Young People in Secure Settings- Feedback Dr Inyang Takon Consultant Paediatrician QEII Hospital, Welwyn Garden City, Herts.

Background Over 2200 young people held in secure setting in the UK at any time Over 2200 young people held in secure setting in the UK at any time Young people have significantly greater unmet, physical, mental and emotional health needs Young people have significantly greater unmet, physical, mental and emotional health needs Moving services at a national level

Evidence of unmet needs High level of substance abuse- 83% regular smokers, >60% drank alcohol daily or weekly, 66% reported binge drinking once a week, >80% had used illegal drug once a month. 10% of males and 5% of females diagnosed with ADHD whilst in secure settings High prevalence of conduct disorders, anxiety and depression, self harm, psychosis

Evidence of unmet needs Unmet physical health concerns- longstanding musculoskeletal, dental, skin complaints, respiratory illnesses Ryan M and Tunnard J. Healthy Children, Safer Communities programme, 2012

The Project Led by RCPCH, GSF involved in care planning expert group. Focus group sessions with young people from across UK and across various secure settings Secure children’s home Secure training centres Young offender’s institution

The Project Joint working with RCPCH, RCCGP Royal College of Nursing Royal College of Psychiatrists Faculty of Forensic and Legal Medicine Faculty of Public Health

View’s of young people Lack of information about available healthcare. Concerns about confidentiality Problems with management of medication.

Entry and Assessment Young people want information about health Identification of key health concerns on entry into secure setting Information sharing and coordination of care between agencies. Clear pathway for managing referrals when health need is indicated YP receives full assessment including mental health assessment ( within 3 days)

Entry and Assessment Annual health reviews Mental health review within 3 months Neurodisability assessment should include assessment for ADHD, ASD, LD Check for features of self harm

Care Planning YP want to be involved in planning their care Lead healthcare professional Healthcare plan developed along with young person

Universal Health Services YP should know how to access health services whilst in secure setting Access to 24 hour emergency medical and dental services Comprehensive health promotion strategy in place

Physical Health Care and Intervention Access to evidence based physical intervention Access to advice on sexual health

Mental Health and Neurodisabilities Comprehensive mental health and neurodisability strategy Timely access to CAMHS and Psychological input Lead mental healthcare professional Pharmacological treatment delivered according to guidelines.

Substance Misuse Care and Interventions YP should have access to substance abuse strategies. Named lead nurse for substance misuse oversees treatment

Transfer and Continuity of Care Continuity of care should be maintained when YP moves to another service Health care records-should be sent to the GP and manager in new secure setting

Healthcare environment and facilities Healthcare should be delivered in safe and fit for purpose places Privacy and confidentiality of young person should be maintained

Planning and Monitoring Service Planning/Commissioning of services for YP in secure setting. Staffing levels

Multiagency working YP is informed about how their information is being shared Written safeguarding policy

Staffing and Training Healthcare practitioners should access training in safeguarding policies, self harm and child and adolescent development.