Shifting Care to the Community: What does this mean for young people?

This report focuses on the Hospital to Community shift by exploring the research question: "How can the shift to community care be set up more effectively to ensure that young people’s health and wellbeing is a priority?"

The NHS Young Researchers work alongside NHS England to voice young people’s priorities for healthcare services so that these can be embedded within national and local policies to ensure the best health outcomes for young people.

This year, the focus for the Young Researchers' projects were on the NHS 10-Year Health Plan produced by the Department for Health and Social Care. The plan looks at reforms to the NHS and wider existing community services to close the gaps and ease pressures that they are currently facing. There are three shifts as part of the plan: Hospital to Community, Sickness to Prevention, and Analogue to Digital. All Young Researchers were split into three groups to focus on one particular shift in the plan.

This document was created by children and young people. To ensure everyone can engage with it we are producing an accessible version which will be available shortly.

Executive summary

This report focuses on the Hospital to Community shift by exploring the research question: "How can the shift to community care be set up more effectively to ensure that young people’s health and wellbeing is a priority?".

To gather evidence, the group developed surveys for young people, parents and carers, and NHS staff. Survey responses highlighted negative experiences of care, numerous barriers and accessibility issues, individuals' sense that they cannot participate in their care, and a lack of confidence in providing feedback.

This was supported by NHS staff responses indicating that participation was ‘tokenistic ’ and that young people were not receiving wraparound, holistic care to meet their needs. Respondents also highlighted the need for services such as education, children and young people's mental health services (CAMHS), social care, youth services, and the NHS to work together to ensure community care is as effective and supportive as possible for young people.

Recommendations and conclusion 

The data showed that the shift from hospital to community care is welcome and positive among young people, parents and carers, and staff. However, without significant commitments to funding and filling identified gaps, such as GP care, neurodevelopmental services, and mental health services, it may be difficult for the NHS to sustain the shift from hospital to community care as per the NHS's 10-Year Health Plan.

Greater improvements to communication, accessibility, visibility of services, and cultural competency are needed 

The data highlighted concerns/negative experiences that young people have had over communication, barriers to accessibility, visibility of services, and a lack of cultural competency within community care services. This was further reinforced by responses from the parent and carer survey.

The responses collected from the King’s Fund conference highlighted areas such as more diagnostic support and discharge support from hospitals, as well as highlighting significant barriers that marginalised groups face when accessing care from the community.

More focus on engaging a broader range of people with diverse lived experiences is needed

Further research and extensive work is needed to include and engage more individuals with diverse lived experiences and marginalised groups, in particular the voices of carers, refugees, asylum seekers and looked after children/care leavers.

This can be done through increasing funding and availability of peer support workers or lived experience workers who can truly understand an individual’s experience from a lived experience lens - this is an area missing from the Government’s National Youth Strategy.

Improving existing services must come before creating new services

The quality of existing services needs to improve before creating new services, to ensure they remain fit and accessible for young people, parents, and carers who use them, as well as staff. It is vital that, during this shift, that the voices of those already excluded from health and social care services are not further marginalised or disadvantaged.

NHS England and social care services need to collaborate to ensure the shift from hospital to community care is truly fit for purpose and meets the needs of young people.

The NHS Young Researchers are 25 young people aged between 16 to 24, part of the wider NHS Youth Forum, who work alongside Barnardo's and NHS England to advocate for valuable participation and provide a voice for young people within healthcare services.

This year, the focus for the Young Researchers' projects were on the NHS 10-Year Health Plan produced by the Department for Health and Social Care. The plan looks at reforms to the NHS and wider existing community services to close the gaps and ease pressures that they are currently facing. There are three shifts as part of the plan: Hospital to Community, Sickness to Prevention, and Analogue to Digital. All Young Researchers were split into three groups to focus on one particular shift in the plan.