Health
Staggering rise in autism and ADHD delays across west Wales
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
Decision pending on adult mental health referral pathway
HYWEL DDA University Health Board will decide next week whether to make changes to the GP referral pathway for routine adult mental health services permanent.
The decision will be taken at a public Board meeting on Thursday (Mar 26).
Board members will consider a proposal to formalise changes already introduced in Ceredigion and, if approved, roll out the revised pathway across Pembrokeshire and Carmarthenshire.
Since March 2025, adults in Ceredigion seeking routine mental health support have been advised by their GP to contact the NHS 111 Wales ‘Press 2’ service, rather than being referred directly to the county’s Community Mental Health Team.
The temporary change was introduced in response to ongoing staffing shortages. Health Board officials say the approach has helped maintain timely access to face-to-face assessments for those who need them, while directing initial contact through a single access point.
The 111 ‘Press 2’ service provides telephone assessments by local wellbeing practitioners, supervised by registered mental health nurses, offering advice, support and onward referrals where required.
At its November 2025 meeting, the Board agreed to extend the temporary pathway until the end of March 2026. A nine-week engagement exercise followed, running from December 8 to February 9, to gather feedback from patients, professionals and stakeholders on the potential long-term impact.
Andrew Carruthers, Chief Operating Officer at Hywel Dda University Health Board, said: “I would like to thank everyone who took the time to share their views and experiences.
“I would also like to thank West Wales Action for Mental Health for supporting engagement with patients, including those with lived experience, alongside GPs, primary care teams, mental health staff and third sector partners.
“Our priority is to ensure mental health services remain accessible, fair and sustainable. The temporary changes in Ceredigion have shown some positive benefits, and the feedback we have received from across the three counties will play an important role in shaping the Board’s decision.”
The Board will review all evidence and feedback before making a final decision on the future of the adult mental health referral pathway.
GPs will continue to refer patients with urgent or complex needs directly to community mental health teams where appropriate, and have access to a dedicated NHS 111 professional line for additional clinical advice.
Further details, including the full Board papers, are available here:
https://biphdd.gig.cymru/amdanom-ni/eich-bwrdd-iechyd/cyfarfodydd-y-bwrdd-2026/agenda-a-phapuraur-bwrdd-26-mawrth-2026/
The meeting will be streamed live from 9:30am on Thursday (Mar 26) via:
www.youtube.com/hywelddahealthboard1
Health
Parents urged to check children’s vaccinations after meningitis cases
Local pharmacy reports MenB vaccine shortage amid rising concern
PARENTS and carers across west Wales are being urged to check their children’s vaccination status following recent meningitis cases in the UK.
The warning comes as a local pharmacy has confirmed a shortage of the Meningitis B (MenB) vaccine, highlighting growing pressure on supplies.
Mendus Pharmacy said it currently has no availability of the vaccine due to what it described as a nationwide supply issue.

In a statement, the pharmacy said: “We would like to inform our patients that, due to ongoing supply issues, we currently have no availability of the Meningitis B vaccine.
“Unfortunately, this is a nationwide shortage and all stock is currently unavailable.
“We understand this may be particularly concerning given the recent outbreak reported in Kent, and we completely appreciate the importance of timely vaccination.”
The pharmacy confirmed it is operating a waiting list and will contact patients once supplies return.
Health officials say keeping vaccinations up to date remains one of the most effective ways to prevent serious illness and reduce pressure on NHS services.
Dr Ardiana Gjini, Executive Director of Public Health at Hywel Dda University Health Board, urged parents to act.
She said: “Vaccination is one of the most effective ways we can protect children and young people from serious illness.
“Ensuring your child is fully vaccinated not only safeguards their health but also helps prevent the spread of infections within our communities.
“I strongly encourage all parents and carers to check their child’s vaccination status. If you are concerned that your child may have missed routine vaccinations, please speak to your GP.”
Meningococcal disease is a serious and potentially life-threatening infection that can lead to meningitis or septicaemia. While many people recover, some are left with long-term physical, neurological or psychological complications. Around one in ten cases can be fatal.
Although the disease can affect anyone, babies, young children, teenagers and young adults are at greatest risk.
In Wales, vaccines protecting against meningococcal strains A, B, C, W and Y are offered as part of the NHS immunisation programme. Infants receive the MenB vaccine, while teenagers are offered the MenACWY vaccine.
Latest figures from the Health Board show that uptake among 16-year-olds for the MenACWY vaccine stands at 76.4%, meaning a significant number of young people remain unprotected as they approach adulthood.
For younger children, uptake of the MenB vaccine is higher but still below the recommended 95% target. Around 92.8% of infants are vaccinated by their first birthday, rising slightly to 91.8% by their second.
Health officials say these figures reflect strong engagement from families and primary care teams but stress that continued vigilance is needed.
Families are being advised to check their child’s vaccination record with their GP or by contacting the Health Board directly. Parents should also ensure babies receive their scheduled MenB doses and that teenagers receive their MenACWY and 3-in-1 booster vaccines, which are currently being delivered in schools.
Parents are also urged to remain alert to the symptoms of meningitis and septicaemia and to seek urgent medical advice if they have concerns.
Further information on symptoms is available via NHS 111 Wales.
Health
NHS ‘on brink of collapse’ during Covid as inquiry exposes failures
Wales warned to act fast as damning report reveals staff trauma, delayed care and deadly gaps
THE UK’s healthcare system came perilously close to collapse during the Covid-19 pandemic, a major public inquiry has found, with Wales now facing pressure to act on urgent recommendations.
A landmark report published on Thursday (Mar 19) lays bare the scale of the crisis, concluding that hospitals across the UK – including in Wales – were pushed to “intolerable strain”, with some patients receiving lower levels of care and others left untreated altogether.
The findings come as First Minister Eluned Morgan welcomed the report and confirmed the Welsh Government will respond within six months.

System “ill-prepared” for pandemic
The inquiry found the UK entered the pandemic in a weakened state, with staff shortages, too few hospital beds, and ageing infrastructure already placing pressure on services.
Healthcare systems “coped, but only just,” the report states, warning that collapse was only avoided due to the “almost superhuman efforts” of NHS staff.
Many workers suffered severe mental health impacts, with burnout and post-traumatic stress widespread across the workforce.
Patients died alone
Among the most distressing findings was the impact of strict hospital visiting rules.
Thousands of patients died without family by their side, while relatives were often forced to say goodbye over the phone or by text.
The report highlights how restrictions, though intended to save lives, caused lasting trauma for families across Wales and the UK.

Missed treatment and cancer delays
The inquiry also exposes the devastating knock-on effect on non-Covid care.
Planned operations were cancelled, screening programmes paused, and patients avoided hospitals out of fear – leading to delayed diagnoses and, in some cases, avoidable deaths.
Cancer treatment performance worsened, with late diagnoses contributing to increased mortality.
“Fundamental flaws” in response
Investigators identified serious failings in how the pandemic was handled, including:
- Early guidance that underestimated airborne transmission
- Shortages of PPE, leaving staff exposed
- Poor communication with vulnerable patients
- Inadequate planning for emergency and critical care capacity
These issues, the report says, put both patients and staff at greater risk.

NHS 111 and ambulances overwhelmed
Emergency systems also struggled to cope.
Demand for NHS 111 surged beyond capacity, while ambulance delays increased – even for life-threatening calls.
The report warns future pandemics could see similar failures unless urgent reforms are made.
Long Covid and hidden impact
The long-term effects of Covid are still being felt, with inconsistent care for Long Covid patients and ongoing uncertainty around treatment.
Meanwhile, millions of people who needed routine care remain affected by the backlog created during the pandemic.

Welsh Government response
First Minister Eluned Morgan said the Welsh Government would respond “openly and constructively” to the findings.
She acknowledged the significant impact on patients, staff and families and confirmed Wales will address the inquiry’s recommendations within the required six-month timeframe.
Urgent warnings for the future
The inquiry makes ten key recommendations, including:
- Expanding hospital and emergency capacity
- Improving infection control guidance
- Strengthening support for healthcare workers
- Better data systems to identify vulnerable patients
It warns that without action, the NHS may not withstand the next pandemic.
“We may not be so lucky next time”
In one of the report’s starkest conclusions, Baroness Hallett warned that healthcare systems came dangerously close to failure.
If the crisis had lasted longer – or hit harder – the NHS could have collapsed entirely.
The message is clear: Wales and the UK must prepare now, or risk repeating the same mistakes.
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