Adolescent and young adult (AYA) health has been on the agenda for some time,1 with no shortage of reports and guidelines highlighting the importance of developing clinical services for young people.2–6 However, these recommendations are yet to be translated into established clinical practice, with a culture of young people's health embedded in every health service. Common causes of morbidity among young people include mental health problems, drug and alcohol misuse, injuries (intentional and non-intentional), and sexual health problems.7 In addition, the number of adolescents and young adults growing up with chronic diseases of childhood continues to increase, placing pressure on both paediatric and adult services.8 There are compelling reasons to increase the focus on young people's health as this is a group for whom improvements in outcomes have not matched those seen among other age groups (eg, the under-5s and the elderly).7 Investment in young people's health is required to address this imbalance and to consolidate the improvements in outcomes that have resulted from previous investment in early childhood. A greater focus on young people will also address many of the health behaviours that determine key outcomes in later life, thus reducing pressure on health service use by older adults.9 ,10 For hospital-based clinicians wishing to establish AYA services, how should they proceed and what might such services look like? This article provides some suggestions.

Adapt to your hospital environment

The scope of any AYA service that clinicians provide will depend on where they work; for example, in a general, children's, adult or subspecialist hospital. General hospitals would seem best suited to developing AYA services as they manage patients across the whole AYA age range (10–24 years). In contrast, clinicians in specialist children's or adult hospitals are frequently faced with having to convince hospital managers that young people's health …