Background 16 years old and beyond is a challenging age group for community paediatric team. In specialist school, young person are often kept 18 years old and beyond. The main concern will arise, if young person needs to attend A&E, they are of often seen in the Adults A&E. However, they could be complex presenting with challenging behaviour and/or complex medical background. Very often there is little information available when seen in Adult A&E.

Objectives

• Capturing the number of young person under community paediatric who attends special school over 16 years old.

• Identify the number of young person requiring transition to adult learning disability (ALD) services

• Identify reasons of not transitioning to ALD

• Identify the number of complex cases that will benefit from case summary made available to young person

Methods This is a retrospective study of reviewing case loads of young person who attends special school 16 years and over. Caseloads were extracted from school attendees’ list and community paediatrics clinic list. This study was carried out in the month of August 2022.

Inclusion criteria

• Young person who was born before 01.01. 2005.

• Young person attends special school and is under community paediatrics

Exclusion criteria

• Young person who attends special school and is not under community paediatrics

Caseloads were reviewed Diagnosis and condition of the young person were identified. Number of caseloads require transition to ALD were reviewed to see if referral was done to ALD team. Reasons were identified if referral did not proceed.

As part of caseload review, number of complex caseloads were reviewed, and case summary made available to young person and/or carer.

Results We have a total of 172 patient under community paediatrics who attends special school. There are 27 caseloads who are 16 years old and above. Out of the 27 caseloads, there are 5 who are above 18 years old.

Out of the 27 caseloads, there are 5 who have chromosomal abnormalities, 9 with complex neurology background, 6 with complex neuro-disability background and 7 with challenging neurodevelopmental background such as ASD and ADHD.

All caseloads require referral to adult services. There are 4 caseloads referred to ALD services but not discharged by paediatrics team as x2 have DNA’d recent appointment, x1 is under section 20 of the children act 1989 and x1 awaiting adult neurology tertiary input. 23 of them are not referred as the referring criteria to ALD service is 18 years old and above.

Out of the 27 caseloads, 16 cases are identified as complex cases. Out of the 16 cases, 3 young person are under Section 20 of the children act 1989. These 16 caseloads will benefit from updated case summary to ensure improved transition.

Conclusions Young person with disabilities who attends special needs school is a vulnerable cohort. They require much support from the health, education, and social sectors. There is evident gap in services for young people above 16 years old. Ongoing strategy to progress is needed to ensure improvement of service for young person transitioning to ALD services.