6792 Transition services and developmentally appropriate healthcare across the north Thames Paediatric network

Objectives Transition is the process of planning and preparing patients for the move from paediatric to adult services.1Developmentally Appropriate Healthcare (DAH) aims to cater to young people's (YP) stage of biopsychosocial development as opposed to their chronological age.2 The NCEPOD has demonstrated inequalities in transition in the UK.3 The North Thames Paediatric Network (NTPN) was created to standardise care across the region. This work aimed to assess how Transition and DAH are being delivered across NTPN hospital trusts to reduce inconsistencies and improve care for YP. Methods An electronic questionnaire was disseminated via the NTPN and paediatric clinical directors to paediatric/adult clinicians from hospital services within the North Thames. Results were collected from July to September 2023. Three follow-up reminders were sent. The questionnaire consisted of 4 sections: Demographics, Transition services/support, DAH, and Patient participation/feedback. Results 123 responses were collected from clinicians across 25 hospitals within the NTPN. 78 (63%) were paediatric services, and the remaining 37% were a mixture of paediatric/adolescent (20), adolescent (7), and joint adult services (14). Transition services: 76% of respondents had access to a transition service. The age when transition is started varies from 12–21 years. 31% indicated there was a gap between paediatric and adult services within their speciality, the most frequent gap being for 16–18 years of age. The most widespread barrier to providing transition was a lack of collaboration between paediatric/adolescent and adult teams. Graph 1 illustrates that only 18% regularly use the NICE transition guidelines, although 45% have read them. DAH: Only 54% regularly see YP alone and explain their right to confidentiality. 50% of clinicians report writing to YP directly. 58% reported adjusting their approach to care as the young person develops. As shown in graph 1, 29% regularly use HEADDS. Patient Participation/Feedback: 51% of respondents indicated that YP were not involved in service development. Table 1 shows relevant qualitative comments. Conclusion These results show a range of differing access to transition services and delivery of DAH across the region. There is an alarming gap in specialist services for 16–18 year olds and further collaboration between paediatric and adult teams could address this. Although some services are using Transition guidelines, seeing YP alone and using a DAH approach, there is a large proportion of services where this is not being done. Future work should support exemplary services within the network to share and embed good practice as a priority across the trusts. References 1.Blum RW, Garell D, Hodgman CH, Jorissen TW, Okinow NA, Orr DP, et al.Transition from child-centered to adult health-care systems for adolescents with chronic conditions. a position paper of the society for adolescent medicine. J Adolesc Health. 1993 Farre A, Wood V, Rapley T, Parr JR, Reape D, McDonagh JE. Developmentally appropriate healthcare for young people: a scoping study. Arch Dis Child. 2015 Transition from child into adult healthcare, national confidential enquiry into patient outcome and death (NCEPOD). 2023