This will help inform future planning for times of national crisis such as a natural disaster, another pandemic, terrorist incident or other cause of nationwide disruption.
Is it safe to go outside?”
We started this work in May 2020 and we'll continue through this year. We'll be sharing findings and resources on this page, so look out for updates.
The insights from the young people we're working with will inform a number of our own programmes and the wider sector - including our Paediatrics 2040 programme, our quality improvement sharing hub QI Central and our workforce impact tracking of COVID-19.
They'll support recovery and surge planning as we move through to reset, restore and recover child health services - particularly for our our programmes such as RCPCH Ambassadors (where members acting as local advocates for children and young people), the NHS Long Term Plan's children’s transformation board and health and social care trust boards across the UK.
Keep, develop or avoid - virtual health services
[We need] clear information, no waffle, more support for families and children and be able to choose how to see your doctor.
Sixty young people from all four UK nations participated in focus groups led by RCPCH &Us in May and June 2020 - exploring healthcare experiences during lockdown. We were also lucky enough to observe other sessions in June with 20 additional young people, also sharing their virtual health experiences.
Young people shared their experiences from lockdown:
- "CAMHS phone calls happening but not to everyone, also problems about having everyone listen in at home so not telling them what is going on” - young person, Northern Ireland
- "Children and young people matter during COVID-19 and should be part of the solution and should consult with them" - young person, England
- "I’ve not spoke to anyone about it [shielding], not my friends it’s a bit odd to talk about it, so I’ve just become withdrawn with it all" - young person, England
- "When lockdown was announced I went home [from university], luckily I had kept my home GP and was able to get prescriptions for long term condition" - young person, Scotland
They also shared their experiences on virtual health appointments:
- “They should have a range of options as some get anxious on a phone and some get anxious meeting the professional in person so they need both options.” young person, Wales
- “Remember that for some YP it is becoming too much with everything happening in their bedroom: school, friend socials, mental health appointments/health consultations. You can't get away from it space wise” - young person, England
- “Offering online appointments issue is that sometimes at home with the family there is no safe space to have confidential call and feel safe that no one is listening in.” - young person, Scotland
- “Phone doctors' appointments are good because they get back to you quick but they can’t see you like if you need to show them your eczema,” - young person, Northern Ireland
What do doctors need to think about to help make virtual health appointments work? They identified six areas:
- Reassure us about how it will work
- Give us choice of how to talk with you
- Help us to keep it private when we are at home
- Help us to prepare for our virtual appointment
- Make it easy for people without good WiFi access
- Make it clear and simple about how we get help when we need it
When we looked at all the results of our consultations, we noticed these common themes:
- Burden: A sense of having to make tough choices about accessing healthcare services, protecting their family or concerns relating to their future due to COVID-19. There is also a sense of the weight of COVID-19 in relation to space; for some young people it is becoming too much with everything happening in their bedroom: school, friend socials, mental health appointments/health consultations. Lots of comments about increasing anxiety due to the pandemic.
- Choice: Young people shared their appreciation of being able to access health services in person, on the phone or online, and would like this choice to be carried forward post COVID-19.
- Resilience: There was a lot of reflection on the impact of COVID-19 on children, young people, families and the organisations that support them, with requests for more mental health support, dedicated school time to reflect on the experiences and increased support around loss, both for bereavement but also missed milestones.
- Planning: Requests were made for remembering children and young people in recovery planning, but to also remember all the non COVID-19 services that have been stopped or reduced and to consider how these will be brought back , as well as wanting school plans to take into account the impact on futures and missed experiences.
- Messaging: Young people shared frustrations about being missed in the messaging, and UK press conferences being confusing both on information but also the differences between nations. Suggestions included using more short videos, peer to peer information sharing and developing children and young people-focused advice messaging. It's also important for doctors to remember about sharing results remotely as can leave them not knowing how to manage. Recent views were shared on the confusion around shielding messaging for children and young people.
- Confidentiality: Accessing health services from home has resulted in privacy issues for some young people who did not want to access mental health support in earshot of their families or talk through health concerns in fear someone could hear, create a code word for children and young people to share with health care professionals and have jointly developed expectations to support virtual conversations.
- Being forgotten: At times children and young people have felt that they have been left in the dark and forgotten as services have adapted, as messages have been created and as plans are being formulated. This was also shared by children and young people shielding who felt all information/support services were aimed at over 70s.
You can read more about what children and young people said in our Paediatrics 2040 post-pandemic report. We have also helped provide links to resources about online health appointments or online group work with children and young people on QI Central.
Mental health pocketbook - supporting mental health in a national crisis
Remember that for some YP it is becoming too much with everything happening in their bedroom: school, friend socials, mental health appointments/health consultations. You can't get away from it space wise
Young people have been identifying and reviewing apps and resources that support mental health and emotional wellbeing during a national crisis. So far, between May and August 2020, over 25 young people have got involved through sessions.
In part one, young people shared ideas and experiences of tools, resources and strategies that they used - or felt were missing - when they needed mental health support during lockdown. We had a big list of apps, websites and information to look through. They came up with great ideas: where there are gaps in the information, or problems with what's already out there. They also shared their personal experiences of the changes in mental health support they have had through lockdown and the impact this has had.
In part two, young people reviewed the findings and prioritised. Here's what they thought needed to be work on first:
- Too much information, overwhelming
- Information too generic
- Mental health services not working through online channels
- Peer support
- Challenges linked to therapy virtually during lockdown
- Adults not knowing where to signpost young people to
- Education wellbeing services through lockdown being different in different areas
Part three is coming soon! Young people will be sharing no cost, low cost and maximum cost suggestions.
We were really lucky to receive a legacy donation from an RCPCH member’s family for this project.
Services and us - voices from specialist experience groups
I’ve not spoke to anyone about it [shielding], not my friends it’s a bit odd to talk about it, so I’ve just become withdrawn with it all
We're running workshops with children, young people and young adults from a range of backgrounds, including those with long term conditions, from vulnerable groups or with specific health care experiences such as LGBT+ young patients. We looked at specific experiences, expectations and perceptions on services.
So far we've hosted one with young people and young adults who have been shielding. We've shared our report from this with NHS England & NH Improvement to help inform guidance and planning for life after lockdown.
Some key themes from the workshop on shielding included:
- Support the mental health of young people who have been shielding as they integrate back into not-shielding
- Improve communication and messages shared about how to shield and what needs to happen when
- Make sure support services recognise under 25s are shielding too, so might need extra support. For example, online shopping slots were available for over 70s at the start of lockdown, but under 16s were being able to get prescription deliveries
Sharing experiences with our members
In the chaos I'm thankful to a team of NHS heroes who step into a mess that others step away from. You are truly appreciated.
Young people from RCPCH &Us have been sharing their experiences about life in lockdown in our members magazine, Milestones. Every member gets this in the post four times a year, and can read it online on our website.
You can read Nadia and Emma’s experiences in the summer 2020 edition. And, Demi and Sashank will be posting call to action for services in our autumn 2020 issue - out soon!
Find out more
If you would like to be involved or to find out more about our approach, contact us email@example.com.