Skip to main content

Main menu

  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us

Future Healthcare Journal

  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

User menu

  • Log in

Search

  • Advanced search
RCP Journals
Home
  • Log in
  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us
Advanced

Future Healthcare Journal

futurehosp Logo
  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

Improving adolescent care in a cross-sector system

Aarthi Ravishankar, Lauren Fraser, Tom Holliday and James Biggin-Lamming
Download PDF
DOI: https://doi.org/10.7861/fhj.9-2-s18
Future Healthc J July 2022
Aarthi Ravishankar
ALondon North West University Healthcare NHS Trust, Harrow, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lauren Fraser
ALondon North West University Healthcare NHS Trust, Harrow, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tom Holliday
ALondon North West University Healthcare NHS Trust, Harrow, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
James Biggin-Lamming
ALondon North West University Healthcare NHS Trust, Harrow, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
Loading

Introduction

Adolescence represents a critical life stage in which there is rapid physical, cognitive and psychosocial development.1 It is the time where the patterns and foundations for future health are laid and thus presents a unique opportunity to promote health and subsequently improve life-long wellbeing and reduce health inequalities.1–3 Historically, this age group has attracted less policy interest and investment.4 In addition to the health benefits of investing in adolescents and young adults (AYAs), there are economic advantages as well as the possibility of greater societal gains.2–3 Mental health problems represent the greatest contributors to disease burden for this population and this contribution is forecast to rise.5 The NHS Long Term Plan states that by 2028 we should move towards service models for AYAs that are person-centred and offer age-appropriate care for physical and mental health needs.6 Furthermore, the World Health Organization states that AYAs need health services that are supportive, equitable and effective.1 The project aims to scope out AYA care at London North West University Healthcare NHS Trust (LNWH) with a view to improve quality of care for this group of patients.

Materials and methods

Quantitative data were obtained and used to assess patterns of presentation to the emergency department (ED). Qualitative data was obtained through stakeholder interviews with healthcare professionals, AYA patients and their caregivers. As of January 2022, 113 stakeholders were interviewed. The data obtained informed the creation of the ‘LNWH AYA Manifesto’ (Fig 1). This was converted into a questionnaire for all professionals involved in the care of AYA patients to assess organisational culture around AYA care.

Fig 1.
  • Download figure
  • Open in new tab
  • Download powerpoint
Fig 1.

The ‘LNWH AYA Manifesto’.

Results and discussion

It was found that AYA care at LNWH lies across a complex cross-sector system. The commonest code for presentation to the ED for those ages 13 to 25 was ‘depressive disorder’. Key themes from stakeholder interviews included the following:

  • AYAs are not always provided with age-appropriate care.

  • Acute trusts may serve as a catalyst for change for AYA patients and youth workers may be better placed to connect with them

  • There is a need for an integrated approach to physical and mental health, with better relationships needed between the acute teams and CAMHS.

The ‘LNWH AYA Manifesto’ questionnaire found disparate opinions regarding the approach to integrated physical and mental health; of the 47 responses obtained, 25.6% reported not feeling confident with recognising and managing mental health and social issues in AYAs and 44.7% believed that physical and mental health problems should be addressed separately by the relevant specialties.

Conclusion

AYA care lies across a complex cross-sector system and thus requires a multifactorial approach to create a culture change towards recognising the distinct needs of this population. One such intervention proposed is the introduction of a youth worker outreach model similar to the King's Adolescent Outreach Service as a way to create a shift towards an integrated approach to physical and mental health care.6,7

  • © Royal College of Physicians 2022. All rights reserved.

References

  1. ↵
    1. World Health Organisation
    . Adolescent health. www.who.int/health-topics/adolescent-health#tab=tab_1 [Accessed 13 December 2021].
  2. ↵
    1. Clark H
    , Coll-Seck AM, Banerjee A, et al. A future for the world's children? A WHO–UNICEF–Lancet Commission. Lancet 2020;395:605–58.
    OpenUrlPubMed
  3. ↵
    1. Shah R
    , Hagell A, Cheung R. International comparisons of health and wellbeing in adolescence and early adulthood. Nuffield Trust, 2019. www.nuffieldtrust.org.uk/research/international-comparisons-of-health-and-wellbeing-in-adolescence-and-early-adulthood [Accessed 13 December 2021].
  4. ↵
    1. Hagell A
    , Wortley E, Ross L, Whitaker E. Key Data on Young People 2021: Overview and Policy Implications. Association for Young People's Health, 2021 https://ayph-youthhealthdata.org.uk/key-data/ [Accessed 13 December 2021].
  5. ↵
    1. Ward JL
    , Hargreaves D, Turner S, Viner RM. Change in burden of disease in UK children and young people (0-24 years) over the past 20 years and estimation of potential burden in 2040: analysis using Global Burden of Disease (GBD) data. medRxiv 2021;2021.02.20.21252130.
  6. ↵
    1. NHS England
    . The NHS Long Term Plan. NHS, 2019. www.longtermplan.nhs.uk/publication/nhs-long-term-plan [Accessed 13 December 2021].
  7. ↵
    1. Pickard L
    , Baynes H, Evans C, et al. 894 managed KAOS: medical and social complexity of adolescent inpatients at an inner-city teaching hospital, a two-year experience. Arch Dis Child 2021;106:A153.
    OpenUrlAbstract/FREE Full Text
Back to top
Previous articleNext article

Article Tools

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Improving adolescent care in a cross-sector system
Aarthi Ravishankar, Lauren Fraser, Tom Holliday, James Biggin-Lamming
Future Healthc J Jul 2022, 9 (Suppl 2) 18-19; DOI: 10.7861/fhj.9-2-s18

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Improving adolescent care in a cross-sector system
Aarthi Ravishankar, Lauren Fraser, Tom Holliday, James Biggin-Lamming
Future Healthc J Jul 2022, 9 (Suppl 2) 18-19; DOI: 10.7861/fhj.9-2-s18
Reddit logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Introduction
    • Materials and methods
    • Results and discussion
    • Conclusion
    • References
  • Figures & Data
  • Info & Metrics

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Service evaluation of the impact of direct ambulance calls from paramedics to the ambulatory assessment unit in the John Radcliffe hospital, Oxford
  • The national census of UK endoscopy services 2021
  • A case for a bottom-up approach in the implementation of health policy in Africa
Show more Research and innovation

Similar Articles

FAQs

  • Difficulty logging in.

There is currently no login required to access the journals. Please go to the home page and simply click on the edition that you wish to read. If you are still unable to access the content you require, please let us know through the 'Contact us' page.

  • Can't find the CME questionnaire.

The read-only self-assessment questionnaire (SAQ) can be found after the CME section in each edition of Clinical Medicine. RCP members and fellows (using their login details for the main RCP website) are able to access the full SAQ with answers and are awarded 2 CPD points upon successful (8/10) completion from:  https://cme.rcplondon.ac.uk

Navigate this Journal

  • Journal Home
  • Current Issue
  • Ahead of Print
  • Archive

Related Links

  • ClinMed - Home
  • FHJ - Home

Other Services

  • Advertising
futurehosp Footer Logo
  • Home
  • Journals
  • Contact us
  • Advertise
HighWire Press, Inc.

Follow Us:

  • Follow HighWire Origins on Twitter
  • Visit HighWire Origins on Facebook

Copyright © 2021 by the Royal College of Physicians