We use the word 'transition' to describe the process of planning and moving on from a children's ward to adult health care. Transition is a gradual process. It gives everyone time to talk about what health care you will need as an adult, choose which hospital or services are best for you and make sure you are ready to make the move.
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When will I move on to adult health care?
Most young people move on to an adult hospital when they are between 16 and 18 years old. Sometimes, young people move from a children’s hospital to an adolescent unit at 13 or 14 years old, instead of moving straight to an adult hospital.
You can ask your parents, consultant or clinical nurse specialist about when you will be making the move. Whatever your plan, you will have time to make sure you feel ready.
Can I choose where I move on to?
Sometimes you can choose a hospital near where you live. Alternatively, you might need to go to a specialist hospital. Your consultant, clinical nurse specialist or family doctor (GP) will be able to recommend which adult hospitals or services are right for you.
Why do I have to move on?
As you grow into a young adult, an adult service will be the best place for you to get the care that is right for your needs. The staff in children's services are expert in caring for babies, children and teenagers, and the staff in adult services are the experts in caring for young adults, adults and older people.
By the time you are at the end of the transition process, you may feel that you have grown out of children’s services and be glad to move on to a more grown-up setting.
The thought of moving to a new hospital and leaving the staff that you’ve got to know can be difficult. We know from experience that it is a good idea to think of this change as a sign that you are growing up and moving on with your life.
You might have felt the same way when you moved from primary to secondary school. Once you get used to the adult hospital, you should settle into your new routine and get to know the staff there.
Will the adult service be different?
One of the main differences between children’s and adult health services is the amount of independence you will be given. This means that you will need to learn about your condition, so that you can be more involved in your care and make decisions for yourself.
You will need to be able to give information about your condition and know how to keep yourself well. Although this can be scary, it is also good to have more control over your health and the care you are given.
When you are asked to make decisions about your health, you will be given all the information you need to make the right choice. You can always ask questions and let staff know if you are not sure about anything. They will make sure that you understand everything that might be involved.
Although you, rather than your parents, will be asked to make decisions, you can still ask their advice before making your choice.
At the adult service, during appointments or admissions, doctors, nurses and other staff will spend more time talking to you than your parents. You will still be allowed to take your parents with you to clinic appointments, but you will be the one to talk about your health and ask or answer questions. Lots of adults take family members or friends along to important appointments for support.
If you go into an appointment on your own, you can still ask your parents for advice on what questions to ask before you go into the clinic room. It can sometimes be useful to bring a written list of your questions with you to appointments.
If you are admitted to an adult hospital, your parents won’t be able to stay overnight with you. Although the visiting times might be shorter, your family and friends will still be able to visit you and speak to you on the telephone.
By the time you are ready to move on to an adult hospital, your friends will probably be old enough to visit on their own, which might make visiting easier.
What will be the same?
Although the buildings will be different and the faces might be new, there may be lots of things about the adult service that are similar to the children’s service. Both children’s and adult health services are there to care for you and your health.
Who can help me get ready?
Your parents have been really important in looking after your health and will be able to give you lots of helpful advice. They will have plenty of experience of things like taking you to the hospital, making appointments, asking questions and making sure you get your medicines or treatments.
It is a good idea for you and your parents to talk about how moving to adult hospital makes you feel. You should make plans with them about how you can practise getting involved in looking after your health and taking responsibility. While you are preparing to move on, your parents will still be involved in your health care and still have an important role.
There may be lots of other young people of your age who are also getting ready to move on to adult services. Sometimes it is useful to get together with them to share ideas, discuss what adult services might be like and talk to somebody else who is going through the same changes as you. Your consultant or clinical nurse specialist should be able to put you in touch with other young people, or give you details of support groups, youth clubs or charities that might be useful.
If you see other young people during hospital stays or clinic appointments, you could speak to each other about transition. You might find that they are feeling the same way as you do and have lots of the same questions about growing up and moving to adult services.
If you know any other young people that have already finished their transition, it might be useful to ask them for any tips on how to get ready. You could also ask them questions about the adult service.
What else can I do to get ready?
It will be helpful for you to practise doing the following things to help prepare you for adult care.
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learn about your conditions and treatments
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practise asking and answering questions during ward rounds and clinic appointments
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try to take some responsibility for remembering what your medicines are called, what they are for, how much to take and when to take them
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learn how to get more supplies of your medicines or dressings
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practise arranging appointments with your consultant, family doctor (GP), physiotherapist or dietician
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keep important phone numbers and appointment dates in your mobile phone, calendar or diary
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when you agree to treatment plans, make sure that you follow them properly
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try spending time without your parents for part of clinic appointments, then when you feel ready try spending the whole appointment on your own.
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find out any changes in your condition that mean you should get urgent help
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find out who to contact in an emergency
Who can I talk to at GOSH about transition?
Every young person at GOSH has at least one member of staff who is responsible for their transition. You will be able to speak with them about anything that is bothering you about growing up and moving to adult services.
They will be able to answer your questions, give you information, offer support and advice, organise things and help you to get ready for the move. Usually this will be your clinical nurse specialist or consultant, but you can also get help from any other member of your health care team.
You can also speak to the Adolescent Nurse Specialist on 020 7813 8541.
