You’re Welcome

making health services

young people friendly

A Resource Pack for Services in Derbyshire

The implementation of You’re Welcome in DerbyshireCounty is supported by:

NHSDerbyshireCounty

Derbyshire County Council

Acknowledgements:

These resources have been developed and adapted for DerbyshireCounty from You’re Welcome resources produced by the Department of Health and You’re Welcome Leads in the East Midlands Region.

You’re Welcome Resource Pack

for Services in Derbyshire

Section 2

You’re Welcome Accreditation

Contents
02.a / YW Accreditation Toolkit Guidelines
02.b / YW Accreditation ToolkitTemplate

Now you have completed the ‘Getting Started’ template and have an action plan in place, you may decide to go for the full YWaccreditation and gain the YW Quality Award.

This section contains the YW toolkit, a guide for its completion and examples of evidence to help you in this process. There is no need to duplicate work you have already done as evidence from the ‘Getting Started’ template can be transferred directly into the YW toolkit.

When you have completed the toolkit please forward it to your local YW Coordinator who will arrange Desk Based Verification and a Service Inspection in conjunction with young people. Throughout this process the YW coordinator can offer support in completing the YW toolkit and enable you to identify resources to help make your service more young people friendly.

Service:
This accreditation toolkit enables you to assess your service against the You’re Welcome Quality Criteria in conjunction with the Derbyshire You’re Welcome process. To begin the You’re Welcome accreditation process answer the questions in this toolkit. You do not have to complete this all at once, save the toolkit as you are working on it and when you have finished. The toolkit can be used as a means of highlighting areas for improvement even if you do not initially meet the criteria for accreditation.
The Department of Health You’re Welcome quality criteria are designed to help commissioners and providers of health services improve the suitability of NHS and non-NHS health services for young people.
You’re Welcome provides good practice guidance based on local practice and evidence, of what has been found to improve patient experience and health outcomes for young people. Applying the criteria also helps effective use of NHS and public health services.
There are ten themes. The first eight themes focus on topics relevant to all health services in general practice, primary, community and acute settings. Themes nine and ten focus on specialist and targeted provision covering sexual and reproductive health services and child and adolescent mental health services (CAMHS).
Summary of themes:
  1. Access – This section outlines how to ensure services are accessible to young people. This section links with Section 2 – Publicity.
  1. Publicity – This theme highlight the importance of effective publicity in raising awareness of the services available and explaining the extent of confidentiality. Effective publicity enhances access.
  1. Confidentiality and consent – This theme addresses confidentiality, consent and safeguarding and how these are implemented by staff and understood by service users. The theme supports and is supported by local safeguarding arrangements.
  1. Environment – This theme addresses the service provision, environment and atmosphere, with the aim of ensuring that they are young people friendly (at the same time as being welcoming to all service users regardless of age). The ‘environment’ is taken to include the atmosphere created by physical arrangements as well as staff attitudes and actions. The environment can contribute to ensuring confidentiality for service users.
  1. Staff training, skills, attitudes and values – This theme addresses the training, skills, attitudes and values that staff need to deliver young people friendly services and ensuring the needs of young people are met.
  1. Joined –up working – This theme addresses some of the ways to ensure effective joined up delivery.
  1. Monitoring and evaluation - This theme addresses the importance of young people’s involvement in service development, monitoring and evaluation.
  1. Health Issues for young people – This theme outlines the health needs of young people as they go through the transition into adulthood. It includes universal issues affecting all young people and issues affecting those with specific long term health needs.
  1. Sexual and reproductive health services – Thissection is only for completion by sexual and reproductive health services including general practice. It is important that all sexual –health related work is informed by evidence of effectiveness. NICE guidance will be of particular importance as will guidance concerning sexual health and HIV from the British Association for Sexual Health and HIV (BASHH) and the Medical Foundation on AIDS and Sexual Health (MedFASH).
  1. Specialist and Targeted Child and Adolescent Mental Health Services (CAMHS) only– This theme covers targeted services (such as counselling) and specialist services (such as multidisciplinary teams or in patient services). Fraser/Gillick Competency and the Mental Capacity Act 2005 are also incorporated into section 1.5. It is important that all interventions are based on evidence of effectiveness. NICE guidelines will be of particular importance.
*Useful documents – the following may be helpful guidelines for working with young people when completing the YW process:
  • Consent: patients and doctors making decisions together (GMC 2008)
  • 0-18yrs:guidance for all doctors (GMC 2007)
  • Confidentiality and young people toolkit (RCoGPs 2006)
  • Working together to safeguard children (HM Govt 2006)
  • Best practice guidance for doctors and other health staff on the provision of advice and treatment of young people under 16 on contraception, sexual and reproductive health (DH 2004)
  • Seeking consent: working with children (DH 2004) Staying Safe action plan (DCSF 2008)
  • Common Core of Skills and Knowledge for the Children’s workforce (DfES 2005)
  • Safeguarding Children and Young People: Roles and Competences for Health Care Staff (Royal College of Paediatrics and Child Health, supported by DH 2006)
  • Hear by Right (
  • Core Dimension 1: Communication’ from the NHS Knowledge and Skills Framework (DH 2004).
  • NHS e learning for health module: Adolescent Health Project – Royal College of Paediatrics and Child Health website.

Service:
You’re Welcome toolkit - summary of criteria / N/A / Getting There / Meets YW / Evidence
1.1 / Where there is a choice about service location, the service is accessible to young people by public transport.
Notes
Most established services do not have a choice about location. This item aims to ensure that, within constraints young people have the best possible access. Publicity can be in print, electronic or mediaformats.
Examples of evidence
Publicity materials – print or other media, evidence of publicity, building layout, feedback from young people.
1.2 / Young people can use the service at times convenient to them where possible.
Examples of Evidence
Publicity materials – print or other media, evidence of publicity, building layout, feedback from young people.
1.3 / When making appointments and attending consultations, young people may express a preference about:
  • Where they are seen
  • Who they are seen by,
  • Attending with the support of a friend or partner,
  • Who and how many people are present during discussion, examination and treatment,
  • The gender of the member of staff seen by.
Notes:
Young people under 16 should be able to make an appointment for themselves without their parents/carers consent. These issues are important to specialist services where the involvement of a parent/carer is desirable for treatment. A responsive approach to young people’s needs is applied unless there are overriding serious risks relating to factors such as known staff safety or child protection issues. Fraser/Gillick competence is assessed during an appointment with a service provider, not at the point of making one.
Examples of evidence
Service information and publicity materials – print or other media, views of young people.
This criterion is mandatory – your rating must be MEETS YOU’RE WELCOME to gain accreditation.
1.4 / Young people are routinely offered the opportunity to be seen on their own without the presence of a parent or carer.
Examples of evidence
Service information and publicity materials – print or other media, views of young people.
1.5 / Where appropriate there are opportunities for self referral and clear lines of referral to specialist services as required.
Notes
This question is for all services that could reasonably be expected to accept self – referral – such as genitor-urinary medicine (GUM) or CAMHS tier one. Self referral could include by telephone, drop in or text, if available in service. It is important for young people to be aware of care pathways.
Examples of evidence
Referral protocols, feedback from young people.
1.6 / Where required, arrangements are in place to enable young women with unplanned pregnancies to be seen immediately by a practitioner known not to have any objections to abortion, to enable impartial discussion of options. Where any member of staff is ethically opposed to abortion, relevant professional guidance for those with conscientious objections is applied.
Notes
Relevant staff include reception staff, who need to be aware of protocols and refer young women to practitioners known not to have objections to abortion. These arrangements are explicitly publicised to young people through the service information and visible posters. Pathways are developed that include signposting to abortion services.
Examples of evidence
Protocols, publicity information
This criterion is mandatory – your rating must be MEETS YOU’RE WELCOME to gain accreditation.
1.7 / The service is provided in accordance with the Disability Discrimination Act (DDA) 2005. The service is easily accessible by people with any form of physical disability or sensory impairment. Disability support aids are fully functional and freely available to assist service users. Reasonable adjustments are made where required.
Notes
This includes learning disabilities
Examples of evidence
Publicity material (print or other media) on disabled access, staff training records, communication and mobility aids are fully functional, availability advertised in building and all staff are trained to use.
This criterion is mandatory – your rating must be MEETS YOU’RE WELCOME to gain accreditation
1.8 / Services are provided to marginalised and socially excluded young people. If specialist services are required, young people are referred.
Examples may include:
Unaccompanied asylum seekers who are minors, looked after children and care leavers, teenagers living in neighbourhoods with high levels of teenage pregnancy and health inequalities, young people from black and minority ethnic groups, young people with disabilities/sensory impairment, lesbian, gay bi-sexual and trans-gendered young people, teenage parents, young people with long term health needs.
Notes:
All services are equally open and welcoming to girlsand boys/young men and women.
Examples of evidence
Statistical monitoring, evaluation and young people’s feedback.
2.1 / The service provides information in a variety of languages and formats including leaflets for young people explaining:
  • What the service offers,
How to access the service,
  • What will happen when they access the service, how the service is linked to other services,
  • How to get other services and get appropriate onward referral,
  • How to make comments, compliments or complaints about the service,
  • Who else has access to any information that the young person shares with the service,
  • Circumstances under which information may be disclosed or shared.
Notes
The content and style of the leaflets should be appropriate for young people. It is good practice to ensure that young people have had input into the development of the publicity materials
Examples of evidence
Publicity/publicity materials – print or other media, views of young people
2.2 / In accordance with the Disability Discrimination Act 2005:
  • Service publicity material is available in forms that can be easily understood by young people with learning disabilities.
  • The service will provide information for people with physical disabilities or sensory impairments in an appropriate format.
Notes
See Disability Discrimination Act (2005)
Examples of evidence
Publicity/publicity materials – print or other media, views of young people with learning or physical disability/sensory impairment.
2.3 / Service publicity material is available in languages that are used by the local community of young people.
Notes
A local assessment will tell you if resources are required in community languages. The language of choice may not be English. A multi-language poster about Language Line may be helpful.
Examples of evidence
Publicity/publicity materials – print or other media, views of young people whose first language is not English.
2.4 / Service publicity material makes clear the following:
  • Young people’s entitlement, including any limitations, to confidentiality with regard to safeguarding legislation.
  • There are routine opportunities for young people to attend a consultation on their own without the involvement of a parent or carer.
Examples of evidence
Publicity/publicity materials – print or other media, views of young people
2.5 / All information provided by the service is kept accurate and up-to-date. The service provides information about other local services for young people, in accordance with DH guidance.
Notes
Information provided by the service is updated at least annually or to reflect significant changes of service details.
Examples of evidence
Publicity/publicity materials – print or other media, views of young people
3.1 / There is a written policy on confidentiality and consent to treatment and the policy is consistent with the current NHS Confidentiality Code of Practice and the GMC - Good Medical Practice guidance. The policy includes a clear protocol for safeguarding concerns and possible breaches of confidentiality. All staff are familiar with the service’s confidentiality policy. Processes are in place to ensure regular review of consent and confidentiality policies. The policy supports how staff will work with parents and carers where appropriate, whilst respecting the confidentiality of the young people.
Notes
*Guidance documents are in the introduction
Audits or review of confidentiality and consent protocols to be undertaken at least annually.
Examples of evidence
Written policy, staff training records, audit/review records.
This criterion is mandatory – your rating must be MEETS YOU’RE WELCOME to gain accreditation
3.2 / Members of staff routinely receive interdisciplinary training on the issues of confidentiality, consent and issues regarding seeing young people without a parent/carer present. Inter-disciplinary training is undertaken in line with *national and local safeguarding children arrangements.
Notes
The aim of training is to reach a shared understanding of young people’s entitlement to confidentiality, and the practical applications If this is in situations where different staff are working together to safeguard vulnerable children and young people. It is important that training is according to *national and local safeguarding arrangements.
Examples of evidence
Confidentiality policy, shared protocols, staff training records.
This criterion is mandatory – your rating must be MEETS YOU’RE WELCOME to gain accreditation
3.3 / Confidentiality and consent policies are made explicit to young people and parents/carers supported by appropriate publicity materials. The information makes clear young people’s entitlement to confidentiality and any limitations to confidentiality with regard to safeguarding.
Notes
This section refers to information on confidentiality that is available. It is helpful to test information to ensure that it is clear and accessible to young people. Posters may also be displayed in waiting rooms and every consultation room/space.
Examples of evidence
Information sharing protocols, information displayed reports of mechanisms such as young inspectors.
This criterion is mandatory – your rating must be MEETS YOU’RE WELCOME to gain accreditation.
3.4 / All staff routinely explain the confidentiality policy to young people and their parents/carers to enable them to understand young people’s right to confidentiality. The service routinely explains to young people that they have the opportunity to attend a consultation without the involvement of a parent or carer.
Notes
This section refers to verbal explanations and support on confidentiality. Parents are only involved with the young person’s consent.
Examples of evidence
Staff guidelines, information resources.
This criterion is mandatory – your rating must be MEETS YOU’RE WELCOME to gain accreditation.
4.1 / Care is delivered in a safe, suitable and young people friendly environment. Young people are not asked any potentially sensitive questions where they may be over heard, for example in the reception, waiting areas, ward environment.
Notes
The documents above* are helpful guidelines to safe and secure provision.
  • All appropriate staff working or volunteering as part of the service have cleared CRB checks and have had child protection training.
  • A safe environment includes psychological and physical safety.
  • It may be helpful to have a line on the floor at reception behind which a queue forms, in order to enhance privacy.
Examples of evidence
Staff training, young inspectors’ consultations, publicity materials, young people’s views, patient surveys.
This criterion is mandatory – your rating must be MEETS YOU’RE WELCOME to gain accreditation.
4.2 / The reception, waiting and treatment areas are accessible, comfortable, welcoming and young people friendly. There are a range of recreational activities appropriate for young people such as up to date reading materials and multimedia. These are maintained and kept in working order in accordance with Health and Safety regulations.