Article by Sara Reynolds and Vanessa Garratt, NHS University Hospitals Bristol & Weston

In University Hospitals Bristol and Weston NHS Foundation Trust, our Youth Involvement Group provides opportunities for young people who are patients, siblings or have an interest in healthcare to get involved in shaping how the hospitals support young people.  This is done in diverse ways from developing resources, to visiting wards, taking part in recruitment and contributing to training.

While this group creates opportunities to find out the thoughts, ideas and opinions of young people and influences practice, it doesn’t place young people’s voices in the meetings where decisions take place.

In the last year we have developed a ‘Youth Ambassador’ mentoring program to support young people to prepare for, attend and feedback from our Women’s and Children’s Divisional Management Board and Children’s Leadership Team meetings. This program supports the division in learning from young peoples experience, thoughts and views and to be challenged about how services are designed and developed. As part of this process two young people were identified for each meeting to enable peer support, and two staff members were identified as mentors to support the young ambassadors. Expectations of the role were developed both for staff and young people.

Supported by the Young Persons Involvement Worker, the development of the programme has enabled young people’s involvement to be more embedded in practice. Young people have led the development and facilitation of projects and reported on learning and influenced decision making at Divisional Management Board level. Through this, young people have been empowered to communicate and advocate for each other more, sharing their priorities and creative problem solving, and not rely on adults to do so.

Impact on individuals

The impact has been wide reaching for all involved. One of the young people shared how ‘it has been amazing to be involved in the youth ambassador programme, I feel I have been able to make an impact on [Divisional Management] board meetings for young people and it is great to have seen actions that come out of these discussions. I feel supported in meetings and my confidence has only grown!’

One of the mentors described how ‘It’s an honour and a pleasure to be a mentor in our Divisional Management Board, especially as [the young person] asks those questions that we might not have ever thought about and so makes us look at things through the eyes of our patients’.

As part of a review of the programme, comments received from Divisional Management Board and Children’s Leadership meeting members identified how ‘they see things from a very different perspective and are able to question some of the dogma and patterns that we routinely follow unquestioningly’ and how ‘They really see things we don’t – their voice is extremely important.’

Alongside the positive impact to the Division, our young people have gone on to support national projects including the NHS England Youth Forum.

Challenges

To develop the Youth Ambassador role, there were a number of challenges. Some have been resolved but there are some that continue to have an impact.

• Confidence – Identifying the key members of meetings who can advocate for the involvement of young people and develop staff confidence has been important. There was initially staff anxiety about the content discussed in meetings and how young people would contribute. Opportunities for the Youth Ambassadors to meet together and share learning with the support of the Young Peoples Involvement Worker helped to ensure they felt able to contribute and develop confidence which then increased staff confidence.
• Capacity – The role of mentors and the meeting chair was crucial in supporting young people’s contributions. It was important that young people and mentors nominated themselves for the role in managing it alongside other demands on their time. Opportunities to discuss papers before meetings or message to ask questions during meetings help the Youth Ambassadors contribute effectively.
• Access – Although support for young people’s involvement was identified, for many young people the meetings were held during education hours. To enable participation, contact with the school enabled them to participate as an educational activity, recognising the opportunity added value to their learning. Holding the meetings virtually enabled young people to attend from where they were too.

What now?

While the current involvement is in divisional level meetings there are opportunities for young people to be involved in speciality specific meetings, this would enable patients to contribute more directly to pathways and is somethings we hope to develop.

About the authors

Sara Reynolds is the Young Persons Involvement Worker at University Hospitals Bristol and Weston NHS Trust; she has 20 years’ experience in working with young people in a diversity of contexts, including education, community and secure children’s homes and has worked for the NHS for 12 years, focused on supporting and empowering young people.

Vanessa Garratt is a Consultant Clinical Psychologist at University Hospital Bristol and Weston NHS Trust and is the Consultant Clinical Psychology Lead for Cardiac and Critical Care.