Aim Adolescents form a significant cohort within paediatric practice, with unique needs and specific challenges associated with delivery of good quality care. Dedicated adolescent wards or areas are associated with the highest levels of patient satisfaction. There is little available data benchmarking current patterns of UK service provision. We set out to ascertain standards of current practice within units accepting adolescent inpatients in the UK.
Methods The RCPCH provided a list of clinical leads for paediatric departments in all acute trusts in the UK and Northern Ireland. They were each contacted by email and a link provided to a Google docs survey. This survey addressed aspects such as service delivery, staffing, infrastructure and departmental policies.
Results We received a response from 56/167 acute trusts (33.5%). Number of inpatient beds ranged from 4 to 193. Most trusts had a maximum age for admission to paediatric services of 16 years, 8 n =18 (32%) or 18 years, n = 16 (29%). Educational status was considered for admission location by 27 trusts (48%). Choice of admission between paediatric and adult services was offered to 16–17 year olds in 28 trusts (50%). Separate adolescent accommodation was provided in 20 trusts (36%). Of these 5 had a separate ward. Minimum age for admission to these areas varied from 11–14 years old. Dedicated recreation space for adolescent patients was provided by 36 trusts (64%). A consultant with a special interest in adolescent medicine was employed by 5 trusts.
Discussion Little improvement in adolescent inpatient provision has been shown since 2000 when around 26% of hospitals had specific adolescent inpatient services.1 It is encouraging that over half of responding trusts provide separate entertainment space for young people. A significant number of trusts have rigid admission policies that do not offer the chance of paediatric care to all those under 18 years. This data would suggest that the UK still lags behind North America, Scandinavia and Australia in providing specific tailored inpatient care to young people with medical and surgical conditions.
Suresh S, Doull IJM, Thomas P. Adolescent inpatient units. Arch Dis Childhood. 2000;82:266