1  We have concerns that the care for teenagers and young adults with cancer is inequitable across the UK. TCT has been developing specialist units for teenagers and young adults for 15 years and currently eight exist in major cancer centres. It is anticipated that a further 14 are needed to ensure that every teenager and young adult has access.

  2.  Over time we have had many discussions with the NHS staff who run our Units and the issues relating to Palliative care are magnified still further with the lack of choice available to teenagers and young adults. Understandably a preference for any young person entering a palliative phase would be to receive a majority of their care and support at home. However, it is common for us to hear that local primary care teams are not experienced working with this age group. Subsequently there is often pressure on the specialist Unit to provide support and advice, even though the patient may live over 100 miles away. Training and development of a community skill base for this group is therefore essential.

  3.  During a terminal phase the choices are more limited still. There are only one or two hospice facilities in the UK that have sufficient facilities for teenagers and young adults. It is therefore not uncommon to find that a young person unable to die at home chooses to die at the one of our specialist unit where at least there is an environment geared especially for them and other young people to relate to. This places an unnecessary burden on the Unit, blocking beds and denies them the opportunity of the facilities the hospice might offer.

February 2004