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Editor,—Although separate dedicated medical inpatient adolescent units have been advocated1 there is little information on their availability in UK. We report the prevalence of adolescent medical inpatient facilities in England and Wales.
We performed a two stage survey between March and September 1998. In stage I we telephoned all hospitals with paediatric departments in England and Wales to ascertain the provision of inpatient adolescent facilities. In stage II we sent postal questionnaires to hospitals reporting separate inpatient facilities. Factors determined included provision of separate ward or designated bay, number of available beds, groups of patient served, visiting times, and presence of multidisciplinary input for adolescents.
All 225 hospitals surveyed supplied baseline information. Fifty nine (26%) had separate medical inpatient facilities, of which 49 (83%) responded to the written questionnaire. Sixteen hospitals had a separate adolescent ward. Seven of these were in university hospitals; five were specialist oncology units. The other nine units were in district general hospitals and catered for all medical specialities. The remaining 33 units had a designated bay for adolescents. The number of beds in the adolescent wards ranged from 3 to 19 (median 6) while the number of beds in designated adolescent bays ranged from 4 to 12 (median 8). Thirty nine of 49 units had a multidisciplinary policy and 29 had nurses with an interest in adolescent care. The age for admission ranged from 11 to 23, but only seven units took patients over 17.
The justification for adolescent inpatient units is based on catering for the unique developmental and psychosocial needs of adolescents, such as independence, peer contact, privacy, and educational opportunity.2 3 Teenagers may prefer an adolescent based service.4 Only a quarter of hospitals in England and Wales have dedicated facilities for adolescents, mostly dedicated bays. There was no geographical pattern and no relation to size of hospital. It is therefore likely that the provision of adolescent inpatient facilities is dependent on other factors such as funding and the presence of interested nurses and clinicians. Neither paediatric nor adult medical specialist training curriculum stipulates adolescent exposure and there may be concern over trainees' exposure to adolescent medicine. We believe that the needs of many adolescent patients are unmet and dedicated adolescent facilities should be increased.