Children and young people can provide a window into the NHS, sharing powerful insights of what it is like for them to use their local health services. ‘I felt really scared’ said an 11-year-old describing his experience in an A&E department on a Friday night surrounded by intoxicated adults. Statements such as this reach right to the heart of how much further we still have to go in getting our services right for young people. No country has yet been successful in giving its citizens a truly central role in improving health and health care, preferring to rely on economic and professional levers, yet there is a shift to empowering citizens and one-fifth of our population are children and young people.

The Report of the Children’s Outcomes Forum (Department of Health 2012) stated that all health organizations must demonstrate how they have listened to the voices of children and young people. ‘We do a great injustice to Children and Young People when as a society, we fail to listen to their views, take on board their perspectives and value their contribution in shaping child health services’ (RCPCH 2010). As active citizens, children and young people take actions and make contributions in everyday life that influence their personal circumstances and society. While their age and level of maturity is influential, all, whether a neonate, toddler, nonverbal child with complex needs or an articulate young person, have a right to be listened to and to be active participants in decisions that affect them, the services they utilize and their communities (Unicef 2007).

There are two fundamental levels of participation and involvement: the making of individual health care choices and being confident in interactions with health professionals, and more generic involvement as a service user or as a member of the public to inform the wider development of health services. The NHS Institute for Innovation and Improvement’s (2010) work in schools confirms that children and young people express a desire to be involved in decisions surrounding their personal care and also in the development of health services. The National Children’s Bureau (2012) highlighted that children and young people want to be listened to, have their recommendations acted on, be informed of what happens as a result of their recommendations and also meet with decision makers so they can explain why their recommendations may not have been taken on board. Children and young people value the opportunity to make a difference and see it as an opportunity to develop skills. High quality productive engagement results in the development of children and young people’s self-confidence; it can be enjoyable, sociable and fun.

Children and young people are key stakeholders in health and health care and are not just beneficiaries or passive recipients of services. As health professionals, it is our responsibility to create the mechanisms to facilitate effective engagement of children and young people who are current and future consumers of health care to cultivate true participation and co-production across the NHS.

If health services are to deliver high quality holistic care, the contributions of children and young people needs to be harvested, valued and acted on. Children and young people’s engagement and involvement will result in a much richer perspective that will assist in improved outcomes and enhanced services.