P1.18: Setting up a transition service for intestinal transplant patients

Abstract

Introduction:Improving survival of intestinal transplantation resulted in an increase in number of young people surviving into adulthood. The prospect of transition is exciting but “scary” in the words of our young people requiring the development of a service which meets their unique needs. It is vitally important that a robust supportive transition process is established for young people and families. Method:Transition is discussed from 12 years with the family at their annual anniversary admission, introducing the concept and describing the process. Young people meet with the transition nurse, youth worker and psychologist. We use a transition programme called Ready, Steady Go and the HEADSS document to support transition. Families first have the opportunity to meet the adult team at our biannual family day. The adult team consisting of the Lead Consultant, Specialist Nurse and Dietician contribute to the information session during the day. These can be a talk or information boards/posters. This allows families to gather information to make informed choices about their young person’s future care. The adult team join us in the outpatient clinic at the children’s hospital to meet the young person and their parents/carer. It is the start of the formal transition. The Paediatric Consultant and Specialist Transition Nurse attend the adult clinic. The adult consultant will lead the consultation with the Paediatric Consultant contributing. Results:Ten young people have been transitioned and care handed over to the adult multidisciplinary team. The emphasis is very much on the young person and the time scale will be driven by their needs. Retrospective review of the medical notes shows that young people are seen once in the paediatric clinic with the adult team, seen two/three times in the adult clinic with the paediatric team in attendance prior to formal handover. Formal handover can take two/three years.Six young people are in the process of being transitioned. Conclusion:Feedback from families has shaped the service. Communication between paediatric and adult teams has highlighted differences in protocol processes.This has helped us prepare the young people to cope with the differences. Healthcare professionals need to therefore work collaboratively with young people to ensure they have all the information and resources to engage with the service. This will help to ensure a good long term outcome in young people undergoing transition.