Affiliation:
1. NIHR Children and Families Policy Research Unit, UCL Great Ormond Street Institute of Child Health
2. Thomas Coram Research Unit, UCL Social Research Institute
3. NIHR Children and Families Policy Research Unit, Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health
Abstract
Abstract
Background: Children in care and care leavers have worse health outcomes than their peers without care experience. This study addresses an evidence gap in exploring care-experienced young people’s views and experiences of accessing general practice and dental services and attending health reviews in England.
Methods: We conducted a qualitative study using podcasting as a creative medium. We recruited young people from two sites: one in South England (A) and one in greater London (B). We held two paired discussions in site A and two focus groups in site B, with 14 participants in total. Participants were aged between 13 and 22 years and were diverse in gender, ethnicity, and care experiences. Data were analysed thematically using candidacy theory as a conceptual framework.
Results: Mental health was a prevailing concern for participants, but general practice was not considered a place to discuss it. Most participants reported distant relationships with primary healthcare professionals and considered opening-up to a professional to be risky, for example, it could result in an unknown/unwanted outcome. A lack of time and personal connection in appointments, and experiences of feeling judged, dismissed, or misunderstood, hindered young people’s ability to disclose mental health or relationship concerns. Participants reported variation in the timeliness and location of services, with salient examples of extensive waiting periods for braces. Participants perceived annual health reviews to be largely inconsequential.
Conclusions: Any primary care presentation by a care-experienced young person should trigger additional professional curiously. To build rapport and trust, professionals should not underestimate the power of active listening, being reliable and honest, and small acts of thoughtfulness, for example, ensuring medical letters are provided promptly. Carers and other trusted professionals should support care-experienced young people to develop health literacy and understand the role of primary care. Health reviews may not be of value to all young people in care. Further research is needed to examine primary healthcare access for care-experienced young people with significant safeguarding and healthcare needs.
Funder
National Institute for Health Research
Publisher
Research Square Platform LLC
Reference62 articles.
1. Children Act (1989) c.41 [Internet]. Sect. 20. https://www.legislation.gov.uk/ukpga/1989/41/section/20
2. Office for National Statistics Children looked after in England including adoptions [Internet]. 2023 [cited 2023 Dec 7]. https://explore-education-statistics.service.gov.uk/find-statistics/children-looked-after-in-england-including-adoptions#releaseHeadlines-tables
3. Children (Leaving Care) Act 2000 c.35 [Internet]. https://www.legislation.gov.uk/ukpga/2000/35/contents
4. England NHS Core20PLUS5 – An approach to reducing health inequalities for children and young people [Internet]. 2022 [cited 2023 Aug 16]. https://www.england.nhs.uk/about/equality/equality-hub/national-healthcare-inequalities-improvement-programme/core20plus5/core20plus5-cyp/
5. Comparison of substance use, subjective well-being and interpersonal relationships among young people in foster care and private households: a cross sectional analysis of the School Health Research Network survey in Wales;Long SJ;BMJ Open,2017