Children and young people’s health and social care

DOI: https://doi.org/10.58248/HS135

Overview

Children and young people (CYP) make up a significant proportion of the UK population, with those under 25 accounting for 29.1% of the population in England and Wales (2021 Census).[1]  Demand for health and social care services for this group is increasing.[2] This includes greater need for early years support, mental health care,[3] and community services[4]  that promote healthy lifestyles (PN649, HS123, HS97). However, access to timely care is often constrained by service capacity and funding pressures (HS134).

Demand for children’s social care services has significantly increased.[5][6][7] According to the Institute for Government’s 2023 Performance Tracker, in 2021/22, there were 650,270 referrals to children’s social care services in England, an 8.8% increase on the previous year. Local authority spending on children’s social care reached £11.1 billion, a 41.6% increase since 2009/10, while the child population grew by less than 10% over the same period.[8]

In March 2025, the Children’s Wellbeing and Schools Bill proposed policy measures such as breakfast clubs, enhanced safeguarding, and improved provision for children in and leaving care, intended to address educational and social care inequalities (PN739, CBP10165).

Challenges and opportunities

The NHS Long Term Plan 2019 identified 1.7 million children with long-term conditions such as asthma and epilepsy and raised concerns about rising childhood obesity and mental distress.[9] Service waiting times have also increased, with assessments for neurodevelopmental conditions such as autism and ADHD facing substantial backlogs (PN733). Even when accounting for the increase in the number of providers submitting data, there has been a more than five-fold increase in the number of open suspected autism referrals since 2019.[10] In March 2024, there were 183,733 open referrals for suspected autism, with over 87% of patients waiting longer than 13 weeks for assessment, against NICE guidelines recommending a three-month wait.[11][12]

In September 2024, Lord Darzi published an independent NHS review diagnosing the service as being in a “critical condition” despite record annual funding. The report flagged escalating pressures in community and CYP health services, with over 70,000 under-18s waiting more than 13 weeks for assessments and 50,000 waiting over a year. Darzi suggested shifting care out of hospitals into communities, prioritising prevention, digital transformation, and system-wide reform.

In response, NHS England’s 2025/26 Operational Planning Guidance prioritises community-based models, digital access, and workforce support, with potential impacts for CYP provision.

Children and young people’s mental health is a growing concern. Around 1 in 5 CYP aged 8 to 25 had a probable mental disorder in 2023. Among 17- to 19-year-olds, prevalence rose from 10% in 2017 to 23% in 2023.[13] Services are struggling to meet this demand. In 2022/23, nearly one million children were referred to Child and Adolescent Mental Health Services (CAMHS), of which 32% received support, 28% were still waiting, and 39% had referrals closed before receiving care.[14][15]

The Children’s Commissioner called for the NHS’s next long-term plan to prioritise CYP mental health.[16] The Commissioner’s 2024 report noted average CAMHS waiting times of six months, with nearly a third waiting over a year.[17] In 2023/24, over 60,000 children were referred for crisis-level support, with nearly 40,000 children waited over two years.[18]

Suggested alternative and innovative treatments are being explored alongside cognitive behavioural therapy and medication, such as mindfulness, nature-based therapies including exposure to blue and green spaces (PN538) and animal-assisted interventions. [19][20][21] However, evidence on the effectiveness of some alternative and holistic wellbeing approaches requires further research.

Disparities in early childhood development remain significant, particularly among low-income, ethnic minorities and vulnerable groups. Child poverty rates (22% in 2024)[22] have increased by approximately 22% since 2012, one of the highest in Europe.[23] With child poverty rates increasing, the regional inequalities in child obesity rates are an example of regional and deprivation-based disparities. In 2022/23, 22.7% of Year 6 children were obese, compared to 9.2% in Reception.[24]

Children in the most deprived areas of England were twice as likely to be obese compared to those in the least deprived areas. Children in the north of England are more likely to be living with obesity at reception age compared to the rest of the country. [25][26] These inequalities reflect similar inequalities in other outcomes, such as infant death[27], asthma, diabetes and oral health.[28] In 2022, NHS England launched Core20PLUS5 to reduce health inequalities for CYP, focusing on five clinical areas.[29]

Vaping among young people is on the rise. Data from Action on Smoking and Health showed that in 2023, regular use among 11- to 17-year-olds reached 3.7%, with experimentation up 50% year-on-year.[30] The 2024 King’s Speech announced a Tobacco and Vapes Bill (CBP10193) to restrict marketing to children by banning branding and advertisement to children.[31]

The 2024 Cass Review on gender identity services recommended stronger evidence-based pathways, comprehensive psychological support, and restrained use of medical interventions. Its implementation will have implications for CYP support models across the NHS.[32]

Children are increasingly facing risks to online harms and exposure to inappropriate explicit nudity.[33] Girls are particularly vulnerable to online harms and impacts to their wellbeing, with girls between 10-and-15 years old being the most common victims of online and tech-enabled gender-based abuse. In 2024, Plan UK (a children’s charity), described violence towards young women and girls as endemic in society.[34]

To improve outcomes for CYP, experts suggest the implementation of combined policies such as interventions in education, behavioural change, access to healthy food and the role of different environmental settings in prevention (PN640). The Darzi report and stakeholders such as the Health Foundation, call for prevention and whole government approaches to tackling health inequalities and wider determinants, that can fuel poor health outcomes.[35]

The NHS 10 Year Health Plan 2025 was published in July 2025 containing measures that respond to the Darzi report.

Key uncertainties and unknowns

• Long-term impacts of delayed access to mental health and diagnostic services.
• There is limited evidence on the effectiveness and equity of alternative wellbeing interventions, such as animal-assisted therapy, access to nature and meditation.
• How the covid-19 pandemic-related disruptions to schooling and services will affect future outcomes.

Key questions for parliament

• How can access and quality of CYP health and social care services be sustained and improved amid rising demand and budgetary constraints?
• What are the long-term consequences of increased waiting times for care, and how might this affect transitions to adulthood?
• How can CYP be involved in shaping the services and policies that affect them?
• What is the appropriate policy balance for regulating vaping among young people?
• How can regional and socioeconomic disparities in CYP health be addressed?
• What support is needed to build the evidence base for effective, inclusive care models for CYP?

References

[1] Gov.uk, Age groups, 31 March 2023

[2] Matthew Fright and Nick Davies, Performance Tracker 2023: Children’s social care, 30 October 2023

[3] Children’s Commissioner, Over a quarter of a million children still waiting for mental health support, 15 March 2024

[4] Jessica Morris “The rapidly growing waiting lists for autism and ADHD assessments” 04 April 2024

[5] Matthew Fright and Nick Davies, Performance Tracker 2023: Children’s social care, 30 October 2023

[6] Bennet, D., Lee, P. et al. Children in care in the North of England, Health equity north, 2024

[7] GOV.UK, Statistics; looked-after children, last updated 12 June 2025

[8] Matthew Fright and Nick Davies, Performance Tracker 2023: Children’s social care, 30 October 2023

[9] NHS, The NHS Long Term Plan, 21 August 2019

[10] Jessica Morris “The rapidly growing waiting lists for autism and ADHD assessments” 04 April 2024

[11] NHS England, Autism statistics, April 2023 to March 2024, 23 May 2024

[12] NHS England, Autism statistics, April 2023 to March 2024, 23 May 2024

[13] NHS Digital, Mental health of children and young people in England, 2023 – wave 4 follow up to the 2017 survey, 21 November 2023

[14] Commons Library research briefing, Children and young people’s mental health: policy and services (England), 26 January 2024

[15] British Association for Counselling and Psychotherapy, Crisis in children and young people’s mental healthcare, 20 March 2024

[16] Children’s Commissioner, Press Notice: Children’s Commissioner calls for urgent action to tackle waiting times and inequality in mental health care for children, 18 May 2025

[17] Children’s Commissioner, Children’s mental health services 2023-24, May 2025

[18] Children’s Commissioner, Over a quarter of a million children still waiting for mental health support, 15 March 2024

[19] Isabelle Bray, Rebecca Reece, Danielle Sinnett, Faith Martin & Robert Hayward, “Exposure to green space and prevention of anxiety and depression among young people in urban settings: a global scoping review”, Journal of Public Mental Health, Vol. 20 No. 2, 28 May 2021 pp. 94-104

[20] Isabelle Bray, Rebecca Reece, Danielle Sinnett, Faith Martin & Robert Hayward, Exploring the role of exposure to green and blue spaces in preventing anxiety and depression among young people aged 14–24 years living in urban settings: A systematic review and conceptual framework. Environmental Research, 214(4), 13 August 2022

[21] Children’s Commissioner, Children’s mental health services 2023-24, May 2025

[22]  Department for Works & Pensions, Official Statistics Children in low income families: local area statistics, financial year ending 2024, 27 March 2025

[23] Unicef, Child Poverty in the Midst of Wealth, December 2023

[24] NHS England, National Child Measurement Programme, England, 2022/23 School Year, 19 October 2023

[25] Kate Pickett, David Taylor-Robinson et al, The Child of the North: Building a fairer future after COVID-19, the Northern Health Science Alliance and N8 Research Partnership (PDF), 2021

[26] Commons Library research briefing, Obesity Statistics, 12 January 2023

[27] Commons Library research briefing, Infant mortality and health inequalities, 29 November 2023

[28] Children’s Rights Alliance for England, UK implementation of the UN Convention on the Rights of the Child. Civil society alternative report 2022 to the UN Committee – England Summary, p 9-10, 8 December 2022

[29] NHS England, Core20PLUS5 – An approach to reducing health inequalities for children and young people, 18 November 2022

[30] Action on Smoking and Health, Use of e-cigarettes (vapes) among young people in Great Britain, June 2023

[31] Prime Minister’s Office, King’s Speech 2024: background briefing notes, 17 July 2024

[32] NHS, Children and young people’s gender services: implementing the Cass Review recommendations, 29 August 2024

[33] Children’s Commissioner Report, “One day this could happen to me” – Children, nudification tools and sexually explicit deepfakes, 28 April 2025

[34] Plan UK, The state of girls rights in the UK 2024, July 2024

[35] The Health Foundation, Health at the heart of government, 29 July 2024

Photo by: Andyheffernan/Wirestock Creators, via Adobe Stock