Homerton University Hospital describes how they have embedded the Redthread Youth Violence Intervention Programme into their A&E department.
What is Redthread?
Redthread, a Youth Violence Intervention Programme, runs in hospital emergency departments in partnership with the major trauma network. The innovative service aims to reduce serious youth violence and has revolutionised the support available to young victims of violence.
Every year thousands of young people aged 11–24 come through hospital doors as victims of assault and exploitation. It is then, at this time of crisis, that our youth workers use their unique position embedded in the emergency departments alongside clinical staff to engage these young victims.
Redthreads extensive experience tells us that this moment of vulnerability, the ‘Teachable Moment’, when young people are out of their comfort zone, alienated from their peers, and often coming to terms with the effects of injury, is a time of change. In this moment many are more able than ever to question what behaviour and choices have led them to this hospital bed and, with specialist youth worker support, pursue change they haven’t felt able to before.
Redthread workers focus on this moment and encourage and support young people in making healthy choices and positive plans to disrupt the cruel cycle of violence that can too easily lead to re-attendance, re-injury, and devastated communities.
Redthread and the Homerton
Redthread is embedded within Homerton’s A&E department. The Redthread youth work team work hand in hand with the emergency department team to safeguard young people between the ages of 11-24 who are at risk of violence or exploitation.
Emergency department clinicians send referrals for at-risk young people to the Redthread team, who work on an individual basis with the young people to support them and endeavour to alleviate the risk in their environment. Redthread achieves this by liaising with statutory services such as CAMHS, Children’s Social Care and Housing to ensure that the young person is being placed first. By linking up services, Redthread ensures that the young person is the focal point and that help is being given, without duplicating existing services.
Redthread works in several major trauma centres across the UK; however, the Homerton practice is the first community hospital based service.
The Redthread service would not be possible without the support of the emergency department staff. Not only is the clinical and non-clinical body supportive of the service and actively referring young people, the emergency department as a whole takes an active interest in Redthread’s work – talking to Redthread staff about their work, fundraising and attending training sessions.
Thanks to the initial efforts of emergency department doctors and nurses in gaining funding and support for this project at Homerton, and the continued work and collaboration by the emergency department and Redthread, the service has excellent track record after its 1 year of service.
The Redthread youth workers work closely with young people in a way that clinicians do not have time to. This means that patients are cared for both medically and holistically. Though difficult to quantify results, a strong qualitative difference to the service is that there is a caring external presence within the emergency department. For young people in crisis, being seen one-to-one by someone in a non-clinical role means that there is someone solely on their side. In a lot of cases, a Redthread worker might be the first person in a long time to ask if they are ok, and to see them for who they are as opposed to the trauma that they have suffered.
For the emergency department team, having a constant youth work presence acts as a reassurance that when a safeguarding issue does arise, this will be followed up and the young person will continue to be cared for.
The emergency department safeguarding has improved as awareness has grown among staff members of safeguarding procedures. The Redthread collaboration has also prompted staff to be more inquisitive with the patients they see, and to consider how that patient’s behaviour may be a manifestation of underlying problems. As such, young people coming into the emergency department are safer as they are more likely to be seen and understood by clinicians, as well as receiving long term assistance as part of the emergency department care package.
As the first community hospital in the Redthread network, the Homerton Redthread team have tailored and changed their service to best fit the community it serves. The team spend longer working with young people, in addition to working more closely with them than in other hospitals – taking on a constant role in our young people's lives. The breadth of presentations seen at Homerton has also resulted in a broader case-load. The result is a service which is ready to adapt to individual cases to best serve young people both in hospital and out in the community.
Redthread at Homerton are also innovating and adding value structurally by meeting young people at the earliest opportunity – the statistic is that young people present to hospitals like Homerton four to five times on average before they are injured to the extent that they have to be taken to a major trauma centre. By being embedded in a local hospital such as this, we have an opportunity to engage people and help them to change their trajectories and avoid escalating harm. We’re also pioneering work around contextual safeguarding, by listening to young people and feeding back to local authorities when for example unsafe spaces in the community are identified.