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Problems in Transition Some Perspectives

Adolescent Health Primary Care Society. Problems in Transition Some Perspectives. Patient Partnership Group. Featuring members of the Scottish Youth Theatre, with Dick Churchill, Ailsa Donnelly, & Jane Roberts. Transition and Transfer.

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Problems in Transition Some Perspectives

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  1. Adolescent Health Primary Care Society Problems in TransitionSome Perspectives Patient Partnership Group Featuring members of the Scottish Youth Theatre, with Dick Churchill, Ailsa Donnelly, & Jane Roberts

  2. 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.

  3. 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: • 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

  4. Generalisation of Characteristics of Paediatric & Adult Services Paediatric Adult • Emphasis on development • Family centred • Triadic consultations • Interdisciplinary • Collaborative, proactive • Emphasis on ageing • Patient centred • Dyadic consultations • Multidisciplinary • Paternalistic, reactive

  5. Knowledge & Skills for Transition • 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 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

  6. 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

  7. Some Practical Suggestions • Identify young people with chronic health 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

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