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New research from colleagues at the Ethox Centre and Institute for Women and Children’s Health considers how, in the post Covid-19 pandemic context, children with chronic illness should feature in healthcare resource allocation decisions and non-emergency treatments prioritisation processes.

In the aftermath of the Covid-19 pandemic, allocation of non-urgent medical interventions is a persistent challenge as health systems currently face an unprecedented backlog of patients requiring treatment. Difficult decisions must be made that prioritise certain patients over others. Ethical resource allocation requires that the needs of all patients are considered properly, but at present there is no guidance that can help support such decision-making which explicitly considers the needs of children with chronic and complex conditions.

This research reviews the NHS guidance for priorities and operational planning and examines how the needs of children with chronic illness are addressed in NHS objectives for restoring services and meeting elective care demands.

The authors find that the current NHS approach does not succeed in capturing their distinct needs. They propose that two new criteria ‘protecting age-related equality of opportunity’ and ‘acknowledging complexity of care’ should be introduced to complement the existing ones, in order to support decisions-makers to make decisions that are consistent, fair and inclusive to the needs of children with chronic conditions. They also consider broader implications of our suggested framework for health care resource allocation decisions in general.

Lignou S, Sheehan M, Parker M and Wolfe I. Healthcare resource allocation decisions and non-emergency treatments in the aftermath of Covid-19 pandemic. How should children with chronic illness feature in prioritisation processes? [version 2; peer review: 2 approved]. Wellcome Open Res 2024, 8:385 (

Visit the research project web page for more information about this work: Children, acceptable health risks and Covid-19