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Health

Staggering rise in autism and ADHD delays across west Wales

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Thousands of children now waiting for assessments as paediatricians warn of crisis in community care

THE NUMBER of children waiting for Autism and ADHD assessments in west Wales has soared by hundreds of percent, with clinicians warning that delays are placing vulnerable children at risk and stretching public services to the limit.

Figures released by the Royal College of Paediatrics and Child Health (RCPCH) show that since 2018, the number of children in the Hywel Dda University Health Board area waiting for an Autism Spectrum Disorder assessment has increased by 781%. ADHD referrals have also risen dramatically — up by 331% over the same period.

Waiting lists for general community paediatric services in Hywel Dda have also risen, though more modestly, increasing by 4.1% from 1,477 in 2018 to 1,538 in 2025.

The data, published this week in the RCPCH’s report Collaborative Healthcare in Wales: Delivering the Services Children Need in the Community, highlights a worsening picture for families across west Wales. It also shows that the scale of the crisis is not limited to one area.

In neighbouring Cwm Taf Morgannwg Health Board, the number of under-18s waiting for neurodevelopmental services rose from 2,173 in 2023 to 3,391 by January this year — a rise of more than 56% in just two years.

Community paediatricians, who lead services supporting children with complex medical and developmental needs, are sounding the alarm. They warn that a chronic lack of funding, staff shortages, and rising demand have pushed services beyond safe capacity.

Across Wales, thousands of children are now on waiting lists for vital care delivered outside of hospitals — including assessments for autism, ADHD, and speech and language difficulties. These services are typically delivered in clinics, schools and local hubs, aiming to support children earlier and closer to home.

In some parts of Wales, demand has more than doubled in the past five years:

Betsi Cadwaladr Health Board saw a 1016% increase in community paediatric waiting lists, from 805 in 2018 to 8,986 in 2025.

Cardiff and Vale reported a 302% increase in waiting lists alongside an 8% drop in paediatricians.

Swansea Bay’s waiting list rose 112% since 2020, with average wait times now 80 weeks.

Powys reported a 112% rise in neurodevelopmental service referrals since 2022, with just three community paediatricians covering the entire county.

The RCPCH has called on the Welsh Government to urgently prioritise investment in children’s health services. It says the aim of delivering care closer to home is being undermined by long waits, inconsistent access, and a growing gap between policy and practice.

The report also highlights wider systemic problems — including poor transitions from children’s to adult services, an over-reliance on formal assessments, and increasing pressure on families forced to navigate fragmented services without support.

Doctors have warned that without urgent action, the impact on children’s lives — including their mental health, education, and future wellbeing — will be severe. The report notes that children with unmet health needs often face long-term disadvantages, with serious consequences for wider society and public finances.

The RCPCH says the system must move away from reliance on goodwill from overstretched NHS staff and invest in early intervention, better staffing, and coordinated support across services.

Health

Major investment confirmed for GP services in Wales

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Government unveils £41m boost, but practices warn pressures remain acute

MORE than £41m in extra funding will go into general practice in Wales this year following a new agreement between the Welsh Government, NHS Wales and GP leaders. Ministers say the deal provides stability at a time of rising demand — but the settlement comes against a backdrop of sustained pressures, recruitment challenges and concerns over patient access.

The package includes a 4% uplift to the General Medical Services (GMS) contract for 2025-26, in line with independent DDRB pay recommendations, and a guaranteed 5.8% recurrent uplift from 2026-27. The Welsh Government says the multi-year commitment will allow practices to plan ahead, modernise systems and strengthen community-based services.

Health Secretary Jeremy Miles said the investment showed an “unwavering commitment” to general practice, adding: “The 4% pay uplift ensures fair recognition for GPs and practice staff who work tirelessly to deliver care for communities across our country. Multi-year funding gives practices the confidence to invest in the transformation primary care needs.”

However, the announcement comes at a time when many Welsh practices continue to report severe workforce pressures, rising demand, and longstanding challenges in recruiting new partners. GP numbers have fallen over the past decade, with some practices handing back contracts or operating list closures because of unsustainable workloads. Patient satisfaction with access has also declined, according to the latest Welsh GP Patient Survey.

What the deal includes

The settlement for 2025-26 comprises £37.9m of new investment and £4m in re-invested capacity funding, with the key elements including:

  • A 1.77% uplift in expenses, intended to help practices manage inflationary pressures in energy, staffing and running costs.
  • A recurrent £20m stabilisation fund to support practices facing immediate operational pressures and to prepare for wider reform under the incoming Sustainable Farming Scheme model for health.
  • An increased partnership premium, aimed at retaining experienced GPs and encouraging new partners into a model that some say has become less attractive due to financial and regulatory risk.
  • A full review of the GMS allocation formula — the first in more than 20 years — which determines how funding is distributed between practices. Some rural and deprived communities have long argued the current system does not reflect the complexity of local health needs.

Wider context

General practice remains the foundation of the NHS, accounting for around 90% of patient contacts, yet it receives a proportionally small share of the overall health budget compared with hospital services. Both the Welsh NHS Confederation and GPC Wales have repeatedly warned that without sustained investment, primary care risks being unable to meet increasing demand from ageing populations and rising chronic illness.

The Welsh Government’s own “community-by-design” programme relies on shifting more care closer to home, reducing pressure on emergency departments and supporting earlier intervention. For that to be achieved, GP leaders say investment needs to be matched with workforce expansion, improved digital systems, and clear strategies to retain experienced clinicians.

Working groups will now be set up to examine access standards, diabetes prevention and new service models.

Mr Miles said he was pleased that GPs would be “actively contributing to creating innovative care models that enhance access, improve outcomes and deliver care locally.”

GP representatives broadly welcomed the deal but have stressed that it is only one step in addressing the scale of challenge across primary care.

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Health

Welsh NHS leaders hail GP contract deal as “vital step” in strengthening primary care

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Agreement secures investment, digital upgrades and better patient pathways

WELSH NHS leaders have welcomed the successful conclusion of the new General Medical Services (GMS) contract for 2025-26 — and key elements of 2026-27 — describing it as a “positive example of social partnership” at a pivotal moment for general practice.

The deal, negotiated between Welsh Government, the Welsh NHS Confederation and GP representatives, sets out new investment and commitments for frontline primary care, including accelerated digital transformation through the NHS Wales App and strengthened support for population-level health management.

Darren Hughes, director of the Welsh NHS Confederation, said the agreement comes at a crucial time for GP services across Wales.

He said: “NHS leaders welcome this agreement as a positive example of social partnership in action. We also welcome the commitment to accelerating digital transformation for patients through the NHS Wales App and the measures agreed in the contract to enable enhanced population health management, such as diabetes management.”

Mr Hughes added that GPs and their multidisciplinary teams remain “the front door to the NHS,” and stressed that investment in general practice is essential if Wales is to treat more people closer to home.

“Evidence shows investing in primary and community care reduces demand on hospitals and emergency care and delivers returns of £14 for every £1 invested. To enable this shift ‘upstream’ from hospital-centred care to integrated services in the community, we must develop care pathways and joint performance measures that address the full needs of individuals,” he said.

Background: Why the GP contract matters

General practice forms the foundation of the Welsh NHS, handling millions of patient contacts every year. According to the latest official figures for 2023-24:

  • Over 29 million calls were received by GP practices
  • 18 million appointments took place
  • 11 million of these were face-to-face
  • More than 200,000 home visits were carried out
  • 78 million prescriptions were dispensed
  • Over 14,000 medication reviews took place

Demand has continued to rise while GP numbers have come under sustained pressure, particularly in rural areas such as Pembrokeshire, Ceredigion and Powys, where recruitment remains a long-running challenge. Practices in West Wales have repeatedly reported difficulties filling vacancies and increasing reliance on multidisciplinary teams, including nurse practitioners, pharmacists and physiotherapists.

The new GMS contract is therefore seen as a key mechanism for stabilising the sector, supporting digital access, improving chronic disease management, and helping to deliver the Welsh Government’s community-by-design programme, which aims to shift care away from hospitals and into community settings.

A recent survey by the Welsh NHS Confederation found that 74 per cent of NHS leaders support moving resources from acute hospital services into primary care, community-based services, mental health and social care, reflecting growing consensus around early intervention and prevention.

What comes next

The Welsh Government is expected to outline further detail in the coming months on how investment will be delivered at practice level, including support for digital tools, workforce development and shared performance measures with health boards.

With winter pressures mounting and hospitals facing record demand, NHS leaders say the success of the new GP contract will be central to improving access, reducing waiting times and ensuring patients in communities such as Pembrokeshire, Carmarthenshire and Ceredigion can receive timely, local care before conditions escalate.

The Welsh NHS Confederation represents all seven local health boards, the three NHS trusts, Health Education and Improvement Wales, and Digital Health and Care Wales.

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Charity

Motorcycle fundraisers transform children’s play area at Glangwili Hospital

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Long-running 3 Amigos and Dollies group marks 25 years of support

THANKS to outstanding fundraising by the Pembrokeshire-based 3 Amigos and Dollies Motorcycle Group, Hywel Dda Health Charities has funded a major improvement of the outdoor play area at Cilgerran children’s ward in Glangwili Hospital — a project costing more than £15,000.

The 3 Amigos and Dollies have supported Hywel Dda University Health Board’s children’s services for twenty-five years, with their Easter and Christmas toy runs becoming landmark dates in the local calendar, drawing hundreds of bikers and supporters from across west Wales.

The latest funding has delivered a full transformation of the ward’s outdoor space, including a re-sprayed graffiti wall, new toys and play equipment, a summer house, improved storage, and a moveable ramp to make the area more accessible for young patients. Members of the group even volunteered to help paint and refresh the space themselves.

Paula Goode, Service Director for Planned and Specialist Care, said: **“We are so grateful to the 3 Amigos and Dollies Motorcycle Group for their amazing support. Not only have they raised an incredible amount for the ward, but they have given their time to help make the outdoor space as special as possible.

“Outdoor play greatly reduces stress and anxiety for children, and it provides a vital opportunity to meet other young people going through similar experiences. It benefits both their physical and mental wellbeing, so we couldn’t be happier with the transformation.”

Tobi Evans, a volunteer with the fundraising group, said: “Because of the generosity of everyone who donates, we are able to give thousands each year. We are always humbled by how much people give, and it’s thanks to them that we’ve reached our 25th year.”

Katie Hancock, Fundraising Officer for Hywel Dda Health Charities, added: “We can’t thank the 3 Amigos and Dollies enough for their support for Cilgerran ward. You have put a smile on so many faces. Diolch yn fawr!”

Hywel Dda Health Charities funds items, equipment and activities that go beyond core NHS funding, making a meaningful difference to children and families across mid and west Wales.

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