More attention should be paid to young adults when planning healthcare services and delivery within cities, according to the chief medical officer’s annual report.
The Chief Medical Officer’s annual report 2024: health in cities, from Professor Sir Chris Whitty, looked at health within cities in the UK, including some of the major issues affecting them.
It highlighted four recommendations, including the need to better consider young adults in healthcare planning as they are often ‘overlooked’.
Professor Whitty noted that young people’s health needs, which often include mental and sexual health, are concentrated in cities, as typically young adults ‘migrate’ there. However, he suggested they are often overlooked and that interventions such as screening are harder to maintain as people may move regularly.
The report said: ‘Healthcare service planning and delivery should consider the needs of young adults in cities.
‘Mental health issues generally emerge by or in early adulthood, and current increases in mental health needs for already stretched mental health services therefore fall disproportionately in cities. Similarly, increasing rates of sexually transmitted infections (STIs) and the weakened provision of STI services is particularly a city problem.’
Professor Whitty also called for changes to the ‘food environment’ which can set children and adults up to ‘live a shorter and unhealthier life’, a reduction of air pollution and accounting for the itinerant nature of city populations when providing routine vaccinations and screening services.
‘Breaking entrenched deprivation in cities will take a long time, but well-evidenced actions can be taken now to improve health and wellbeing for people living, working and studying in cities. Deprivation is highly concentrated in specific parts of cities,’ the report said.
‘This affects millions of people in England and can lead to worse health and wellbeing. This impacts individuals and society as a whole, with higher health and care costs and lower productivity. National and local government should undertake co-ordinated and concerted efforts to break the cycle of ill health in those areas of cities where it has become entrenched.
‘Concentrating prevention efforts and resources in these areas and adapting to their local communities is likely to be both more efficient and more effective than spreading a uniform service thinly over entire cities.’
Meanwhile, the Health Services Safety Investigations Body (HSSIB) released a report today that found ‘a number of challenges’ persist for young people who move from children and young people’s mental health services to adult services.
The report, called Mental health inpatient settings: Supporting safe care during transition from inpatient children and young people’s mental health services to adult mental health services, interviewed children and young people, families and staff in mental health services.
It found that many had concerns that moving the services children and young people access based on age might be inappropriate and could impact on safety.
The report found that due to the different criteria for ongoing inpatient care as an adult, some young people are discharged into an alternative setting that is ‘not suitable’ for their needs, such as bed and breakfast hostels.
The HSSIB called on NHS England to review mental health service specifications and commissioning guidance to support a more consistent approach to needs-based transitions, and the government to support closer collaboration between local government, education and health systems.
Craig Hadley, senior safety investigator at HSSIB, said: ‘An inconsistent approach to transitions, compounded by a lack of integration between health, social care and education puts the safety and wellbeing of vulnerable young people at risk.
‘Evidence shows that a more flexible approach to transition is much safer and more therapeutic for young people. There are examples of organisations taking this type of approach, but they are not underpinned by a system that supports this overall. We heard from providers and commissioners that to achieve flexibility they “were pushing the boundaries of how inpatient care had been delivered in the past.”’
He added: ‘The safety recommendations from this investigation are aimed at improving collaboration and supporting inpatient transitions that are based on needs rather than age. The move from inpatient children and young people’s services to adult services currently happens at an already challenging time of life for young people and it should not be made harder for them, and their families.
‘The reality is, as we say at the end of the report, the person did not change, their needs did not change, their risks did not change – the health, care and education system changed around them because they were a day older.’
It comes as the UK ban on prescribing puberty blockers in under-18s with gender dysphoria has been extended indefinitely.
