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‘I was so much older then, I'm younger than that now…’ Bob Dylan
The RCGP's Adolescent Task Group is 15 years old, an interesting age and time to consider what we've achieved. Any glance at the media will imply that we've made no difference! Fifteen years on there are still issues about drugs, unhappiness, poor health and antisocial behaviour. But so many positive things have happened in that time: teenage pregnancy rates have been falling, the Department of Health is pioneering ‘Teen Health Demonstration Sites’, and the Royal Colleges are collaborating on training to establish adolescent health as a discipline in its own right.
The original Task Group shared a common vision that teenagers needed somebody to act as their advocates, and that their health care in primary care was under-valued, under-researched, and under-played. Members were asked to consider how to provide better primary care for teenage patients against the backdrop of the government's Health of the Nation document with its plan to reduce teenage pregnancies, risky behaviour, smoking, and alcohol and drug use.1 We considered that if GPs didn't help then who would? Malus wrote a BMJ editorial advocating teenage health specialists as occurs in the US,2 but this concept never took off in the UK. Thus, we reasoned that teenagers needed their advocates — the RCGP agreed and allowed us to make future plans with more secure funding.
When we set out, little was known about teenage health, but we have helped establish an evidence base for improvements of the care of teenage patients, and a lot of this research is down to members of the Task Group.3–5 We have used parallels from other aspects of health care and we have assimilated information from a variety of academic sources. We have also taken a very practical approach, facing the fact that a large part of teenage health takes place in the context of established primary care. We have constantly held the ethos that minor changes in general practice can make major inroads into ‘getting it right’ for teenagers, which ultimately will help get it right for all patients.
In the last few years, we have campaigned hard under the ‘Getting it right for teenagers in general practice’ banner, with leaflets sent to all surgeries, and workshops held around the country. We hope we've encouraged GPs and others to see teenage patients as individuals and not as some feckless social misfits who need to be ‘prevented’ from having their unhealthy lifestyle. We continue to explore ways of helping GPs and others to communicate in a helpful, age-appropriate respectful manner, so that our teenage patients feel respected and listened to.
All Task Group members enjoy working with young people, and we feel that all GPs need to remember what it was like to be young and to retain that vigour. Our membership of the Task Group has kept us young, however we know teenagers want us to act our age, hence the quote at the start of this article is from Bob Dylan, not The Kaiser Chiefs, Lily Allen, or Mika.
We know that we have more to do, that the era of the GP contract and QOF points potentially mean that teenage patients will have some aspect of recorded care on the computer. However, we want to maintain our original view that teenage health is about establishing rapport and support for teenagers who should perceive their GP as a port of call in times of trouble. We would welcome others to join in our continuing vision.
Any RCGP members interested in joining the Task Group should contact firstname.lastname@example.org