Hundreds of children are in hospital unnecessarily on any given day across England because they lack the necessary support to return home, a report has found.
The discharge delays mean young patients are missing out on vital childhood activities, while also creating bed shortages for other children in need of care.
The Children’s Commissioner’s report, published on Monday, which includes new analysis of NHS England data, found more than 260,000 youngsters spent three or more weeks of their childhood in hospital and 1,300 were there for more than a year.
Medical advancements have meant more children with complex or life-limiting conditions can live longer, but community services such as children’s social care, housing, education and home nursing have not kept pace, the report said.
“For all the debate and attention given to hospitals, waiting times and social care, children are rarely mentioned,” Dame Rachel de Souza said.
“Childhood is a short and precious time – so when a child spends months or even years confined to a hospital ward, not because they are too unwell to leave but because the right community support cannot be found, the system has failed.”
This failure is partly driven by a “lack of good data”, she said.
The NHS does not consistently record how many youngsters are medically fit to leave hospital but remain there as a result of factors external to the health service, the report said.
One hospital that documents that data found five per cent of children on its ward in June 2025 were medically able to leave but could not.
“My work shows a hidden crisis, as services do not definitively know how many children are stuck, waiting to be discharged, how long they wait, or how many days’ worth of beds could be saved and offered to children who truly need to be there,” the commissioner said.
The report found more than 14,000 children have spent more than 10 per cent of their younger years in hospital, while more than 400 have spent half their lives there.
Ethnic minorities and children from deprived backgrounds were disproportionately likely to experience prolonged stays in hospital, it said.
The lack of beds also affected elective and emergency admissions, the report added.
Multiple factors were found to delay children from leaving facilities, including long waits to secure community care packages, often caused by funding disputes between health and social care.
There was a severe shortage of children’s social care placements, as well as inconsistent access to community care, nursing, palliative care and therapeutic services.
Suitable housing for families was found to be lacking and there were delays to adaptations and equipment needed for youngsters to safely live at home.
Long hospital stays can mean families have to travel between home and medical facilities, take time off work, and balance caring for other children while navigating challenging support systems.
Dame Rachel called on the government to create a coordinated method to support children with complex needs outside hospitals.
She recommended a cross-government system to bring together health, social care and education.
It could ensure support is available at home or that there is a specialist placement for those who cannot safely return home.
She also suggested a national plan to expand home nursing and care for children, so that families can rely on that support consistently.
Guaranteed access to palliative and end-of-life care for children was also recommended, as well as a boost to paid leave for parents of sick children.
Nick Carroll, chief executive of Together for Short Lives charity, said: “Sadly, Dame Rachel’s findings reflect what Together for Short Lives has heard from families for some time: despite the incredible support that NHS and voluntary sector children’s palliative care services provide, too many families do not get the choice to access it at home or at a children’s hospice.
“This is due to workforce shortages, fragile funding and ministers not holding local NHS bodies to account for planning services which meet best practice standards.”
The building of Cambridge Children’s Hospital is underway and it will be the east of England’s first specialist children’s hospital.
In light of the report, hospital leaders said: “We need a fundamentally different approach, one that connects hospital specialists with community teams, social care and schools from the start.”
Professor Isobel Heyman, its clinical co-lead for mental health, and Dr Rob Heuschkel, the clinical lead for physical health, said in a joint statement: “(The hospital) will include an embedded research institute focused on early intervention, and a hospital school working with children’s own schools to keep education on track, as well as extending specialist support into communities through stronger links with social care and home nursing.
“Our ambition is not just to transform care locally — but to create a national model for how children’s services work together beyond hospital walls.”
The children included in the data had been admitted to hospital and were 17 years old and younger on November 30 2024.
It included the hospital stays of children born and who died in hospital.
Interviews were also carried out between June and December 2025 with parents of children with complex needs, and health and children’s social care professionals.
It also used previously unpublished data on discharge delays from five hospitals.
