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How equitable is the NHS really for children?
  1. Elizabeth Cecil
  1. Faculty of Life Sciences and Medicine, King's College London, London, UK
  1. Correspondence to Dr Elizabeth Cecil, Faculty of Life Sciences and Medicine, King's College London, London WC2R 2LS, UK; lizzie.cecil{at}

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Health inequalities present a major challenge for the UK National Health Service (NHS), which has set that reducing health inequalities is a key priority in the 2019 NHS Long Term Plan.

New research confirms that use of healthcare services is deeply inequitable, and reflects inequitable access to healthcare for children.1 The COVID-19 pandemic has exposed and compounded effects of inequity across all ages. There are promising initiatives that integrate healthcare for children and aim to mitigate inequities in healthcare. However, healthcare alone cannot rebalance health inequalities and government policies need to address the wider determinants of health.


The key components of high-quality healthcare are accessibility, effectiveness, responsiveness, safety and equity.

Access is particularly important for children and young people (CYP) as they are frequent users. Young children for routine vaccinations and developmental checks, as well as for unplanned care because they are more susceptible to infectious diseases than older children and adults. Moreover, the epidemiological transition from infectious to non-communicable disease as the main burden of disease across all age groups affects CYP too. These changes have resulted in a substantial increase, over recent decades, in health service use among CYP for long-term conditions. Emergency admissions for long-term conditions in adolescents are now more common than for injuries.2 Moreover, as the Mental Health of Children and Young People in England, 2020 Survey suggests, around 20% of young people (27.2% of young women and 13.3% of young men) are likely to have a mental health disorder. These CYP identified with a potential mental health condition compared with …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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