6366 Review of children’s transition to adults’ services the paediatric allergy/immunology department

Objectives The aim of the study was to review the compliance regarding children's transition/transfer to adult services with the NICE/Trust guidelines. The objectives of the study were: To improve the awareness of the staff about the standards of the transition and transfer process. To improve the quality of documentation of the timing, plans, children competency check tools, and introduction to the adult team in patients' records. Where possible generate a service-specific template regarding the transition process in line with the guidelines. Methods Retrospective review of the transition/transfer outcome of patients in the year 2022. The data was collected from clinic letters, correspondences, and encounters. The study took place at The Royal Manchester Children's Hospital, allergy/immunology department. 90 cases who were 17 years or older (born 2002–2004) in the year 2022 were included in the study and their outcome was reviewed. The assessment was conducted against 4 NICE guidance standards which are adopted by the Trust. Results 87% of the reviewed cases were in the allergy section, while the immunology section accounted for 13% of the cases. 58% of the cases had joined the service younger than 13 years of age, and 42% had joined equal or older than 13 years old. In the year 2022, 86 (95.6%) of the reviewed cases had transition/transfer completed, and 4 (4.4%) were under follow-up. Transition/transfer was completed for 71/90 young people by the age of 19. Standard 1 was achieved in 11.3% of the cases who joined the service younger than 13 years and in 23.7% of cases who joined the service ≥ 13 years. Annual (or more frequent) review before transfer (standard 2) was achieved in 52.2% of the cases, while there was a lack of documentation regarding the annual review in 47.8% of the cases. In almost all cases, there was a named worker (standard 3) to coordinate their transfer either back to GP or to adult service. Standard 4 was not applied for cases transferred back to the GP care. Conclusion Patient familiarity with the allergy management plan is a key component of competence but has not been documented as assessed for the purpose of transition. Transition/transfer was completed for 71/90 young people by the age of 19. Only 19 transitioned later than this or had yet to transition, the reason for the delay in completing the transition was the implementation of a three-year immunotherapy plan at age 16 or thereabouts. There was an overlap between the use of the transition and transfer words in some cases which raised the importance of educating the staff regarding the difference. Concern that 3 out of 4 standards scored red (achieved in ≤ 74%). Good documentation of the transition plan, timing, and outcome is an important reflection of the department's transition practice. References Transition from Children's to Adults' services for young people using health or social care services. NICE guideline 24 February 2016. www.nice.org.uk/guidance/ng43 Transition from Children's to Adults' services. Quality Standard 21 December 2016. www.nice.org.uk/guidance/qs140