QualityWatch

Growing problems

What has been the impact of Covid-19 on health care for children and young people in England?

QualityWatch is a Nuffield Trust and Health Foundation programme.

The Health Foundation | Nuffield Trust
Scroll
10X less likely to be hospitalised with Covid-19
81% Increase in demand for mental health services

Although the direct effects of Covid-19 on children and young people are usually milder than for older age groups, the pandemic’s effect on the overall health and care of the youngest generation has nonetheless been extensive.

 
Learn more about this data
Percentage of people with long-term conditions saying they receive enough support
6% Drop in people feeling supported since 2018

Young people with long-term conditions are less likely to say they receive enough support from local services than adults, and both groups’ views on feeling supported have continued to worsen during the pandemic.

Ages 16-24
Learn more about this data
Referrals from GPs to hospital care for children and young people
79% drop in urgent GP referrals
In April 2020

As the pandemic struck there was a huge reduction in referrals from GPs to hospital care for children and young people.


Learn more about this data
Referrals from GPs to hospital care for children and young people
up to 47% increase in urgent GP referrals
In December 2021

Since then, urgent referrals have surpassed pre-pandemic levels.

This may be a worrying sign of deterioration in children's health.


Learn more about this data
Waiting list for planned paediatric hospital care
54,811 more children waiting for treatment
 

With the country emerging from lockdown, the waiting list for planned paediatric hospital care grew by 22% in seven months, leaving 300,465 children and young people waiting.


Learn more about this data
Percentage of children with suspected cancer waiting over two weeks to be seen
1in7 waited over two weeks to be seen after referral

It’s also taking longer for children with suspected cancer to be seen by a consultant. 

For serious cases like this the NHS sets itself a two-week target for seeing patients with the aim of faster diagnosis and treatment.

<16 years
Learn more about this data

And demand for mental health services is soaring.

337,000
referrals to children and young people’s mental health services between April and September 2021 - this is...
81% more
than the number of referrals during the same period in 2019. This compares to only an 11% increase in referrals for adults.
1 in 5
children and young people waited more than 12 weeks for a follow-up appointment with mental health services between April 2020 and March 2021.

Learn more about this data
Number of children with an eating disorder waiting to start treatment
4x the number of children with an eating disorder waiting to start treatment

Eating disorders have been an area of particular concern since the pandemic hit. 

And despite the numbers starting treatment increasing, many children are having to wait longer and longer for help.

<19 years
Learn more about this data
A&E attendances for eating disorders

This has had serious consequences.

A&E attendances for eating disorders for children and young people doubled during the pandemic.

<19 years
Learn more about this data
Percentage of people diagnosed with a mental health disorder who spend more than 4 hours in A&E

People use A&E as a last resort, and young people with mental health concerns wait significantly longer for help in these settings. 

<19 years
Learn more about this data

The pandemic’s effect on children and young people’s health, care and wellbeing has been dramatic and concerning, particularly with regard to mental health.

Access to timely care is being severely compromised. Early intervention and treatment is especially important for young people, so this could have lifelong consequences.

Services are facing an uphill battle to recover. More support and funding is needed to prioritise children’s health and avoid disadvantaging a generation.

Share this story

Find out more

Delve deeper into the impact Covid-19 has had on young people and their futures as we explore the issues further and take a more detailed look at the data.

Read the briefing

QualityWatch tracks over 200 care quality indicators to monitor whether health and social care quality in England is getting better or worse.

Visit QualityWatch
×

About this data

Source: UK Government, Coronavirus (COVID-19) in the UK, Office for National Statistics, Population estimates for England: mid-2020, NHS Digital, Mental Health Services Monthly Statistics

The UK Government publishes daily Covid-19 hospital admissions by age group. Using cumulative hospitalisations up to 17 January 2022, and mid-year population data, we estimated the likelihood for children and young people (aged 0-17) to have been admitted to hospital with Covid-19 compared to adults (aged 18+).

The number of referrals to children and young people's mental health services (aged 0 to 18) was used as a proxy for demand for mental health services. The 81% increase in referrals relates to the period between April-September 2019 and April-September 2021.

×

About this data: Young people with long-term conditions

Source: NHS England, GP Patient Survey

Since 2018, the GP Patient Survey has asked, “In the last 12 months, have you had enough support from local services or organisations to help you to manage your condition (or conditions)?”. We classified ‘feeling supported’ as respondents who answered “Yes, definitely” or “Yes, to some extent”. Respondents who answered “I haven’t needed support” or “Don’t know / can’t say” were excluded for comparison purposes.

‘Young people’ were defined as respondents aged 16 to 24, and ‘adults’ were aged 25 and over.

The data was weighted at source to adjust for differences between all patients at a GP practice and the subset of patients who actually completed the questionnaire.

Fieldwork (the time during which questionnaires are sent out and returned) for the 2021 GP Patient Survey took place between 4 January and 6 April 2021.

×

About this data: Drop in urgent GP referrals

Source: NHS Digital, NHS e-Referral Service Open Data

NHS Digital publishes weekly data on referrals through the NHS e-Referral Service (e-RS) by specialty. The e-RS is used by all GPs in England to make referrals to consultant-led outpatient services.

Here we display the weekly percentage change in GP referrals to children’s and adolescent hospital services, compared to a baseline of the average number of referrals between 7 October and 22 December 2019. The data is broken down by priority into routine and urgent referrals. Hospital providers do not currently have a nationally standardised age definition for children and adolescents.

The maximum drop of 89% for routine referrals occurred in the week beginning 13 April 2020, and the maximum drop of 79% for urgent referrals occurred in the week beginning 6 April 2020.

×

About this data: Increase in urgent GP referrals

NHS Digital publishes weekly data on referrals through the NHS e-Referral Service (e-RS) by specialty. The e-RS is used by all GPs in England to make referrals to consultant-led outpatient services.

Here we display the weekly percentage change in GP referrals to children’s and adolescent hospital services, compared to a baseline of the average number of referrals between 7 October and 22 December 2019. The data is broken down by priority into routine and urgent referrals. Hospital providers do not currently have a nationally standardised age definition for children and adolescents.

The maximum increase of 47% for urgent referrals occurred in the week beginning 6 December 2021, while there was a 6% decrease for routine referrals in the same week.

×

About this data: Planned paediatric hospital care waiting list

Source: NHS England, Consultant-led Referral to Treatment Waiting Times

Since April 2021, NHS England has published data on the waiting list for planned paediatric hospital services (previously it was included in the ‘other’ category). Here we present data on the number of patients who have been referred but are still waiting to start treatment in paediatric services at the end of the month.

Note that this data is for the ‘paediatric services’ treatment function and does not equate to all children and young people on the waiting list for planned care.

×

About this data: Referral for suspected children’s cancer

Source: NHS England, Monthly Provider-based Cancer Waiting Times Statistics

NHS England publishes data on two week waits to see a specialist following an urgent referral for suspected children’s cancer. The operational standard states that, following an urgent referral for suspected cancer, at least 93% of patients should be seen by a specialist within two weeks. The dataset guidance defines a child as a patient under 16 years of age at receipt of an urgent referral for suspected cancer.

Here we display data on the percentage of children with suspected cancer seen by a specialist after two weeks since their referral.

×

About this data: Mental health statistics

Sources: NHS Digital, Mental Health Services Monthly Statistics, BBC freedom of information request

NHS Digital publishes monthly data on the number of referrals to children and young people’s mental health services (aged 0 to 18). Here we present the percentage change in referrals to children and young people’s mental health services in April to September 2021, compared to the same period in 2019.

In September 2021, the BBC published data from a freedom of information request for half of England’s child and adolescent mental health services. Between April 2020 and March 2021, 20% of patients seen by children and young people’s mental health services waited over 12 weeks for a second appointment. Waiting times data for child and adolescent mental health services is not routinely published.

×

About this data: Waiting to start treatment for an eating disorder

Source: NHS England, Children and Young People with an Eating Disorder Waiting Times

NHS England publishes quarterly data on waiting times for treatment for children and young people (aged up to 19 years old) with an eating disorder. Here we present data on the number of children and young people with an eating disorder waiting to start treatment at the end of September in 2019, 2020 and 2021.

×

About this data: Time spent in A&E

Source: Emergency Care Data Set (years 2019 to 2021) Copyright © 2022, re-used with the permission of NHS Digital. All rights reserved.

This work uses data provided by patients and collected by the NHS as part of their care and support. Read more.

The Emergency Care Data Set collects information about why people attend emergency departments and the treatment they receive. We receive this data at patient level, without patient identifiers, from NHS Digital under a data sharing agreement, and used it to construct this healthcare metric.

We defined an A&E department attendance for an eating disorder in children and young people as: patients aged 0 to 18 who attended a Type 1, 2 or 3 A&E department and received a primary diagnosis for eating disorder, and had a valid arrival and departure date and time. Adults were aged 19 and over.

×

About this data: Time spent in A&E

The Emergency Care Data Set collects information about why people attend emergency departments and the treatment they receive. We receive this data at patient level, without patient identifiers, from NHS Digital under a data sharing agreement, and used it to construct this quality metric.

We measured the percentage of children and young people (aged 0 to 18) who spent longer than 4 hours between arriving at a Type 1, 2 or 3 A&E department and leaving the department. The data was broken down according to a primary diagnosis for anxiety disorder, personality disorder, depressive disorder or eating disorder, and compared to the percentage for all primary diagnoses.