Analysis: Practice - Health services - Teenage health servicesbegin to come of age

After months assembling partners and honing their services, the Government's adolescent health demonstration sites are poised to go live to young people. The pilot sites in Hackney, Portsmouth, Northumberland and Bolton could point to the future of teenage health provision.They aim to make health information and services accessible via a range of providers in surroundings in which 13- to 19-year-olds feel comfortable.

At Hackney in inner London, a network of health drop-in centres has been set up to combat the territorialism that stops many young people leaving their estates to access services. Jose Figueroa, public health consultant at City and Hackney Primary Care Trust, which is running the pilot, says: "For us the pilot is a combination of outreach work and establishing links with different areas."

The drop-in centres will report to City and Hackney Young People's Services (CHYPS), a sexual health and substance misuse service. It is changing its name to CHYPS Plus next month and adding services including long-term disease management, smoking cessation, mental health and counselling. Opening hours will be extended to take in evenings and Saturdays, and the upper age limit will be lowered from 25 to 19. Over-19s will be helped to transfer to adult services.

Agencies involved in the Hackney pilot include The Learning Trust, which runs the education service, the youth offending team, the local mental health trust and groups from the voluntary sector. The youth service runs a health information bus, and "health hut" drop-ins will be set up in Hackney schools.

Schools involvement

Schools are an important part of the Portsmouth pilot. From September the number of school nurses will double and they will be available in the evenings and at weekends. There will also be five drop-in centres, one in a Connexions centre. Youth workers will be trained in health matters, and will help young people evaluate services - the youth service will work with voluntary youth organisation Motiv8 this month to enable young people to carry out "mystery shopper" tests.

The new adolescent health department at Portsmouth City Council brings together services in areas such as substance misuse, healthy schools and teenage pregnancy services. Charlotte Bemand, adolescent health programme manager at the department, says: "GP surgeries are traditionally a barrier to young people, but they will get 'mystery shopped' by young people."

Voluntary network

As it represents one of the largest counties in England, the Northumberland Care Trust had to take into account the largely rural region's poor transport links when it set up its pilot. With about 1.2m from the government fund, the pilot has been developing a network of services across the county delivered by the voluntary sector.

Patrick Price, health improvement lead at Northumberland Care Trust, says: "It would be difficult to set up a one-stop shop-type service for young people, so we have got eight contracts with the voluntary sector to deliver the pilot." These include Barnardo's and NCH, which will deliver counselling support services, and The Point Blyth Young People's Centre, which will focus on smoking cessation. Barnardo's will also survey young men to find out why they so rarely use health services.

The Doxford Youth Project will run a bus service called "The Beat", which will travel round the Blyth Valley to deliver health information to young people.

The Berwick Youth Project, another contract holder, has 45,000 to encourage leisure providers to improve access for 13- to 19-year-olds under the Cash for Clubs scheme. John Bell, project manager, says: "Although we live by the sea we don't have watersports activities for young people. So we are working with a local sailing club to set up a junior canoeing club for 13- to 19-year-olds."

All the workers in the pilot, including youth workers, will meet every two months to share their experiences, says Price: "Youth workers are the best interface with young people who have a trusted voluntary relationship with an adult. We want all the statutory and health services to learn from this."