Introduction: Within the Bristol diabetes service, we recognised that we were failing to meet the needs of young people (YP), who reported feeling unprepared for transition and intimidated by the unknown entity of the adult service and changes in their diabetes management.
Methods: We set up a multi-disciplinary steering group, including the paediatric and adult diabetes teams and a youth involvement worker, to develop an effective, multi-faceted transition strategy. To enable patient-led service improvement, we sought the opinion of YP with diabetes in a focus group (n=5). Utilising focus group feedback, the following changes were established:
i) Introduction of age-banded clinics
In paediatric service fortnightly YPs clinics for over 14 years to transition, attended by an adult consultant or diabetes nurse specialist (DSN).
In adult service paediatric DSNs to start attending pre-existing monthly young adults clinic from transition to 25 years.
Patients over 14 years given the opportunity to be seen alone at every consultation.
ii) Transition paperwork
Introductory transition pack was developed, including an introductory letter explaining the new clinics and service changes, a leaflet about transition, and transition checklists for patients and parents to be discussed at clinic.
Checklists covered: a) education, b) lifestyle, c) access to support and services, d) transition.
Additional copies of clinic letters sent to patients, not just parents.
iii) Diabetes transition website
Developed website to provide reliable, accessible information for YP covering transition, management of diabetes and various lifestyle topics such as exercise, alcohol, sex, smoking and education.
Results: 1 year later, YP (n=21) were asked to complete an anonymous questionnaire. 70% reported that they had been spoken to about transition, 71% knew more about the adult service as a result and 85% valued having met the adult team. Patients frequently reported they wanted more opportunities to both meet the adult team and be seen alone.
Conclusion: The transition service changes, designed utilising patient voices, have been well received by YP although further work is needed. To facilitate continual improvement, we plan to incorporate further valuable patient input from additional focus groups, ongoing questionnaires and patient satisfaction surveys into service design.
27 - 29 Nov 2019
British Society for Paediatric Endocrinology and Diabetes