How we can help children improve their health

Image caption Teenagers may not always be comfortable talking to a doctor

The health of our children and young people matters to us, and it matters to them. We want them to understand what makes them healthy, what keeps them healthy, and what to do when they have worries, are not feeling so good, or are simply ill.

In this week's Scrubbing Up, Barbara Hearn, deputy chief executive of the National Children's Bureau, says the launch of the government's Children's and Young People's Forum presents a key opportunity to improve services for them.

Teenage years are the transition years. Adolescents face choices that will affect their health now and in the future.

But while they can get information from parents, will it be up to date? When they ask their mates, will they be well informed?

While health promotion plays a key role, a significant and early point of private contact with health services for a teenager is their GP.

Some children and young people express feeling embarrassed and judged when they seek advice from their GP. They can find it hard to describe their own health concerns and find it hard to understand their doctor's response.

While GPs continue to improve in terms of their own confidence and capacity to make a child patient feel comfortable it is not yet a guaranteed good experience for those under 18's everywhere.

Practices need to be attuned to just how intimidating an all adult environment can be for teens and pre-teens to enter.

Three changes are required. Firstly, better professional development. GPs do have some training in child development but it is insufficient.

Learning how to talk to 12 -18 year olds; and even more importantly, how to listen to what they have to say; how to encourage them to speak up; and to be confident that they understand what is said to them before they leave, takes time.

We can include young people as the 'teachers' here to help GPs learn how to interact effectively with their younger patients.

GPs would benefit from feedback about their manner, the quality and simplicity of their communication, their clarity in explaining diagnoses, treatments and next steps -thereby going beyond theory to learning by doing.

Secondly, the 10-minute patient slots are simply too short to establish a relationship with a tentative young person.

Once it was clear that a patient was under 18, a double slot could automatically be booked, and re-booking done with the same GP or only GPs that have had the training.

Thirdly, to ensure the services GPs are offering are the right ones, young patients should be involved - alongside other patients - in decisions about the services their GP surgery provides.

'Break the myth'

In addition, children and young people are rightly a target for public health services.

The fact of their youth means there is time to prevent damaging behaviours and flippant attitudes developing. And time to help them establish good patterns of managing their health for the rest of their lives.

It is time to break the myth that has grown-up over the 60 years of the NHS, that health services manage your health for you making it OK to get 'hammered' and end up in A&E; or to try a drug and see what happens; or remain ignorant of what is going on inside your body while fretting over glamour and goodies on the outside.

Involvement of young people invariably moves into the 'too difficult' box, to be dealt with later, but later never comes.

Young people are avid learners. They contribute through voluntary activity far more than adults and are deeply committed to and interested in the health services.

We need to think of these reforms not as 'do to populations' but 'do with them'.

Children and young people are those with the time and energy to put into making our communities healthy. And in doing so they are able to educate themselves and their peers in ways which can change lives.

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