Primary healthcare – The Well Centre

The Well Centre is a free and confidential primary care service for 11-21 year olds in Lambeth and Wandsworth. It's GP led, youth friendly and responsive to young people’s needs.

Following an initial GP assessment, there is a flexible service delivered by either the GP or other practitioners, such as youth workers or mental health practitioners. In recent years, the service has moved its focus from general primary care to mental health problems.

This research was funded as part of the VRU’s Research and Evaluation Fund, which supports local authorities to build their knowledge of local interventions.

The process evaluation aimed to:

• assess how the service is functioning
• document the demographics and health needs of clients
• assess the extent to which the service reaches young people at risk of violence
• provide an assessment of enabling factors, barriers to and impact of delivering primary care to these clients.

The data collection and analysis process included:

• evidence scoping to understand existing research on the role of public health in youth health outcomes and violence reduction 
• documentary analysis
• meeting observation 
• stakeholder interviews with practitioners (3), service managers (3) and stakeholders (2), to explore views on the design and delivery of the service
• analysis of service data and form responses (Friends and Family Test) and end of service form.

Although the service does not have violence reduction as its central aim, the report demonstrates how generic primary care can be a key lever for early intervention to support young people at risk.

Primary care is already a largely trusted source of help, and one that most young people will already be familiar with.

The evaluation identifies key principles for youth friendly primary health care, specifically:  

• Easy access – for example, accessible appointment system or drop-in clinics.
• One stop shop for young people’s health needs.
• Holistic assessment and treatment approach, flexible and responsive to individual needs.
• Led by GPs with specialist interest in adolescent health.
• Services provided by a range of practitioners in addition to the GP. They are trained in principles of youth friendly health care.
• Focus on empowering young people. Solution-focused and trauma-informed interventions that build up their resilience and ability to navigate systems.
• Effective integration of primary care with secondary care and other local services.
• Reduction in health inequalities.
• Better support for young people with specialist needs, such as neurodiverse, gender questioning and more.

Key challenges identified include the funding context, the local complement of other services for the age group and the particular needs of the age group.  

Additional challenges included providing the right staff team at the right time in the right place, and supporting them appropriately.