'Young people have a right to good health and high quality accessible healthcare.’
Last week I attended the Association for Young People’s Health (AYPH) Conference in Manchester. The AYPH is the UK’s leading charity working to improve the health and wellbeing of 10 to 24 year olds.
As well as presenting a poster on the use of a screening tool for high-risk behaviours in adolescents, I accompanied one of our CC4C doctors, Irene Frantzis, who showed her work on the teenage pregnancy pathway. Both of these presentations demonstrate innovative thinking for better adolescent health using simple measures. They also express the ethos of CC4C in creating tools and pathways that are easily accessible to GPs in the community.
Addressing adolescent health within the community was a strong theme throughout the conference. Many of the discussions made me think of ways CC4C could be positively impacting our adolescent population. We know that typically adolescents are a healthy population, but they are also engaging in high-risk behaviours that put them at risk not only now, but as they grow into adults.
We also know that 50 per cent of adults with mental health diagnoses have presented by age 14, and 32 per cent of 15 year old girls are self-harming. Interestingly, 50 per cent of 12 to 18 year olds have visited their GP in the last three months. So why do we have so many preventable deaths in the age group, and why is our teenage pregnancy rate still way higher than other countries?
A strong message coming from the conference was our general inability to engage this population effectively; quite evidently more teaching, tools and guidelines are needed to empower providers of adolescent healthcare. Added to this is the need to think ‘out of the box’ and be innovative in making the most of adolescent face-to-face consultations.
Nicola Gray, a pharmacist and researcher in Manchester, really opened my eyes. Adolescents with chronic conditions often establish a rapport with their community pharmacist when they attend every few weeks to pick up medications: a perfect environment to screen for risky behaviours and to deliver health education. Additionally, pharmacies happen to be where pregnancy tests are bought, and the morning after pill is picked up – yet more opportunities to educate.
David Terry, another pharmacist, also discussed the pharmacist's expanded role in a project with teenagers with juvenile arthritis. Think Pharmacy is a forward-thinking brand that has been developed to engage commissioners to think differently about the provision of services from pharmacists. Nicola also talked about the role of dentists and opticians in engaging teenagers: ‘the first contact may be the only contact’. This is enlightening evidence that we need to look beyond the hospital and to empower other health professionals within the community to address adolescents in a developmentally appropriate and targeted way.
Marian Davis, a GP with a special interest in adolescents, discussed the relatively high rate of adolescent attendance at a GP surgery, but noted the lack of ‘gain’. She put this down to GP lack of education, lack of time and lack of compensation. She expressed the need for a specific quality outcome framework addressing confidentiality, seeing patients alone, improving coding, universal high-risk screening tools and targeted services. She also saw the role of a policy being put in place to have the GP link up with secondary centres when follow-up specialty appointments have not been attended.
These are just a few of the highlights of a thought-provoking day which reinforced how projects such as CC4C can deliver effective, efficient and engaging healthcare, especially in the more hard-to-reach populations.