Young people across the country are actively shaping health services in significant ways. They’re setting agendas in hospitals, holding leaders accountable, and co-designing digital health tools. We’ve heard from passionate teams across the country who are working with young people to embed and amplify their voices. Yet in many settings, traditional, top-down methods still dominate. The challenge isn’t proving that youth voice is valuable; rather, it is ensuring that these methods don’t remain isolated projects and instead become standard practice.
Since January 2025, IVAR has been listening to what makes youth engagement meaningful. We’ve facilitated eight regional sessions, a national workshop and a themed webinar, bringing together practitioners who work directly with children, young people, and system leaders. The message we consistently heard was both simple and powerful: ‘youth voice is more than a box to tick’. It’s a shift in power, culture, and trust. When done effectively, young people don’t just participate; they lead change.
Principles for meaningful youth engagement
The following principles come directly from those conversations. They’re based on practical experiences across the country, where teams are already demonstrating that youth voice can drive real impact in the NHS.
Share power and decision-making
Move from consultation to youth-led decision-making.
Invest for the long term
Build lasting relationships, not one-off projects.
Use diverse and inclusive approaches
Utilise diverse and inclusive engagement methods to enable broader youth representation and participation.
Respect contributions
Show young people how their contributions make an impact and value their time with real recognition.
Equip the workforce
Train staff to engage confidently and share learning to avoid duplication across sectors.
Share power and decision-making
Young people should be involved as equal partners at every stage of the process. This means being transparent about what can actually change, adjusting timelines to support youth leadership, and ensuring young people are included from beginning to end. It also means embedding youth voice in governance, with formal roles on boards, panels, and recruitment processes that carry real influence. In Somerset, The Unstoppables group sits on strategic boards across the council, NHS, and education sectors, directly influencing service decisions.
In Hull, young people worked with the local ICB team to co-produce a series of five videos about mental health and emotional wellbeing services. Young people co-designed the scripts, language, colours, and overall tone. The videos are hosted on the ‘How Are You Feeling?’ website and are included in every school’s year planner.
Invest for the long-term
Building strong relationships takes time and patience, and it can’t fall to statutory services alone. Youth workers, community connectors, peer mentors, voluntary groups, and paid staff all have a vital role in reaching seldom-heard young people. Together, they provide the trust and continuity that statutory services often struggle to offer in isolation. When statutory and community partners work collaboratively and consistently, they create the conditions for meaningful participation: spaces where young people feel safe, respected, and in control, with adults offering the ‘scaffolding’ for engagement without taking over.
In Gloucestershire, an engagement team spent 18 months visiting a Traveller site monthly before introducing health services. The visits began informally, i.e. just showing up, listening, and building rapport with the community. Only after trust was firmly established did the team bring in healthcare staff to meet with young people on-site, answer questions, and talk about health in a way that felt safe and relevant.
Use diverse and inclusive approaches
Engagement doesn’t have to mean formal meetings. Youth-friendly approaches, such as podcasts, videos, art, games, and informal conversations, make it easier for young people to express themselves. In South Yorkshire, for example, the Digital Health Hub ran creative workshops where young people worked with digital health experts to co-design a charter on digital health technologies and contribute to wider innovation and policy.
Peer-to-peer recruitment and visible representation also help reach young people who are often excluded. When young people see people like them being involved and respected, they are more likely to feel that their voice matters too.
Barnardo’s HYPE programme created the Neurodivergent Voice Council. They work with the autism hub and the ICB to ensure young people’s voices are heard in new service developments for young people who are autistic or have ADHD.
Respect contributions
For engagement to be meaningful, young people must see the impact of their time and ideas. When feedback is missing, the process itself becomes a barrier to trust. Feedback loops, such as ‘you said, we did‘, help build trust, demonstrate accountability, and counter tokenism. For example, in Bristol hospitals, young people set the agenda through youth involvement forums and clinical walk-arounds, providing their feedback for tangible service improvements.
Valuing contributions means recognising young people’s time and expertise, through payment where possible or alternatives like work experience, accreditation, or references. In Waltham Forest, for example, Young Advisors are paid the London Living Wage, showing real commitment to youth input.
In one London borough, a care-experienced youth council meets bi-monthly with senior decision-makers, including councillors, service managers, and directors. Young people set the agenda, and at every meeting, there are formal updates on how their priorities have been acted on. If action is lacking, young people challenge leaders directly, making participation a mechanism for accountability.
Equip the workforce
Practitioners need confidence and support to engage young people. Training, ideally delivered with or by young people, can both build the skills required and challenge assumptions.
Good practice depends on organisations working together in a more coordinated way, so the workforce must be equipped to foster collaboration, build partnerships, and drive coordinated responses. This includes aligning priorities, sharing insights, and building on existing networks prevents duplication. Shared platforms, such as city-wide maps of youth voice work, help spread learning and ensure consistency.
Chilypep’s Community of Practice in South Yorkshire connects practitioners across 60 organisations, sharing resources, mapping youth voice work, and coordinating opportunities. One of its first actions was a major youth-led event bringing together 100 young people and 100 decision-makers.
Holding the space for real change
The examples here show what is possible when youth voice is treated as a genuine partnership. Yet power dynamics remain a challenge. If decision-makers hesitate to share control or avoid difficult conversations, engagement risks becoming symbolic. What is needed is a cultural shift built on trust, shared power, and spaces where young people know their voices can shape the future of health services. This requires more than goodwill. It needs sustained investment. With the 10-year NHS plan and a new youth strategy on the horizon, there is a rare opportunity to build lasting change and ensure young people’s voices shape what comes next.
