Healthy London Partnership and the Association of Young People’s Health (AYPH), the UK’s leading independent voice for youth health, have worked with colleagues across London to produce a set of resources for primary care networks as they seek to address the needs of children and young people in their local areas.
Despite national and regional focus on the development of primary care networks there has been little focus on the specific needs of children or young people. Nearly a third of the UK population is aged 0-25 and a fifth is aged 10-24. In total there are 11.6 million young people in the UK aged 10-24. Young people access their GP regularly for a wide range of health issues and over half of Year 10 pupils (age 14-15) reported visiting their GP within the last three months.
Recognising the many calls on the time and attention of developing primary care networks (PCNs), this work aims to enable them to avoid duplication of effort and provides advice on how networks can ensure that young people’s needs are fully considered as PCNs take shape.
From recent engagement workshops with four youth projects (Step Forward, Spotlight Youth Centre, the Royal London Hospitals Health Youth Forum and Healthwatch Tower Hamlets) young people highlighted the significant opportunity which primary care networks could create for care, support and prevention work with children and young people.
They came up with priorities that they felt were important, which covered a range of areas from confidentiality, communications and digital interaction, to outreach and engagement.
Some of the priorities included:
Peer support and youth work skills: additional support is needed to help manage the social impact of certain health conditions, particularly long-term conditions or conditions that can have stigma attached (such as sexual health or mental health)
Option to choose who they see: knowing that they can choose the gender or ethnicity of the healthcare professional would make them feel more comfortable and engaged with their care
Primary Care Networks to be proactive: young people would feel more engages with services if they actively “advertised” and educated young people in places where they already are – such as schools; colleges; social or religious community groups
Support in communicating with family: young people wanted support from primary care networks to help them explain their health needs with their family, particularly around mental health or sexual health.
Consent and confidentiality: services should not take for granted that young people understand what this means in the context of their health and in relation to information sharing
Young people should be kept informed about their treatment: young people valued being kept up to date with treatments, waiting lists and referrals
Choice: knowing what services are out there and what they do helps young people feel in control of their health
Access: young people felt that they should be able to access services around their schedules, some of which could be very busy. This included drop-in clinics or peer support groups
Online and app-based support: accessing support, information and practical guidance online and through technology was felt to be useful to help young people feel empowered, less alone and able to seek health support
Professionals understanding young people: healthcare staff should believe young people, respect their opinions and work to understand their point of view.
One young person, from Tower Hamlets, said: “As a Muslim I really wanted to see a female doctor, but I didn’t know I could ask for one, so I saw a male doctor and just lied about why I was there”.
Dr Mo Akindolie, Clinical Director for Healthy London Partnership CYP Programme, said: “Children and Young People make up 25 per cent of the population seen in primary care by GPs. Their physical and mental healthcare needs are however distinctly different from those of adults.
“Primary care networks represent a unique opportunity in this regard. Meeting the healthcare needs of children and young people is the most impactful way by which we can definitively shape the future health of the nation.
“These resources will assist primary care networks with ensuring that their young patients are able to access the right services at the right time through primary care and feel welcomed by these services. By connecting in a collaborative manner with education, social care and other sectors, this will ensure a truly integrated approach to improving the health and wellbeing of children and young people.”
Liz Wise, Programme Director of Transforming Primary Care, said: “How primary care networks present themselves to children and young people is important; they offer a great opportunity to care for and support young people.
“Networks will want to take on board the learning from this work by the Association of Young Peoples Health– which is also relevant for the prevention agenda.”
Alongside the engagement work, HLP have created a set of resources for PCNs to draw on. A workforce model has been developed for networks to use in assessing and planning the workforce needed to deliver an all-ages, patient-centred approach in primary care. The model describes how PCNs can define their vision, assess resources and gaps and develop plans to ensure the workforce meets the needs of their populations.
A set of case studies describe local, national and international models of care that PCNs can draw upon for inspiration in the planning of their services for CYP. While no single model exactly mirrors the vision for PCNs in England, each of the case studies provides relevant information on specific areas of care, or a model that reflects in some way how PCNs can meet the needs of CYP.
Finally, a set of related, additional resources has been developed, including the principles and proposed linkages that PCNs may wish to consider as they embed their CYP-focussed services within their local community.
Download the resources at www.transformationpartnersinhealthandcare.nhs.uk/resource/primary-care-children-young-peoples-toolkit/primarycarenetwork
Download the report here