SHEU data: #youngpeople and visiting the doctor #health

SHEU : nationally-recognised, since 1977,
as the specialist provider of reliable local survey data for schools and colleges

Young People and visiting the Doctor

The Schools Health Education Unit (SHEU) have been talking to children adolescents teenagers, about their health and wellbeing, for over 30 years. The results from the Health Related Behaviour Questionnaire (HRBQ) are used by health and education authorities to inform their planning. Among the many topics that are explored in the surveys is the issue of visiting the doctor. As the HRBQ evolved, questions about visiting the doctor were asked in schools from the early 1980s. Responses from over 400,000 12-15 year olds cover issues about frequency of visits and feeling at ease. For example, Chart 1 shows results about the last visit to the doctor.

Chart 1. Responses, in 2011, from 12-15 yr. olds to the question: "How long ago did you last visit the doctor?"

Up to 51% report having visited their GP within the past 3 months and slightly more older females than males report going to their GP in the past 7 days/month. More older males than females report going to their GP in the last year and more than a year ago. Are the numbers going up or down? Table 1 shows that, since 1999, the percentage of those visiting the doctor in the past month remains consistent.

Table 1. Results, from 1999-2011, of those pupils visiting their doctor in the past month

Visit GP
in past month
Yr 8 Male 26 27 27
Yr 8 Female 28 26 26
Yr 10 Male 26 21 22
Yr 10 Female 31 29 28

Females have usually been visiting slightly more frequently than males. The differences are small with the exception of older pupils.

In the 1990s, an opportunity arose to check young people's reports of GP attendance. A practising doctor from Barnham was presented, at a meeting, with results of the HRBQ survey in West Sussex and thought that the rates shown for Year 8 and Year 10 pupils visiting the doctor were implausibly high. He immediately organised a check on his figures, and a colleague searched the computer files from the group practice. He was astonished to find that in his practice the GPs had seen 40% of their patients aged between 13 and 19 in the past three months, which fitted within the SHEU summary data for the whole District Health Authority (Letter from Dr Wallis, 1993, For the record, Education and Health, 11:1,13).

Do young people feel at ease with the doctor?

From 1993, the same set of HRBQ questions have asked if pupils felt at ease with the doctor on their last visit. There are four answer options: At ease; A little uneasy; Quite uneasy; Very uneasy. Chart 2 below show responses.

Chart 2. Responses, in 2011, from 12-15 yr. olds to the question: "On your last visit, did you feel at ease with the doctor?"

More males than females felt at ease on their last visit. Up to 22% of the females felt quite uneasy or very uneasy with the younger females reporting higher figures. This question has been asked since the early 1980s. Earlier surveys recorded the gender of the GP last visited, and suggested that both male and females pupils were more likely to be at ease with female doctors, who are of course in the minority. Table 2 below shows results, from 1991-2011, of those pupils who felt at ease with the GP.

Table 2. Results, from 1991-2011, of those pupils who, on their last visit, felt at ease with the GP

Visit GP
felt at ease
Yr 8 Male 64 57 52
Yr 8 Female 48 40 36
Yr 10 Male 65 59 59
Yr 10 Female 47 43 43

More males than females consistently report feeling at ease on their last visit. Are males less likely to admit to unease? The level of ease with the doctor could reflect general confidence with adults, or concern about the reason for the visit as well as the ability of the GP to create a relaxed atmosphere for the consultation. In previous results we have shown that those young people who say they were at ease with their GP on their last visit were also likely to have visited their GP more recently: At ease (whole sample): 50%; At ease (visited last week): 55%; At ease (visited last year): 48%. Are the more distant consultations remembered less warmly, or is there less opportunity to build up a positive relationship with a GP if consultations are so infrequent?

For details about the SHEU HRBQ please visit this link

See also -

There are a number of studies into young people and visits to the doctor including:

Young teenagers’ attitudes towards general practitioners and their provision of sexual health care

Developing adolescent services in general practice

Review of teenage health: time for a new direction

Report on consultation activities with children and young people about GPs and dentists  The Care Quality Commission's report

Young people's views and experiences of GP services in relation to emotional and mental health  A report from Right Here Brighton and Hove

‘Oh, I’m just, you know, a little bit weak because I’m going to the doctor's’: Young men's talk of self-referral to primary healthcare services

Adolescents who are frequent attenders to primary care: contribution of psychosocial factors



Comments about SHEU

"I really think that the HRBQ is a wonderful piece of work in terms of getting useful information for so many different organisations in one go." Healthy Children's Research and Statistics Officer

Research and Statistics Officer

"I would like to say how much we appreciated the work you and your team have put in to this project, a big thank you for the excellent reports that you have completed on our behalf." Assistant Director of Public Health

Assistant Director of Public Health

"...the most comprehensive health education survey."

Daily Telegraph

I think the HRBQ is an absolutely wonderful, informative tool and I am keen to really encourage schools/other relevant partners (as appropriate) to utilise this invaluable data to encourage voice of the child, and subsequently contribute to shaping priorities and services.

Senior Health Improvement Practitioner (Children and Young People)

Any comments on specific survey questions that may have caused difficulty? No problems. My children were fully briefed before the survey and they understood that they could miss questions if they did not want to answer them. We did not have any children with any concerns regarding the survey at all.

Any comments on the use of the web site? No it was easy to use.

Any general comments on the exercise? The children really enjoyed completing the survey, It has lead to many positive discussions about our health and how we all have slightly different experiences and home lives.

Class teacher

“(The SHEU survey) was very, very useful. It gave us reassurance we weren’t missing a trick. For example not many pupils in the sample year groups were taking illegal drugs, which re-enforced our opinions. But the survey also raised issues and flagged some things up. We discovered that some of our girls weren’t eating enough – the percentage of girls in our school not eating lunch the day before the survey was higher than the county average. There were other concerns too, specifically around cigarettes, alcohol and attendance.
The school used this data and took a number of actions to address it. More female peer mentors were put in place and the school asked NEXUS (the Extended Schools service) for help, so they developed a programme for girls which addressed their eating patterns, healthy eating, sex education and self-esteem issues.
We ran an anti-bullying group for Year 9 as a preventative measure, based upon data provided by our current Year 10 students.
The travel data revealed that a high number of pupils took the car to school so we involved the BIKE-IT scheme who ran assemblies, brought in their bikes (including one with a pedal-powered smoothie maker!), and raised awareness of health and green issues.
The information about how happy the students were with their lives raised some concerns as far fewer girls were as happy as the boys, so work was done around developing aspirations, role-models and self-esteem."        

Deputy Head, Secondary School

Thank you for following up with schools the comments that caused concern. It is very sad to hear that some of our children have these thoughts and feelings and I am so grateful that you were able to make the schools aware of this so that they can attempt to offer some support.

This is another reason why I am so pleased that we have been able to work with you to offer this survey.

Health and Wellbeing Adviser

"The Health Related Behaviour Survey is an incredibly useful resource for (us) as it provides schools, with invaluable data which can inform curriculum content, methods of lesson delivery and empower schools to better meet the needs of their pupils."

Health Education Advisor

...our analyst here in Public Health- is beside himself with excitement about all the juicy data pouring in...he can't wait to get his hands on it!!!!
He is happier than I have seen him for years.

Public Health Principal

"You have often stood alone against the media who were often looking for the sensational headline. I have noticed an important change: the media now look out for and report very fairly and fully on the reports from the team." 
Tributes from a Health Education Advisor to John Balding, presented at his retirement lunch, May 2005

Health Education Advisor