Delays to good healthcare for children risks failing their future, says watchdog

Lack of access to good and timely care for children and young people “risks failing their future”, a health watchdog has warned.

Delays in both physical and mental healthcare for young people is not only an immediate risk but can also lead to them becoming adults with long-term illnesses as a result, the Care Quality Commission (CQC) said in its annual report.

This year’s report comes just over a week after a damning review into the CQC insisted there is an “urgent need for a rapid turnaround” of the watchdog owing to “significant failings” in how it works.

The final report of senior NHS leader Dr Penny Dash found changes were needed at the CQC to “restore credibility” amid failings including a backlog in new health and care settings being registered, delays in re-inspecting hospitals and some ratings for trusts and care homes being years old.

The health inspectorate, which is reporting on the overall state of health and social care in England, said its latest report showed access to good care on time “continues to be a struggle for many” and highlighted persistent inequalities for people from deprived backgrounds.

Rates for people attending urgent and emergency care living in the most deprived areas of England were almost double those for people in the least deprived areas in the year to March, the CQC said, while for those attending for mental health reasons, the difference was more than three times higher.

The report, published on Friday, stated: “Many children and young people are not currently getting the support they need. We are highlighting this as a risk not just for today, but for the future.

“Children who do not receive the care they need today are at increased risk of becoming adults with long-term mental or physical illnesses, which could affect their quality of life and their ability to contribute to society tomorrow.”

On early years support for babies and parents, the regulator highlighted that the number of health visitors had dropped by 45% over the last nine years.

Lengthy waits in mental healthcare are a source of “particular concern”, the CQC said, quoting an estimate from 2023 suggesting a fifth of people aged between eight and 25 had a mental health disorder.

Difficulties in recruiting to specialist roles including occupational therapists and consultant psychiatrists are having a knock-on effect on the health service to ensure appointments as needed, the CQC added.

Their research on people with mental health issues attending urgent and emergency care settings found that those aged 18 to 21 “consistently have the highest rates of presentation”.

Acknowledging the good care received by some, the regulator said: “Sadly, for every child who gets ‘lucky’ by receiving timely, appropriate support, we know that there are many more who don’t, potentially affecting their chances of a healthy adulthood.”

A warning last year about a two-tier system where those who can afford to pay go private while others are left languishing on long waiting lists “remains a concern”, the regulator said.

It also described waiting times for people to start assessment for a possible autism diagnosis as “far too long”, at 356 days as of April this year for children and young people, compared with 238 days for adults.

The CQC noted that despite fewer new referrals for autism diagnoses in the year to March, the average waiting time to start an assessment was almost a year – 328 days by April- soaring well beyond the recommended three months.

Tom Madders, from YoungMinds said: “What is devastating is that young people at the heart of this are being so severely let down by the systems that are there to support them. What this report shows is that this is not just taking a toll on individuals, but will continue to impact the whole of society.

“Successive governments have lacked the will to make changes for the sake of young people. We hope that the Government see this as a moment to take real action.”

The Association of Directors of Adult Social Services (Adass) warned “we’re storing up problems for the future” unless things improve, while NHS Providers said the findings echo what trust leaders are telling them.

Saffron Cordery, its deputy chief executive, said: “Too many young lives are being blighted by delays to accessing care.

“Trust leaders are deeply concerned about meeting demand for services, including mental health, and the impact long waits for care are having on inequalities among children and young people.”

Elsewhere in its almost 200-page report, the regulator highlighted persistent concerns around the quality of maternity care, with women from Black and ethnic minority backgrounds continuing to face a higher risk of poor maternity care and outcomes.

Adult social care remains in a “precarious” state, the CQC said, equating the almost 4,000 people enduring daily delayed discharges from hospital to care homes or home care to “50 double-decker buses full”.

Unfulfilled requests for adult social care to local authorities rose by more than a quarter (27%) over the past 5 years, the CQC said.

The Health Foundation said while the “start of a national conversation on a new NHS plan is welcome – as are promises to bring forward a plan for social care”, the new Government must not let people down with broken promises.

Its director of policy, Hugh Alderwick, said: “Ministers must avoid repeating mistakes of successive governments that promised social care reform then failed to deliver”.

CQC chairman Ian Dilks said: “Action now – targeted funding for early intervention, better understanding of local need and improved management of demand, and genuine two-way communication with children and families – will help to ensure a healthier population tomorrow.

“The health and wellbeing of a nation’s children has been described as the best predictor of its future prosperity; failing to ensure good, safe care for our children today also risks failing their future.”