We congratulate Harden and colleagues on their article ‘Bridging the Gap: an integrated paediatric to adult clinical service for young adults with kidney failure,’ which demonstrates that greater engagement with health services is key to improving outcomes in this age group.(1) The article is timely, coming the week after the government’s latest strategy to increase patient involvement in all aspects of NHS care. Disappointingly, this strategy pays little attention to the specific needs of different age groups, stating only that improvement ‘will be achieved by treating all patients and the public as grown ups’.(2)

Young adults report the lowest level of patient involvement of any age group,(3) highlighting the potential for them to benefit from the approach of ‘No decision about me without me’. Similarly, children benefit from services that encourage appropriate participation in their care, while recognising their specific needs and legal rights.(4) In both cases, age-appropriate, patient-centred care involves much more than simply treating them as grown ups. We urge the government to recognise the distinct needs of different age groups and we encourage all those interested to contribute to the ongoing consultation process (closing date 20th July).(2)

Reference List

(1) Harden PN, Walsh G, Bandler N, Bradley S, Lonsdale D, Taylor J, et al. Bridging the gap: an integrated paediatric to adult clinical service for young adults with kidney failure. BMJ 2012;344:e3718.

(2) Department of Health. Liberating the NHS: No decision about me, without me - Further consultation on proposals to secure shared decision-making. 23-5-2012. http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_134221 (accessed 8th June 2012)

(3) Hargreaves DS, Viner RM. Children's and young people's experience of the National Health Service in England: a review of national surveys 2001-2011. Arch Dis Child [Epub ahead of print] doi:10:1136/archdischild-2011-300603 2011.

(4) Wood D, Turner G, Straw F. Not Just a Phase: A Guide to the Participation of Children and Young People in Health Services. 2010. London, RCPCH.

Competing interests: None declared