1. FEATURING MEMBERS OF THE SCOTTISH YOUTH THEATRE, WITH DICK CHURCHILL, AILSA DONNELLY, & JANE ROBERTS Problems in Transition Some Perspectives Patient Partnership Group Adolescent Health Primary Care Society

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

5. 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

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