Transition from Paediatric to Adult Services

Abstract

The transition from child to adult services is a crucial time in the health of young people who may potentially fall into what has been described as a poorly managed ‘care gap’. Health service provision, which fails to meet the needs of young people and families at this time of significant change, may result in deterioration in health or disengagement with services, which can have negative long-term consequences. There are two main challenges to providing transitional care: how care is organised and the impact this has on the continuing delivery of care to young people. In this chapter, the issues with transitional care are discussed along with the key principles of transition. Interventions to improve transition are presented along with examples from the literature which include: transition clinics, enhanced support/follow-up, transition coordinator, skills training/education for young people, and technology-based interventions. Endocrine care within the transitional process will also be touched upon, with particular reference to children and young people requiring growth hormone therapy, young people with a disorder of sex development, and young people who have undergone cancer treatment as a child. A successful transition process involves the provision of care that is uninterrupted, coordinated, and developmentally appropriate over a period of time before, during, and after a young person transfers to adult services.