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Lung cancer investigation, treatment and survival
P97 Transition from a District General Hospital (DGH) Clinic to a Distant Adult Centre
  1. SL Prudon,
  2. R Casans,
  3. F Hampton
  1. James Cook University Hospital, Middlesbrough, United kingdom

Abstract

Background Transition between CF centres in the same town is well reported but there is less work on transition from large DGH clinics to distant adult centres. Our local paediatric unit provides total care for 60 patients. The majority will move on to the adult centre in a city 45 miles away. Until the last 2 years transition had been taking place very late because low staffing at the adult unit limited outreach support for the local patients who were thus reluctant to move on. The paediatric team felt that although transition was hampered by the lack of a local adult centre an increase in adult staffing was an opportunity to review current practiscs and identify areas for improvement.

Aims To identify ways in which the transition process could be improved and to explore the need for the introduction of formal transition clinics.

Methods Adolescents (13–18 years) within the paediatric clinic and young adults (18–26 years) who had completed transition to the adult centre in the last two years were surveyed using a proforma merging the standards of the CF trust and Department of Health. The CF nurses also completed questionnaires about these patients.

Results 16/19 identified patients took part. CF nurse results showed that only 37% of patients started transition between ages 13 and 16 and only 50% had a key worker. Whilst the nurses felt that they offered most teenagers the opportunity to be seen alone only 14% of patients stated they were seen on their own and most said they would strongly prefer it. Discussions of careers, finance, higher education and fertility took place in up to 43%, but commonly after age 16. Patients reported wanting more information on these topics. Although 60% of patients marked the adult clinic was easy to reach and had appropriate facilities, the ‘free comments’ section revealed difficulties.

Conclusions There are areas of practise that can be improved in the paediatric clinic independently of the setting up of transition clinics. More teenagers need to be seen on their own and cheque lists are needed to ensure all relevant areas are discussed.

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