**Drastic Increase in Waiting Times Leaves Welsh Children Without Essential Community Care**
Children across Wales are facing unprecedented delays in accessing vital community health services, according to a stark report from the Royal College of Paediatrics and Child Health (RCPCH). The organisation released new data showing waiting times for key paediatric services have soared, casting a long shadow over children’s development, education, and future wellbeing.
While much of the public narrative surrounding the NHS focuses on delays in adult care, the RCPCH warns that children’s needs are slipping dangerously down the priority list. The report—*Collaborative Healthcare in Wales: Delivering the Services Children Need in the Community*—reveals waiting times for community-based children’s health provision have, in many areas, more than doubled. Senior doctors say the consequences are already being felt in schools and hospitals nationwide.
Community child health services comprise a broad range of support for children outside hospital, including physical and mental health, safeguarding, and help with learning difficulties. These services are delivered by multidisciplinary teams: paediatricians, health visitors, continence nurses, dietitians, speech and language therapists, and more. Their work often involves long-term care and coordination in clinics, schools, and community hubs.
Teachers have sounded the alarm, reporting a rise in children starting school without having reached basic developmental milestones. Some arrive unable to use cutlery, tie laces, or are even still in nappies. These early delays are increasingly evident, echoing findings from the RCPCH’s investigation into wait times and service provision.
A detailed look at the Welsh health boards exposes the scale of the problem. Data obtained through freedom of information requests, covering March to May 2025, shows staggering increases almost everywhere. For instance, the number of children waiting for community paediatric services in Betsi Cadwaladr University Health Board soared by over 1,000% since 2018, reaching nearly 9,000 in 2025. Cardiff and Vale witnessed a more than threefold rise, while speech and language therapy waits alone in Aneurin Bevan UHB saw an increase of 115%.
Neurodevelopmental assessments, such as those for autism and ADHD, remain particular pressure points. In Hywel Dda, the number of children awaiting autism spectrum disorder assessment soared by 781% since 2018. Cardiff, Cwm Taf, Swansea, and Powys all reported alarming spikes in both overall community paediatric wait lists and demands for neurodevelopmental services. The average wait in some regions for specialist assessment can now extend past two years.
These numbers, according to the RCPCH, should not be collectively tallied because inconsistencies exist in the data provided by each health board. However, the trend is clear and concerning. Delays are stretching not just health outcomes but affecting school attendance, social development, and children’s future economic prospects. Early intervention is widely acknowledged as essential for improving long-term wellbeing—delays risk missing a crucial window for effective support.
Doctors warn that resources are being funnelled into diagnostics at the expense of ongoing support services after assessment. “Even initial assessments come after a lengthy wait and the lack of ongoing care means many children and families are left in limbo,” stated one paediatrician involved in the review. The RCPCH has now called on the Welsh Government to honour promises of “care closer to home” by investing urgently in early years support and boosting staffing in all community child health sectors.
Dr Nick Wilkinson, RCPCH Officer for Wales, underscored the issue: “Children and young people are too often overlooked, with services overwhelmingly geared towards adult care. Despite the Welsh Government’s stated aim to deliver more care within communities, provision for children remains underfunded—especially among key health professionals like health visitors, continence nurses, and speech and language therapists.”
This crisis has not gone unnoticed by watchdogs. Rocio Cifuentes, Children’s Commissioner for Wales, stressed that a failure to intervene early often means health issues are allowed to escalate, carrying extra burdens into adulthood and increasing strain on already stretched public services.
The RCPCH is now urging significant investment: expanding training and consultant posts for community paediatricians and broadening education across the child health workforce. Dr Lizzy Nickerson, chair of the Wales Community Child Health Network, described the findings as “the part of the iceberg that has been ignored for too long,” warning of the bleak socioeconomic consequences for the country if neglected children’s needs are not prioritised.
In response, a Welsh Government spokesperson said, “We take improving children’s health seriously. We’ve invested £50m to help health boards tackle waiting times and seen some improvements, particularly in speech and language therapy and children’s mental health. We’re also putting £294m into health professional education and training in Wales.”
While the government points to investment and some progress, the evidence presented by the RCPCH and echoed by experts across Wales leaves no doubt: unless urgent action is taken, the health and wellbeing of the next generation could be damaged irreparably by systemic delays in care.