Transcript Transition Some Perspectives

Adolescent Health
Primary Care Society
Problems
in
Transition
Patient Partnership
Group
Some Perspectives
FEATURING MEMBERS OF THE SCOTTISH YOUTH THEATRE,
WITH DICK CHURCHILL, AILSA DONNELLY, & JANE ROBERTS
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:
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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
Generalisation of Characteristics of Paediatric &
Adult Services
Paediatric
Adult
 Emphasis on development  Emphasis on ageing
 Family centred
 Patient centred
 Triadic consultations
 Dyadic consultations
 Interdisciplinary
 Multidisciplinary
 Collaborative, proactive
 Paternalistic, reactive
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 care
 Monitoring
 Coordinating
 Facilitating
 Taking over aspects of care
 Supporting other family members
 Picking up the pieces
Some Practical Suggestions
 Identify young people with chronic health
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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 / carers
Review progress