Our Model
The Well Centre model helps primary care services to support staff in order to provide dedicated and expert adolescent health services within the usual GP service delivery model. It builds a hub and spoke model to ensure young people have an equitable experience of local services and can attend in ways that suit them. The aim is that their needs are met in a holistic way that protects their future health and solves their immediate problems.
Each Well Centre is different, tailored to fit local needs. Our model allows GPs to draw from a 15-year clinical evidence base and to share and collate evidence.
The Approach
The general approach is integrated and holistic. Young people’s health issues are understood in the context of their lives, their experiences and the daily pressures they face. The response to each young person will be personalised and unique, depending on their needs and will consider physical and mental health as intertwined. The service is part of the broader landscape of provision for the age group in the local area and is well connected to social care, education and the voluntary sector.
Another crucial aspect of the general approach is that the Well Centre is an integral part of the host GP practice or network, so that governance, safeguarding and risk are all managed in exactly the same way as they are for regular GP appointments. This is important for allowing the service to see clients who may be too ‘high risk’ for local voluntary sector organisations. In this respect, commissioners have described the Well Centre as equivalent to a ‘2.5 tier’ adolescent mental health service.
GPs and HWPs
Each young person accessing a Well Centre for the first time gets a holistic biopsychosocial assessment (‘The Teen Health Check’) either with a GP or, if initially presenting with less complex needs, one of the Health and Wellbeing Practitioners (HWPs). The young person has an opportunity to discuss any concerns they may have and a plan is jointly developed to support their ongoing care.
The majority of support and engagement at the Well Centre is provided by the HWPs – they are the heart of the service. They combine the talents of youth work and engagement with additional training in counselling skills and social prescribing. They will see young people at the hub, in local schools, in local voluntary sector organisations, at other GP practices or their own homes. They liaise with parents, schools and social services where appropriate.
The Teen Health Check
A key resource underpinning the work of the Well Centre is the ‘Teen Health Check’ (sometimes also referred to as the ‘Teen Health Talk’), developed by Dr. Stephanie Lamb as a biopsychosocial health assessment for adolescents in primary care.
The Teen Health Check shares a family resemblance to existing screening instruments for use with this age group but unlike them is not framed primarily as a risk assessment. Instead, it has been developed as a conversation aid; a way of introducing important topics in an approachable way in order to improve communication and disclosure by adolescents.
At the Well Centre the Teen Health Check has been translated into a local EMIS template although other ways of using it would be possible, for example by developing a SystmOne template. Topics covered include any significant past medical history, current medication, risk taking behaviours, sleep and mental health, the education situation, safeguarding and living arrangements.
The Well Centre approach can support Integrated Care Systems improve health outcomes for young people and provides a clear roadmap for better prevention and early intervention with this age group. It also has an important role to play in tackling health inequalities, by improving services for young people who may be finding it more difficult to access support.