FEATURING MEMBERS OF THE SCOTTISH YOUTH THEATRE, WITH DICK CHURCHILL, AILSA DONNELLY, & JANE ROBERTS

Problems in

Transition

Some Perspectives

Patient Partnership Group

Adolescent HealthPrimary Care Society

Transition and Transfer

• Transition should be an active, future-focussed process which is young person centred, but at all times remaining inclusive of parents/care-givers.

• Current guidelines advocate starting transitional care in early adolescence (11-13 years) which fits naturally with the concurrent transfer to secondary school in the UK.

• Transfer of responsibility for care is a single step within the whole process of transition.

Transfer

• Transfer is a single event during the transition process which must be carefully planned and should not solely rest on chronological age.

• Other factors include:– Time since diagnosis and knowledge of condition– Prognosis in life-limiting conditions– Cognitive and physical maturity– Adherence to treatment and follow-up– Personal and parental preparedness / willingness

PaediatricPaediatric AdultAdult

Emphasis on development

Family centredTriadic consultationsInterdisciplinaryCollaborative,

proactive

Emphasis on ageingPatient centredDyadic

consultationsMultidisciplinaryPaternalistic,

reactive

Generalisation of Characteristics of Paediatric & Adult Services

Knowledge & Skills for Transition

Health Understands condition and

treatment Understands differences

between paediatric and adult care

Understands concepts of healthy lifestyles

Understands confidentiality, rights, and consent

Is able to make own appointments and consult independently

Collects repeat prescription and administers medication

Independent living• Knowledge of services,

resources, and financial support

• Independent travel• Information seeking and

problem solving skills• Social competencies

Vocation• Career plan • Work experience• Impact of condition on

chosen career/job • Employment rights e.g.

Disability Discrimination Act

The Role of GPs in Transition

From none ... to complete take over of careMonitoringCoordinatingFacilitatingTaking over aspects of careSupporting other family membersPicking up the pieces

Some Practical Suggestions

Identify young people with chronic health conditions in your practice

Check what arrangements are being made for transition in secondary care

Offer an appointment to discuss with the young person and identify unmet needs

Consider involving family members / carersReview progress