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P55 Moving on: from pond to sea – provision of transition services for young people with neuro-developmental conditions
  1. SS Patwardhan,
  2. R Singh
  1. Department of Paediatrics, Glangwili General Hospital, Hywel Dda University Health Board, Carmarthen, UK


Introduction ‘Transition’ is the purposeful, planned process that addresses medical, psychosocial and educational needs of Young people with long-term conditions as they move from child-centred to adult-oriented healthcare systems. The importance and challenges of healthcare transition are recognised in UK National Institute for Health and Clinical Excellence (NICE) Guideline and Quality Standard (2016). A new dedicated transition clinic for Young people with neuro-developmental problems was initiated in Carmarthenshire in September 2016

Aims To demonstrate the provision of transition services for children with neuro-developmental conditions; benchmark services against NICE standards and illustrate areas for improvement.

Methods Young people aged 16-19 years who were seen in a transition clinic with diagnosis of neuro-developmental problems in Carmarthenshire. 50 Young people from September 2016 to July 2018 were reviewed.

Results 38 were male and 12 were female. Diagnosis were ADHD 40%, Learning difficulties 34%, ASD 24%, Developmental coordination disorder 16%, Physical disability 14%. Co-occurrence of ADHD, ASD and/or learning difficulties was prevalent in 74% of cases. Age at first appointment was 16 years 10 months to 18 years 8 months. The only NICE quality standard met was discussion of transition care ideas with cares/parents. Majority had one appointment only. Repeat appointment was given to 5 patients. Outcome from clinic included discharge to GP (64%), referral to adult mental health services (16%), referral to Adult LD team (12%), and review by behavioural team (8%). Social worker involvement was recommended for all cases. All of them were seen in age banded clinic. Written transition plan was provided to all. 24% saw adult team before transfer, 14% had a key worker. 6% had a co-ordinated team. Holistic life skills training were discussed with all those who attended.

Conclusion Start of new transition clinic has facilitated transfer of Young people with neuro-developmental conditions. NICE quality standards were not met in many cases. ‘Proposed beneficial features’ are suggested in literature to improve outcomes; which we aspire to implement. We aim to start by providing a meeting with the adult team before transfer and providing a key worker/transition manager for all patients to achieve optimum transition.

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