Objectives To investigate what data are available on the National Health Service (NHS) experience of children and young people (0-24 years), and how their experience compares with that of older patients. .52, 95% CI 0.51 to 0.53, p<0.001). Young people also reported a poorer experience than older adults for their perceived involvement in care, having confi dence and trust in their doctor and being treated with respect and dignity. Conclusions Despite the current focus on services for young people and the importance of patients' views in improving services, the voice of under 16s is not included in most national surveys. Despite high levels of overall satisfaction, young adults report a poorer experience of care than older adults.
Design and data selection
BACKGROUNDThe Kennedy Report 2010 1 called for a more effective approach to improving health services for children and young people, based on the satisfaction of patients, carers and staff. The principle of listening to and engaging young people is supported by current proposed government reforms to the National Health Service (NHS), 2 3 professional guidance, 4 5 well-established legal obligations, 6 and not least, by children and young people themselves. 7 Yet we know little of their experiences of healthcare, either in the UK or internationally, despite the fact that children and youth under 24 years of age use 36.8% of emergency department attendances, 19.3% of inpatient care, 17.8% of outpatient appointments and up to 40% of primary care consultations in England. 8 9 Services for children and young people are also key to improving the future health of the whole population, as the attitudes and behaviours people develop while young infl uence their interaction with health services and their decisions about health behaviour throughout their lives. 10 -12 To address this subject, we investigated the extent to which children and young people (aged 0-24 years) have been represented in national NHS surveys between 2001 and 2011, and how their experience of care compares with that of older patients (25+).
METHODSWe undertook a review of national surveys, comparing the experience of children and young people (<24) with those of older adults (25+) over the past 10 years.
Survey selectionNHS surveys were identifi ed through ' Liberating the NHS. Transparency in outcomes -a framework for the NHS', 13 which reported 38 national surveys that were completed or underway in the period
What is already known on this topicThis is the fi rst study which systematically ▶ reviews the inclusion and experience of children and young people in national NHS surveys. Children and young people under 16 are given ▶ little weight in national surveys, comprising <0.6% of respondents over the past 10 years. Young people 16-24 consistently report poorer ▶ experience of care than older adults.