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894 Managed KAOS: medical and social complexity of adolescent inpatients at an inner-city teaching hospital, a two-year experience
  1. Lucy Pickard1,
  2. Hannah Baynes2,
  3. Chris Evans3,
  4. Barnaby Dunn3,
  5. Timothy Sullivan4,
  6. Simon Chapman2
  1. 1King’s College Hospital NHS Foundation Trust
  2. 2King’s College Hospital NHS Foundation Trust
  3. 3Redthread
  4. 4NewGlobe


Background Adolescence (10–19 years) and young adulthood (20–24 years) are often seen as the healthiest times of life, yet 22% of 16–24 year olds report living with a chronic condition, 45% of these conditions involve their mental health. Adolescents in hospital are an under-researched cohort, they may be located on different wards across the hospital under paediatric and adult teams and are often invisible as a group.

To address this, in 2018 we created KAOS, an Adolescent Outreach Service where a youth worker team visits adolescent inpatients prospectively, supported by a clinical team, providing risk assessment, support, information and advocacy.

Objectives To review the two-year experience of KAOS in a large inner-city teaching hospital and regional referral centre.

Methods We collected cross-sectional data at the time of contact with KAOS (n=540 patients, 47% female). Stata was used to test correlation, with a Pearson rank coefficient, between borough Index of Multiple Deprivation (IMD) and number who had mental health or safeguarding need.

Results 540 inpatients (11–26 years) were seen by KAOS from April 2018-April 2020. 43% had a chronic physical or mental health condition, 63% had medical complexity, denoted by being under two or more clinical teams. Areas of adolescents’ need identified included: 29% mental health, 12% safeguarding, 12% education or employment, 10% sexual health, 4% substance use. 43% came from two boroughs neighbouring the hospital. The borough IMD had a moderate positive association with the number who were inpatients (r = 0.31), the number who had safeguarding (r = 0.38) or mental health need (r = 0.36).

Conclusions In-hospital adolescents are medically complex and more socially vulnerable than their out-of-hospital peers. Clinicians may underestimate this and we advocate for an adolescent outreach team to proactively identify and address these needs.

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