Young people in hospitals face a range of challenging issues. Many have chronic conditions and experience stigmatisation, anxiety and family conflict. They may also experience social isolation in hospitals, separation from local peer groups and sources of support, and separation from trusted carers during transition to adult care. These issues can require careful handling. However, there is evidence that clinical staff often do not communicate effectively with young patients, that relationships can become contested, especially around "adherence" to treatment regimens, and that important underlying difficulties that young people face are not addressed, leading to resistance and disengagement from care. This paper explores this range of challenges, and presents some research evidence to argue that youth work is particularly well placed to engage with such issues. Although youth work in UK hospitals is currently very rare and under-researched, we contend that what evidence is available suggests that it can be effective in addressing the challenges of young people's experience, and may have important health and wider-ranging general benefits for young people, health staff and hospitals. (Contains 2 notes.)