Aims To compare the practice of paediatricians in hospital and outpatient settings with standards taken from Working Together 2010 and the UN Convention of the Rights of the Child to establish whether adolescent patients in the UK are being included, involved and allowed to participate in their healthcare.
Methods A retrospective review of the clinical notes and clinic letters of ninety adolescent patients aged 12-18 years was carried out by two researchers. 30 were inpatients, 30 were new referrals to outpatients and 30 had chronic medical conditions. The following questions were then applied:
Has the young person been seen and spoken to?
Was the young person seen alone?
Have the wishes and feelings of the young person been recorded?
Has the young person had sufficient opportunity to communicate any concerns they may have?
Have results from investigations been shared with the young person?
Have their views regarding management been recorded?
Results The majority of the young people in all 3 groups were seen and spoken to. On the paediatric ward and amongst the chronic outpatients, in all other areas investigated, no more than 30% of the young people had their voice heard. Amongst the new outpatients, approximately 70% of the young people had their voice heard in several areas – their wishes/feelings were recorded, they had the opportunity to communicate concerns and the results of investigations were shared appropriately.
Conclusion Evidence suggests that involving children and young people in decision making improves their outcomes. This study has shown that paediatric services have significant room for improvement in hearing ‘the voice of the adolescent’ and are falling short of standards taken from Working Together 2010 and the UN Convention of the Rights of the Child. Young people are rarely being seen alone by paediatricians and their feelings and concerns are not being ascertained often enough. Paediatricians need to be reminded of the importance of including, involving and allowing young people to participate in decisions about their health care. ‘No decision about me without me’ should be central to adolescent health.