Introduction

Over the past decade, demand for children and young people (CYP)’s services across all sectors has increased dramatically, with the pandemic exacerbating longstanding challenges. In our 2024 survey (NHS Providers, 2024), trust leaders told us that they are unable to keep up with rising demand for children’s services, leaving many without the vital support they need, particularly for their mental health and wellbeing.

Latest NHS performance statistics show demand for mental health services has more than doubled since the pandemic, with 562,840 CYP waiting for services in March 2025. In the community sector, a record high 314,430 CYP are waiting for community health services, of which 22% have waited 52 weeks or more compared to 1.3% of adults. Not only are children more likely to have a long wait for care, those long waiting times have a disproportionate impact on children and young people compared to adults. Given that childhood is a key period for development, delivering timely interventions is critical to both present and future outcomes. The health and wellbeing of children and young people must therefore be a key priority in national policy making.

In its election manifesto, the government pledged to ‘raise the healthiest generation of children in our history’ (Labour Party Manifesto, 2024). Since being elected in July 2024, it has set out its key ambitions for the service, including a commitment to returning to the NHS constitutional standard on elective waiting times and developing a neighbourhood health service. It is also developing a 10-year health plan to create an NHS fit for the future, underpinned by three long-term shifts in the way care is delivered: from hospital to the community, analogue to digital and treatment to prevention.

The government’s three shifts set important strategic direction for the NHS and can bring specific benefits to the delivery of children and young people’s services. Our recent survey of trust leaders on CYP services (NHS Providers, 2024) showed that the most popular ask of government was ‘increased investment in prevention and early intervention’. Trust leaders are clear that identifying and addressing the needs of children and families at the earliest possible opportunity is key to improving outcomes both now and for the future.

This report highlights examples of trusts across the country that are working in new and innovative ways to improve services for children and young people in a challenging operational context. However, despite this good work, trust leaders are concerned that a narrowing focus on waiting time targets, at a time of extraordinary financial pressure, risks distracting systems and providers from dedicating resource to children and young people’s services.

Improving the health and wellbeing of the next generation is key to creating the resilient workforce of the future, and ensuring that the government’s economic growth mission is met sustainably. A healthy generation of children and young people will in time boost economic activity and help public services, including the NHS, to keep pace with demand.

We are therefore calling on the government to prioritise CYP services, including in the upcoming 10-year health plan and Comprehensive Spending Review. These present important opportunities for government to deliver on commitments around preventing ill-health and growing the economy. Trusts and system partners are already working innovatively to improve CYP services at a local level, and will be central to progressing government’s ambitions.

This report features four case studies demonstrating how trusts are successfully improving services for children and young people across a variety of sectors:

• Delivering mental health support to children and young people in the community – In response to rising demand for mental health services and increased inpatient admissions, Humber Teaching NHS Foundation Trust has developed a number of initiatives to support children and young people in the community. Working with the local Mind charity, the trust has established a Safe Space service which provides a calm and welcoming environment for children and young people to access support and expertise following a mental health crisis incident. This supports better outcomes and alleviates pressure on services by preventing escalation.
• Collaborating at neighbourhood level for the benefit of children and young people – Over the past few years, London North West University Healthcare NHS Trust has been working closely with system partners to improve services for children and young people in Harrow, by establishing hyper-local preventative care teams. These teams bring together existing GP child health hubs in the area with voluntary sector and local authority services to support the most vulnerable families. Strengthening collaboration across organisational boundaries at a neighbourhood level contributes to the provision of high-quality, joined-up support for families.
• Improving access to care through digital interventions – In 2024, Alder Hey Children’s NHS Foundation Trust launched its strategic vision for 2030 which focused on delivering timely access to acute care, and driving innovation and digital health solutions. In line with this strategy, the trust is harnessing digital interventions to empower children and young people to manage their health through ‘AlderHey@nywhere’, an interactive platform designed to provide a hybrid access point for care. The platform was developed in response to rising demand and waiting times for services and reflects the trust’s ambition to move towards a 'hospital without walls’ model of care.
• Using co-production to improve services for children and young people – Since April 2024, Wirral Community Health and Care NHS Foundation Trust has delivered sexual health services for young people aged 13 to 19 years old. When designing the service, the trust carried out engagement and outreach activity with young people to understand what they wanted from a new sexual health service. The trust sought to co-produce the service to ensure it met the needs of young people in the community, and continues to engage with the community to raise the profile of the service.

This report shares some of the approaches trusts have taken to improve health and care services for children and young people amidst rising demand. Trusts will continue to develop fresh, forward-thinking initiatives to ensure children and young people are able to receive high-quality, timely care when they need it most.