This week we’ve been reflecting on transition and young people who are cared for in adult services up to the age of 25, it’s really helpful that the NHS Long term plan raised the bar and asks the NHS to work on improving care for those from 0-25 years of age. Previously Children’s services have focused mostly on the care of young people up to 16, sometimes up to 18, the statutory definition of becoming an adult. It’s helpful that research over the past 20 years or so has confirmed that brain development continues until we’re 25, hence the need to support young adults as they continue their journey to independence, particularly those who have long term health needs.
We know how vulnerable young people can be and the impact great, positive, encouraging, support can have, which is why it’s important we continue to work to improve transition and young adult care. It’s vital children’s and adult services work collaboratively and take a ‘system wide approach’ along with primary care, local authorities, the voluntary sector and schools, colleges, universities and employers.
We know than when young people move into adult services, particularly in inpatient care they are often surrounded by much older people. Only last week we had a 19 year old with Sickle Cell Disease being cared for on a ward between two elderly patients which was far from ideal. Young People can feel intimidated by professionals who they haven’t had a life time of getting to know. Sadly we have now have evidence that health outcomes for young people with long term conditions can deteriorate and result in the worst case scenarios of significant long term complications and untimely death as they disengage with services, if they feel we don’t connect with them.
So what would good transition and young adult experience look like? This model gives us an ambition to aim for…
Young people want honesty and they want us to start preparing them early, they want their GPs to be involved, they want a named point of contact, they want shared care plans with emergency care instructions too. Importantly peers matter, young people want us as health care professionals to connect them with other young people in similar situations.
So at the Trust I’m working at there is wonderful senior leadership on this agenda, the executive team are all supportive of this work. We have 2 fabulous nurse specialists Neil Fletcher and Angela Thompson, funded by the wonderful Roald Dahl Charity who are leading the way, supported by fabulous consultants in Paediatrics and in Adult Medicine. We’re embedding the transition framework ‘Ready, Steady, Go, Hello’ https://www.uhs.nhs.uk/OurServices/Childhealth/TransitiontoadultcareReadySteadyGo/Transitiontoadultcare.aspx (thanks Arvind Nagra @arvnagra & Southampton UHT 😉) where teams don’t have a transition framework in place. The Trust strategy team are helping make this happen. We’re also strengthening our links with primary care, GPS like Helen Jones are testing different models for young people’s clinics. And the numbers of youth workers are growing across the Trust. We’re also been part of the National improvement programme with NHS Improvement/England.
So what do young people from us?
They tell us they want to be welcomed, reached out to, to feel safe and ideally cared for with people of similar ages. They want to be respected and for us to remember it’s scary being a young person using the NHS.
Importantly, we are just as concerned about those young people who ‘crash land’ into adult services as those who transition to adult care from Paediatrics. We need to get it right for all young adults.
Lucy kindly shared her experiences of being a young adult receiving care, please follow her @LucyAlexandria she’s totally inspiring! Huge thanks to all of the amazing young people informing and helping to move this work forward.
Young People’s health is a responsibility of all of us shares the Health Foundation in a recent report https://www.health.org.uk/sites/default/files/upload/publications/2019/HEAJ7109-Young-Peoples-Health-Report-WEB.PDF So we asked our Trust if they’d be allies for and with young people and adults, 220 senior leaders said yes! Will you ask your Trust to do the same? 😉
Kath Evans Connecting 