Young people aged 10-17 who find themselves in contact with the Youth Justice Service (YJS) and accessing Youth Offending Services are known to experience poorer health and consequent increased complex health needs than young people in the wider non-offending population. Their health needs are often missed at an earlier stage, despite many of these young people being known to children’s social care, and despite a sharp incline in offending behaviour during adolescence, health services and criminal justice responses often fail to reflect these changes (The Bradley Commission, 2014). With far more unmet needs, often compounded by a range of entrenched difficulties including school exclusion, social exclusion and unstable living conditions (DH, 2009a), offenders and reoffenders are at greater risk of not achieving good health outcomes and future economic stability. Poor self-reported health, low body mass index, and mental health disorder co-morbidities are much more common amongst this cohort, and medical interventions are vital to mitigate against worsening health outcomes.

This needs assessment considers the health and wellbeing of children and young people (CYP) who have come into contact with Nottinghamshire County Council’s (NCC) YJS and local Youth Offending Teams (YOT), focusing on both the health needs of this cohort and targeted health service provision for those CYP who are on community-based orders in Nottinghamshire. This chapter endeavours to establish if provision of community health services across Nottinghamshire are sufficient to meet the health needs of this group; the chapter excludes an evaluation of custodial health provision.

• Scope for further research regarding the health needs of females within the cohort.
• Scope to establish if those young people who lack access to appropriate health care systems when entering the YJS are from a particular vulnerable group.
• Evidence suggests that there is a lack of early diagnosis amongst the cohort and the needs of young people are often not met by the current provision of universal services.
• Fragmented communications between community and custodial settings limit the streamlined transfer of health service delivery to young people.
• Excluded young people and looked after children often fail to access universal services and continued healthcare, becoming lost in the wider health system.
• There is a risk that the young offenders do not gain the relevant support to access targeted health services due to the limited capacity of the clinical nurse specialist.

• Develop opportunities to undertake preventative work and engagement with groups including looked after children and excluded children, with regard to both health provision and wider social provision including alternative educational or employment provision.
• Develop an electronic information sharing system to enable the secure and efficient sharing of patient information between targeted community health services.
• Establish protocols for the sharing of information between community health services and custodial settings.
• Develop strategies to increase the capacity of the clinical nurse specialist to ensure that the physical health needs of young offenders are met.
• Develop a formal evaluation process for each of the services.

Sophie Edwards, JSNA author sophie.edwards@nottscc.gov.uk

Irene Kakoullis – Senior Public Health and Commissioning Manager irene.kakoullis@nottscc.gov.uk

Maria Craig, Clinical Nurse Specialist marie.craig@nottscc.gov.uk

Samantha Sykes, Head2Head samantha.sykes@nottshc.nhs.uk

Denis McCarthy, SMS operations manager denis.mccarthy@nottscc.gov.uk

Melanie Craven, Youth Justice Information Officer melanie.craven@nottscc.gov.uk