A guest blog from the Association for Young People’s Health
By Arrash Yassaee and Ann Hagell
Although adolescence is usually a very healthy life stage, young people do go to primary care practitioners throughout their teens with a variety of health issues. They go more often than we sometimes think – the average is around three or four times a year.[1] This is an age when young people are developing health behaviours that may stay with them for life. Good experiences with primary care at this time could potentially be very important for young people’s sense of confidence and trust in health services for many years to come, and may promote better health outcomes.
Although young people in the UK are lucky in that they have good access to primary care services, free at the point of use, there is evidence that services are not terribly responsive to their particular health needs.[2] [3] The last sweep of the English Health Behaviour in School Aged Children study (HBSC) offered a unique opportunity to find out more about how they felt when they visited their GP, and how this might be related to their health status. Is poor experience of primary care associated with worse physical and mental health measures?
The HBSC draws on a large, nationally representative sample of 11-15 year olds.[4] The overwhelming majority felt that they were treated with respect by GPs (92%), which is good news. Four out of five (79%) felt at ease, and 86% were satisfied with the explanations they were given. However, only 54% felt able to discuss personal matters, and poor experience on any of the measures was associated with increased risk of self-harm and sleeping problems. We couldn’t establish the direction of causality in these cross-sectional data, but the findings raise a concern that poor experiences may lead to disengagement and poor health outcomes among adolescent patients.
Particular skills are needed to work with young people, to build trust and respect confidentiality. If prevention and early intervention are to be taken seriously, policy makers and commissioners need to ensure that adolescents are not left out of the picture. Paediatric and adolescent health training are currently not statutory for British GPs, and there is little recognition of the importance of adolescent health outcomes in the various outcomes frameworks that shape provision in the NHS and public health. Good practice guidelines such as the English ‘You’re Welcome’ quality criteria for provision of healthcare to adolescents are an important way forward in promoting youth friendly services.
This blog is based on a recently published article, ‘Experience of Primary Care Services Among Early Adolescents in England and Association With Health Outcomes’. To view the full article by the blog authors, click here.
Yassaee A, Hargreaves D, Chester K, Lamb S, Hagell A and Brooks F (2016) Experience of primary care services among early adolescent in England and association with health measures. Journal of Adolescent Health, in press
Arrash Yassaee is a foundation year two doctor at Colchester Hospital University NHS Foundation Trust and Ann Hagell is Research Lead at the Association for Young People’s Health
[1] Hagell A, Coleman J and Brooks F (2015) Key Data on Adolescence 2015. London: Association for Young People’s Health
[2] Davies S (2012) Our children deserve better: prevention pays. London: Department of Health
[3] Churchill R, Allen J, Denman S, Williams D, Fielding K and von Fragstein M (2000) Do the attitudes and beliefs of young teenagers towards general practice influence actual consultation behaviour? British Journal of General Practice, 50, 693-97
[4] Brooks F, Magnusson J, Klemera E, Chester K, Spencer N, Smeeton N (2015) England national report: findings from the 2014 HBSC study for England. Hatfield: University of Hertfordshire