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BSR Vice President Jacqui Clinch discusses key paediatric and adolescent takeaways from our recently released report 'Rheumatology workforce: a crisis in numbers'.

Last month, we released Rheumatology workforce: a crisis in numbers, in which we support the RCPCH’s call for a child health strategy for all four nations to ensure children and young people have access to a fully-staffed and sustainable workforce.

More than 10 years ago we published the UK Standards of Care workforce figure, working with the Arthritis and Musculoskeletal Alliance (ARMA), of one paediatric and adolescent consultant per 200,000 child/young person population. This figure doesn’t even account for the care of patients with non-inflammatory MSK conditions, which is a significant part of paediatric and adolescent services’ workload.

Our 2021 workforce data reveals many nations and regions fall far short of this figure. In Wales, the recent Welsh Health Specialised Services Committee draft service specification included only one paediatric and adolescent rheumatologist for a population of about 1 million children and young people.

Allied health professionals and specialist nurses, the backbone of all our work, also fall woefully short of the number needed to provide complete care for our families. Alarmingly, our report also highlighted that many children and young people lack access to psychology health professionals.

We know children and young people have emotional challenges that are different as they develop, chronic disease and associated environmental pressure only heightens this. Currently 68% of paediatric and adolescent rheumatology departments reported they have a psychologist embedded in their team, and this was often as little as 0.1 WTE (four hours per week).

As a multidisciplinary, holistic profession, we all agree that this is totally unacceptable and leading to unnecessary suffering for our young people and their families. Adolescent and young people with rheumatic disease are relatively invisible in both adult and paediatric services and a priority in neither.

To ensure equity in access to rheumatic services, the NHS workforce must be able to confidently deliver developmentally appropriate care across paediatric, young person and adult settings. This will be a challenge for future workforce planning and any national NHS workforce strategy on the new Health Secretary’s agenda.

Read the report