Moving from Children’s Services to Adult Services (Transition)
Please read this page if the young person you care for has reached an age when we need to start talking about preparing, planning and moving their care from children’s to adult services.
The decision about what age to start this process will be made in partnership with you, the young person and the clinical teams involved.
Moving to adult services can be a worrying time for all concerned, as over the years you will have developed a trusting relationship with the doctors and nurses within children’s services.
By the age of 18 years however, all young people should have made the transition from child to adult services. Medical and nursing staff are aware of your concerns and will do their best to make the move as easy as possible.
Ready Steady Go Hello
To make sure the transition is well planned and goes smoothly, the children and adult teams use the “Ready Steady Go Hello” programme. This means they are able to plan and support transition both within the paediatric and adult services, with each phase of the process being carried out in partnership with the young person and their parents/carers.
Ready – is the introductory and initial planning phase
Steady – is the preparation phase
Go – is the transfer phase
Hello – is when the adult team check and review the transition plan
If Ready Steady Go is not suitable, an individualised plan will be made for the young person.
At what age would the transfer start?
The age at which the young person will start the process of moving to adult services will very much depend on their ability to adapt to the change. The process may start from the age of 11 years onwards.
During this process there will be opportunities to learn more about their medical condition and how it may impact on their daily life. A meeting with the adult team who will be taking over the young person’s care will be arranged and this is often called a ‘Transition Clinic’. The transfer to adult services will happen by the time the young person reaches 18 years old, but most young people move to adult services between the ages of 16 to 17 years old.
How will things change?
As the young person prepares to move to adult services, they will be encouraged to speak to their paediatrician or specialist nurse on their own. You, as parents or carers, will then be invited to join the consultation.
This will only happen if it is felt to be appropriate and the young person is able to do so. The aim is to build the young person’s confidence in taking responsibility for their own medical condition and needs.
During the transition process, staff, parents/carers and the young person will agree on who they feel will be the best person to lead on the young person’s care once they move to adult services. This will either be their GP or a hospital consultant.
What are the similarities and differences between children’s and adult services?
Transition will be complete when the young person reaches the ‘Hello’ part of the programme. This may be upsetting as it means saying goodbye to the supportive team the young person has grown up with, but it can also be a positive change, as the ‘adult world’ opens up lots of possibilities for how care is planned and delivered.
In adult services, the young person will always be admitted through the Emergency Department, either through self-referral or via their GP.
Following assessment in the Acute Assessment Unit they will then be transferred to the most appropriate ward. This may mean that the young person will not always go to the same ward on each admission and you and the young person may come in to contact with a lot of different members of staff.
What if my child has a learning disability?
If the young person has a Learning Disability (LD) the staff involved in the transition process will consider their individual level of disability and needs.
In order to do this the Paediatric Neurodisability Nurse Specialist and the Learning Disability Hospital Liaison Nurses (LDHLN) will work closely with you to make sure the transition is as smooth as possible.
The Trust aims to make sure that all adults with an LD have an alert in their notes. This indicates to hospital staff that ‘reasonable adjustments’ must be made in order to meet their needs during a hospital admission and that they are referred to one of the LDHLN.
During the transition process you may also be asked to complete a ‘Hospital Traffic Light Assessment’ on behalf of the young person. This assessment provides adult services with the information they need, for example, how best to communicate with the young person. This information will help hospital staff give the best care for the young person and access any equipment if needed.
If you have any further questions, you can contact the Paediatric Neurodisability Nurse Specialist or Learning Disability Hospital Liaison Nurses using the contact details at the end of this page.
Consent
Up until now, as an adult with parental responsibility for a child, you will have been able to give consent for treatment, procedures and operations. From the age of 18 years, the young person will make their own decisions about their treatment.
If there is any doubt as to whether they have the capacity to make an informed decision about a given treatment option, an assessment of their capacity to consent to care and treatment will be made.
Information about the Mental Capacity Act can be found by typing the following into your web browser:
www.scie.org.uk/mca/introduction/mental-capacity-act-2005-at-a-glance
Contact information
Learning Disability Hospital Liaison Nurses (Adult)
Tel: 0300 4224 953
Monday to Friday, 9:00am to 5:00pm
Paediatric Neurodisability Nurse Specialist
Tel: 0300 4225792
Please leave a message. Your call will be returned within 48 hours.
Health Facilitation Team – Easy read information and resources
Tel: 0800 019 3346
Monday to Friday, 9:00am to 5:00pm
As a paediatric team we wish you and the young person all the best as they move to adult services. We trust the information and support we provide at this time will help during this process.