Introduction

As a young person grows up from child to adult, the roles and responsibilities, powers and procedures that govern their ability to consent and control over their care changes.

This means that, as they get older, young people have more rights to have a say in what happens to them.

The part that their carers and parents play in this will also change to reflect this.

This can be a confusing time for everyone involved, i.e. the young person, the parents and carers as well as healthcare professionals.

In this module we look at those processes, roles and powers, and how they evolve during the stages of healthcare transition.

The content you find here is based on the work of the LINK project, which listened to young people, their parents and carers and healthcare professionals about the questions they have when it comes to who can make health-related decisions and when. The Project Team created leaflets specifically for young people, for their parents and carers and for healthcare professionals.

Understanding and following the guidelines and processes protects and empowers young people, their parents/carers and the professionals who provide their care.

The Doctor’s dilemma

In the healthcare transition period from the ages of 11 to 25, there are several people that may be involved in a young person’s healthcare experiences. As well as the young person themselves, there will be a clinician and possibly a relative or parent. Issues around consent and agency can become complex to navigate for all parties.

Here is what is, at first hearing, a Doctor’s own dilemma – but it’s actually an issue for everyone involved.

What we'll be covering

We hope that you’ll find answers to some typical questions here, such as:

• When can I make decisions about my healthcare?
• When can I make my own appointments?
• When can I see a healthcare professional on my own?
• Can I see a doctor or visit a clinic without my parents being told?
• When can I use a pharmacy/chemist on my own?
• Can my parents still help me when I’m 16 or older?

We will also:

• share some lived experience
• provide links to further information and resources.

When can I make decisions about my healthcare?

You can make decisions on your own before 18 years old if your healthcare professional feels that you have a good understanding of the situation (competence).

When you are 18 years old, you can make independent decisions.

When can I make my own appointments?

You can make an appointment for yourself with a GP at any age. From 16 you can access GP online services, where you can book & cancel appointments, see test results and order repeat medications. From 16, your parents should only make, change or cancel your appointments if you have agreed given permission for them to do so (consent)

When can I see a healthcare professional (doctor/nurse) on my own?

• At any age
• Everything you tell a healthcare professional should stay confidential unless you give permission to share or your safety is at risk
• You should be told before any information is shared

Can I see a doctor/visit a clinic without my parents being told?

Yes. If you don’t want your parent to know about a visit, this information should be kept private. Your healthcare professional might encourage you to speak to your parents (or someone you trust) if they think it would be helpful. If your healthcare professional is concerned about your safety, or the safety of someone else, they may need to share information with other professionals. They will tell you if this is going to happen.

When can I use a pharmacy on my own?

From 16 years old you can collect your own prescriptions and can buy over the counter medications. Under 16 years you can sometimes collect prescriptions from a pharmacy but this depends on the specific situation – you will need to talk to your pharmacy.

Can my parents still help me when I’m 16 or older?

Yes, when you turn 16 it’s your choice how much to involve them. They could:

• help you to book appointments
• accompany you to appointments.

Lived experience

Stories are a powerful way of learning, and can help put your learning into context.

Watch or listen to the stories below and think about they relate to the material in this module.

The boy whose best friend was a Hoover

Summary

• Involving your parents, or someone you trust, can be helpful at any age
• You can bring a friend or parent to an appointment or request a chaperone (chaperones have been trained to provide unbiased support for patients)
• As you get older, it can be really valuable to start seeing healthcare professionals alone for the whole or part of your appointment
• It can help to write down any concerns and questions, or make a diary of your symptoms, and take this to your appointment
• If you’re unsure about something a healthcare professional has said, ask them to explain again
• Some people find it helpful to write important information down during/after an appointment
• Try to be as open and honest about your worries/concerns so that the healthcare professional can help
• If you are unhappy with the care you have received, it is important to give feedback on your experiences (find out how to feedback)
• For young people, your healthcare documentation should be addressed and sent to you – speak to your healthcare professional if this is not happening
• Keep the contact details for your GP, school nurse and other healthcare professionals and a reminder of your appointments in your phone
• If there is not time to cover all your questions in one appointment ask about booking a follow up

If you want to know more...

There are plenty of ways to find out more. One great one is to use your NHS account to access services online on your computer, tablet or mobile phone.

Find more information on the 11to25hub

Why not dip into one of our other modules, where you can find out about other aspects of healthcare transition in more detail.

Bust the jargon!

Whether you’re a young person, a parent or a professional you’ll have realised that there’s a lot of jargon in the health and social care systems. This jargon buster from Think Local Act Personal may help. Just type in a term…

 

External resources

Here are some more resources that you may find helpful, engaging and informative:

• Youth Rights in Healthcare is a quick guide to your rights to confidentiality, to consent to treatment and to give feedback on your experiences
• Find out more on the British Youth Council website
• Young people and young adults with learning disabilities have a right to be involved in their decisions and need to be supported to do so. You can find out more on the Mencap website.
• NHS England, the Care Provider Alliance and the Local Government Association have teamed up to produce An Easy Read Guide to the Mental Capacity Act 2005
• The Department of Health in an easy read fact sheet that covers what you need to know about People making decisions for you
• A deputy is authorised by the Court of Protection to make decisions on someone else’s behalf. You can find out on the UK Government website about their role in Deputies: make decisions for someone who lacks capacity.