Background: Transition from paediatric to adult services is a crucial process for young adults with long term conditions (LTC) affecting quality of life and engagement with medical services. The recent NICE report has outlined overarching principles for an effective transition. This can be a challenge for paediatricians and adult physicians as both hospital sites and medical/nursing teams can change. There is a dearth of evidence regarding the effectiveness of the process.
Objectives: 1. To audit the process of transition in a tertiary endocrine centre describing the current transition pathway and patients experiences versus NICE guidance.
2. To highlight achievable goals to improve our services.
Material and Methods: The medical records of 100 patients transitioning from paediatric to adult care in a dedicated endocrine clinic for young adults were reviewed for the following variables:
1. Referral information and diagnosis
2. Specific transition issues identified by the referrer
3. Discussion on transition at first consultation
4. Continuity of care
5. Encouragement of seeing patient alone
6. Discussion of psychosocial issues
Preliminary data from a focus group of 4 adults was assessed.
Results: Explanation of transition and continuity of care was universal. Full psychosocial discussions were reported in less than 8% of consultations. 20% of patients had incomplete referral documentation. Transition issues were documented in 51% of cases. The focus group highlighted the importance of continuity of care, receiving information about transition before the transfer, need for a patient passport and the psychology impact of LTC on young people.
Discussion: These data have highlighted a number of changes we can make immediately to our service. These include establishing contact with the young adult before the transfer, ensuring all aspects described above are discussed during consultations as well as encouraging patients independence.