State of Child Health 2026

The Royal College of Paediatrics and Child Health released its third State of Child Health review in 2026. It tracked twelve indicators across the four nations.¹

The headline is stark. Almost ten years after the first review, children in England are doing worse or staying the same in nearly all areas. This decline mainly affects deprived communities and ethnic minority groups.

For general practice, the first thing to understand is what this report is not. It is a policy document, not a clinical guideline. There are no thresholds, no prescribing guidance and no pathway changes. Its recommendations are addressed almost entirely to government departments, and the RCGP is named as an addressee in only one of the twelve indicators. This is more a description of the children who come through your door. It includes two sections that clearly state primary care capacity as the issue. The section that matters most for you is asthma.

Emergency admissions in England had been falling for years, from 217.1 per 100,000 in 2014/15 to 122.2 in 2022/23, before reversing to 147.9 in 2023/24. Between April 2019 and March 2023, 54 children in England died following an asthma exacerbation. Here is the actionable finding.

Among children who died, 87% had been dispensed three or more reliever inhalers in the year before their death.² That is a marker of poor control sitting in your repeat prescribing record before the event.

The report connects this to review capacity. Children in poorer areas are less likely to get an annual review. In 2024, GPs in these areas had about 2,450 patients each, which is over 300 more than their peers in other places.³ The intervention has no extra costs. The prescribing data already identifies the highest-risk children, and the review is the response.

The second theme is immunisation. The uptake of two-dose MMR by age five in England has fallen to 84%, below the 95% target.⁴ The College attributes this mainly to systemic barriers, not hesitancy. Problems include booking systems, appointment availability, location, and reminders. That reframes it as an access problem general practice can influence.

Beyond these, the report is best used as a well-sourced document to point at when arguing locally for review capacity, immunisation outreach and early years support.

References

1. RCPCH. State of Child Health 2026: England quick read. 2026.

2. National Child Mortality Database. Child deaths due to asthma or anaphylaxis. 2024.

3. RCGP. GPs in deprived areas manage significantly more patients. 2024.

4. RCPCH. State of Child Health 2026: immunisations. 2026.

This article reports on published evidence and policy. It is not medical advice and does not constitute prescribing guidance.