The survey results demonstrate the scale of the challenge facing children and young people’s services. Yet, the responses also highlight good practice among trusts, particularly around prioritising training and development to support the child health workforce. Partnership working among providers and across sectors has been an effective lever for enabling change, including reducing demand for beds and improving waiting lists. There are also examples of redesigning pathways and prioritising specific groups of children and young people that might require more targeted support. Elsewhere, we have spotlighted trust case studies that are targeting their efforts in reducing health inequalities (NHS Providers, 2023) experienced by children and young people.
These are welcome examples which will be improving children and young people’s outcomes and reducing the burden on services. But much more is needed to effectively address the issue. The government can play a key role in supporting trusts to do more for children and young people, by ensuring prioritisation, policy focus, commissioning and funding alignment. Trusts have told us that there is more that they could do if the right conditions were in place to enable them to act. The recommendations provided here represent a starting point for improving children and young people’s health services.
Prioritisation
1. The new government should develop and implement a cross-departmental strategy for the health and well-being of children and young people to support national prioritisation and focus on early years support and prevention. A cross-departmental strategy would mirror collaboration taking place between services and across systems at a local level, and would also align with similar recommendations made by the Children’s Commissioner for England.
Setting strategy and direction
2. Using the insights from frontline services, NHSE should review children and young people’s services facing the most significant issues meeting demand, for instance autism and ADHD, with a view to setting national strategy to improve access, experiences and outcomes. This is likely to build on and bring together existing national work, for instance the new ADHD taskforce NHSE announced in March 2024.
3. NHSE should undertake a full review of transitions between paediatric and adult services to understand where there are common gaps. This would build on existing national work around delivering a 0-25 service, and inform the development of nationally led policy and guidance to support providers and systems to tackle this.
Funding and investment
4. NHSE and government should require ICSs to give sufficient prioritisation to children and young people’s services, and ICSs should protect local capital and revenue funding to help to address the challenges outlined in this report.
5. Government should increase the public health grant to restore the provision of key services, such as health visiting and school nursing, which support children and young people to live well in the community and help to prevent ill health. Without this fundamental enabler the efforts of services closest to children, young people, their families and communities will not reach their full potential.
Workforce
6. To support and embed the work that frontline trusts are pursuing, government should commit to fully funding and delivering the LTWP and, at the review taking place in summer 2025, update the plan so there is a stronger and clearer focus on prevention and early intervention.