512%). The rapid increase may relate to the recent surge in
demand for GLP-1 medicines for weight loss.
- In recent years, the number of NHS staff has increased much
more in hospitals compared with community settings. Between 2010
and 2025, the number of nurses working in community settings
increased by only 1%, while the number of adult hospital nurses
increased by 42% and children's hospital nurses increased by 93%.
The authors say that boosting community staff will be key if the
‘hospital to community' shift is to be successful, and there
should be a particular focus on services and parts of the country
that are struggling the most.
In a health system where targets tend to increase visibility of
key issues, there are limited national targets for community
health services, with most focusing on hospitals. To begin to
tackle the issues around neglected community services, the
authors say that introducing a waiting time target should be
considered, to draw attention to how they are coping. As the
government says community services and “neighbourhood health” are
a priority, this needs to come with a shift in resources, along
with realistic workforce and service plans to drive faster access
for patients and reduce variation across local areas. The
briefing also calls for a dedicated strategy to tackle community
waits for children and young people as part of the implementation
of the 10 Year Health Plan.
Nuffield Trust Fellow and author of the briefing, Jessica
Morris 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.”
Dr Luisa Pettigrew, Senior Policy Fellow at The Health
Foundation said:
“This report should be a wake-up call for the government. Waiting
lists for community services are a major problem, with too many
people, including children, waiting far too long for vital care.
If the government is serious about moving care from hospitals to
the community and from sickness to prevention then addressing
long waits in community care is crucial.”
Ends.
Notes to Editors
A copy of the briefing is available here.
QualityWatch is a Nuffield
Trust and Health Foundation programme providing independent
scrutiny into how the quality of health and social care is
changing over time.
