Healthcare Transition

The aim of healthcare transition at GOSH is to make sure the young person and their family or carer have the right information to allow for a smooth process when moving to adolescent or adult services.

As with other aspects of a young person's life such as, university or getting a job, we want to ensure that every young person has the rights skills and knowledge to prepare them for adulthood. The healthcare transition process is aimed to enable the young person to understand why they attend hospital and what they can do to manage their own conditions as they become more independent.

Not all patient's will have the capacity to manage their cares independently as they reach adulthood. Therefore, we have a tailored transition process to ensure the relevant documents and resources are provided to support the changes that will take place as the young person reaches adulthood.

Healthcare transition is the process for patient's to become more independent in managing their health needs and having a better understanding of their own clinical condition.

Whether a patient transitions to adolescent or adult services or is discharged from hospital care, we want to provide them the tools to understand their condition and empower them to manage it through planning and preparation, to ensure that their processes is as smooth as possible. Transition is a gradual process of change, which gives everyone time to ensure that young people and their families are prepared and feel ready to make the move to adult health care. That is why at GOSH we aim to start the process from the age of 12 years old, unless specified by the clinician.

The healthcare transition process can vary from person to person and can also vary by speciality. However, we will aim to communicate this with you in your clinic appointments. Some services may continue at GOSH for longer or shorter periods depending on the child's individual treatment plans.

Some young people move to adolescent services from the age of 13 or 14, otherwise, the young person may begin to transfer to adult services between the ages of 16-18 years old.

Often young people will also be experiencing other transitions at similar times, such as moving from secondary to sixth form or starting work so we will aim to work in collaboration with the young person and family to support a smooth transition process, avoiding potentially busy times.

At GOSH we want to make the transition process as easy as possible and want to include the young person in that journey. Therefore, you may start to hear 'healthcare transition' after the young person has turned 12 years old or begun year eight in school.

Each speciality may run their transition service slightly differently, however the medical team or the nurse specialist will support you throughout your healthcare transition journey.

By using ‘My Gosh’ you will be able to complete aspects of the ‘Ready, Steady, Go’ documentation and have conversations with the team upon your clinic or inpatient appointments.

It is important that both you and your teenager are comfortable with the transition and the new service. There may be a choice of which adolescent or adult service your teenager can transfer to, but this depends very much on their illness or condition.

It might be possible for your team at GOSH to arrange an informal visit to the adult service or organise other ways for you and your teenager to meet the new team and start to get to know them.

A visit to the new service can help all of you get used to travelling to the new hospital and find out where appointments are held or the location for tests and scans.

• Download our transition workbook for patients

We know that approaching a move to adolescent or adult care can be a scary time in a young person’s life. As they get older, they will start to take more responsibility for things like medicines and treatments, just as they take on more responsibility in other areas of life.

As a parent, this can be a difficult time for you as well. It can take time for you to get used to handing over some of the responsibility.

Young people in adult services are generally seen as being independent. The transition process often involves ensuring that your teenager has all the skills necessary to feel comfortable in the adult health care service.

In children’s services, parents are given the responsibility for managing young people’s health care, communicating with health care professionals and making important decisions. This is different to adult services, where the responsibility is usually given to the patient rather than the family.

However, you will still be able to give your teenager advice and be there to provide support.

At GOSH, we value the role that families have in the health of children and young people. Because of this, we feel that parents have a great deal of valuable experience to offer young people who are in the transition process.

Families will often be able to give young people tips on how to organise appointments, find out information, remember medicines and treatments and which questions to ask during admission, ward rounds and clinics.

Families can also support young people in gradually developing independence and becoming more involved in their health care.

Topics for you and your teenager to think over and discuss might include:

• learning the names of regular medicines, why they need them, how much to take and how often asking and answering questions about their health and treatments
• seeing their doctor or nurse on their own, for part of clinic appointments or consultations
• staying overnight in hospital without you sometimes
• keeping track of hospital appointments
• the ways that his or her GOSH team can help your teenager feel ready to move to adult services

There might be some aspects of growing up with a medical condition or disability that have not been discussed.

For example, you may have questions about how your teenager’s condition might affect their adult life, in relation to things like career choices, benefits, relationships or family planning.

It is a good idea for you to discuss these things with your GOSH team, who will be able to advise you or put you in contact with appropriate organisations that can help.

Support groups and charities can sometimes offer valuable support to young people and their families who are going through the transition process. It may also be useful to speak with other families of teenagers who are getting ready for adult services.

Alternatively, you can access the organisation Contact, who can provide support to the young person with disabilities and their family, to access resources to support transitioning into adulthood.

The most difficult thing for some families is to break contact with the children’s service once the move to adult services has happened.

It is important for your teenager’s continuing health that any questions or concerns are discussed with the adult team. While you can stay in touch with the team at GOSH, the new team should be the first point of contact in all matters related to your teenager’s health.

The 'Ready, Steady, Go' website has access to alternative language options if English is not your first language.

At present we do not have ready made alternative languages for the other documentation, but if you need support or interpretation, please contact healthcaretransition@gosh.nhs.uk.

If you have any questions or concerns about transition, please talk to your clinical nurse specialist or consultant as there may be some speciality specific differences in the healthcare transition process.

Email: healthcaretransition@gosh.nhs.uk