Care leavers’ transitions to independence
Physical health after care
- Health conditions and physical health problems
- Causes and contributing factors
- Registering for and accessing health services
Health conditions and physical health problems
The care leavers we talked to spoke about a range of physical health difficulties, from chronic illnesses to injuries and ongoing symptoms linked to earlier experiences in care. Some lived with multiple conditions at once, and several of them described their health as fluctuating, unpredictable, or worsened by stress and instability. Their conditions weren’t always well assessed, recorded or followed up, and support often depended on the knowledge and persistence of individual workers or carers. Many young people told us they had managed their symptoms alone for long periods, sometimes because they didn’t want to ask for help, and sometimes because support simply wasn’t there when they needed it.
Elijah described living with knee pain, hypermobility and asthma.
Elijah described living with knee pain, hypermobility and asthma.
I had my friends staying with me for a couple of weeks while I had first been put into a training flat because my knee had gotten so bad that I could barely walk at all, and I was living up two flights of stairs, so I could barely get up and down the stairs to where I lived.
So I needed a lot of help at that point in time with everything because I couldn’t walk very far at all, and I’m now waiting to be assessed for arthritis in my knee, and it’s very likely that if it is, which we suspect is osteoarthritis, that if it is that, that was the firsts signs of it, and it was being completely ignored by social services. ’Cause things like my hypermobility and my asthma were all diagnosed while I was in foster care.
Causes and contributing factors
Young people linked physical health problems to a range of overlapping factors like childhood trauma, unstable or unsafe housing, poor emotional wellbeing, malnutrition, stress, and limited early access to treatment. Several felt their physical health needs were overlooked because services focused on their behaviour or mental health instead. Others described health decline during periods of homelessness, semi-independence or financial hardship, when they found eating well, resting, and getting medical support harder to sustain. A lack of safety and stability meant their physical health wasn’t always prioritised, and problems sometimes got worse as a result.
Abdul said being moved into a mouldy, damp house made his life miserable and worsened his physical and mental health.
Abdul said being moved into a mouldy, damp house made his life miserable and worsened his physical and mental health.
They took me out of that house, where I’m comfortable, and they put me into another house, maybe, let’s say, four... four months ago, something like that. And then now, since I moved to that house, my life became miserable, really miserable, because, one: it’s not clean, it seems like a dumpster, a damp place, it’s a damp place, ’cause the smell you can’t go through. Even the house is not clean. I share it with one person and he’s from some part of Asia. But still, it’s not clean, I mean, yeah, I don’t know how he lives in that place, and there is a way different smell in that house, still now, even now, when I’m talking about it, huh, I can sense it.
So, they took me out of that clean, pure house, where I can breathe fresh air, to the house that, even I open the window, I’m smelling damp.
So, then they took me to that house, I started living there. I hated it. I used to cook, and now, I’m not cooking. I used to take care of myself, like, I still take care of myself, like, huh, when I say that, I don’t mean I’m... I’m being stinky, or stuff, but everything is not right, Even me, before I wasn’t happy, but now, it made me more depressed, because it’s not good, the house and everything. ’cause the first time when I went into that house, there are moulds on the walls, like algae, and stuff; it was so dirty.
Elijah felt his physical health suffered because he couldn’t attend appointments without support, even when doctors needed to see him in person.
Elijah felt his physical health suffered because he couldn’t attend appointments without support, even when doctors needed to see him in person.
But also because of things like my autism and complex PTSD, I need support to attend things that I’m not used to, and I don’t have that right now. That I’ve not even had access properly to medical care really in the last few months because I’ve not had support to attend my medical appointments, so unless it could be done over the phone, I’ve not been able to do any of that. So, it’s like I had a telephone consultation about my asthma recently and they wanted me to come in so that they could double-check and make sure that I didn’t have like a chest infection, or anything, but I couldn’t go in because I didn’t have the support to do so.
Registering for and accessing health services
Some young people registered with a GP easily and knew where to go for help. Others struggled to access appointments, request repeat prescriptions or seek referrals for support. Moving house meant changing GP surgeries, retelling medical history, or losing continuity with health professionals. A few young people described experiencing stigma and misdiagnosis, especially when physical symptoms were assumed to be psychological or behavioural. Navigating the NHS could feel overwhelming without guidance, particularly for those with additional needs, limited transport, or who were anxious about interacting with health professionals. Support was strongest where someone helped them book appointments, explain symptoms, and attend appointments with them if needed.
Elle explained that moving so often meant her GP never had her records, making it hard to get care or build trust (read by an actor).
Elle explained that moving so often meant her GP never had her records, making it hard to get care or build trust (read by an actor).
Yeah, so every time I moved I would have to re-register because I would go, like, quite far each time. And so, when I was back in this city, which is where I have been, to be fair, for like the last couple years, it’s just been in different places, I did have a GP registered, but I’d never really been to see them. And they didn’t have any of my previous records from previous GPs, because apparently there was an issue getting hold of them, so it was like having to start brand new.
And it was frustrating, because I was like: if I do have an issue that I don’t feel really comfortable talking to people about, and I have to go to someone that I feel like I can trust, and then I show up at this GP who knows nothing about me, because, apparently, all my medical records can’t be transferred, or whatever, it’s difficult to think: ‘oh, you’re a professional who’s supposed to know what you’re doing, when you know nothing about me.’
So that definitely put in, like, a barrier. I don’t think I ever really went to see the GP for, like, ages until I moved to where I live now, and I’ve lived here for over a year, which is the first time I’ve ever lived somewhere for over a year in, like, six years, so... if not longer, actually.
So... and only, like, six months into living here was I able to be like: ‘OK, I can go to my GP and I can get to know them because it seems like this will be a fixed address.’ Because before, I was a bit hesitant to ever kind of connect with people because I didn’t even know how long I’d be staying.
Helen said it was hard to get an appointment with a GP or nurse, and she often felt they didn’t care (read by an actor).
Helen said it was hard to get an appointment with a GP or nurse, and she often felt they didn’t care (read by an actor).
And then also with anyone else, you know, like if you have a GP, or if there’s a specialist nurse, or even staff or college staff, school staff, I mean, do you have any advice for them? Do you feel like maybe you need to tell them something, whether it’s good or bad?
Maybe GP or nurse.
What would you say to them?
I think something, I don’t know, it’s so hard to find, like, if you’re ill. Like, I don’t know. I don’t see like the care, if you call them, they don’t care, it’s very quiet.
So you feel like they need to support you more?
Yeah.
Is it so hard, to try to get an appointment?
If you’re ill, you can’t do anything now, they say to you after one, two, other point.
So you feel like it’s really hard to see someone?
Yeah.
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