What is transition?
In healthcare, we use the word “transition” to describe the process of preparing, planning and moving from children’s to adult services. Transition is a gradual process that gives you, and everyone involved in your care, time to get you ready to move to adult services and discuss what healthcare needs you will require as an adult.
This includes deciding which services are best for you and where you will receive that care. Transition is about making plans with you - and not about you. We understand that moving away from a team of doctors and therapists that you have been with for many years can be scary but hopefully, by getting involved in the transition process, you will feel more confident and happier about the move. Planning this now makes sure that transitions will run as smoothly as possible.
Why do I have to move?
As you get older, you will find that some of the things you want to discuss or some of the care you might need is not properly provided by our children’s services. Adult services are used to dealing with all sorts of issues that may arise, such as higher education, travelling, careers, relationships and sex. You may also find that you would prefer to be seen in a more grown-up environment, rather than the usual children’s departments or wards.
Who can help me get ready?
Your healthcare team will be able to give you information and support about moving on. As part of this young people are invited to our multi-disciplinary transition clinic.
Who is invited to the Transition Clinic?
All young people who need support from physiotherapy, occupational therapy and/or from the paediatricians are invited for these transition meetings. We plan to invite young people who are in school years; 9, 11 and 13.
What happens at the appointment?
At the appointment, you will meet with your paediatrician and a member of both the physiotherapy and occupational therapy teams. The therapists who attend may not be your usual therapist, however they will be able to guide you to ask questions, share concerns and plan for your future. If you have any worries about the therapist being someone you do not usually meet with, please discuss this with your usual therapist.
You are welcome to invite another professional or a member of your family if you would like. Please advise us prior to the appointment if you plan to do this.
When you are ready, the team will see you on your own for part of the clinic appointment with the aim of working towards seeing you on your own for the whole clinic appointment as you near the age of transitioning to adult services.
Topics that may be covered include:
- Teaching you about your condition or illness, its treatment and any possible side effects
- Making sure you know when to get help and who to contact in an emergency
- Helping you understand how your condition or illness might affect your future education and career plans
- Making sure you know about the support networks available
- Making sure you understand the importance of a healthy lifestyle, including exercise, diet, smoking and sex.
Ready Steady Go
As part of the appointment we ask that you complete a colour-coded questionnaire named; “Ready, Steady Go”. These are available on the below links and also on the documents at the bottom of this page.
Parents/carers can assist with filling it in but the answers should reflect the thoughts of the young person as much as possible. We will use your answers to help guide our discussion.
When do I have to move?
At age 18 or after the final year of school you will be discharged from the Children’s Integrated Therapy team. The purpose of the transition clinics is to get you thinking about moving on and preparing for it.
Your parents or carers have been really important in looking after your health and will be able to give you lots of helpful advice. While you are in the process of transitioning, your parents will still be very involved in your care and their role is still important. Try to talk to them and your health care team about how you feel about moving on to adult care and any questions or concerns you might have. Also try to discuss practical issues relating to your health, such as getting to appointments, obtaining repeat prescriptions and asking questions in clinic.
While transition is all about you, it is important to realise that your parents may also be finding the process difficult as now they are handing over the responsibility to you. This can be hard for many parents and they may have worries of their own. You may find talking to them about your feelings, and allowing them a chance to tell you how they feel, will help you all through the process.
Questions you may like to discuss with your healthcare team:
- What is the plan for my transition?
- When am I moving to adult services?
- Can I choose which adult service I move to?
- What is different about the adult service?
- Can I meet the adult staff before I leave children’s services?
- Can I visit the adult service to look around?
- Are there any young people I can talk to about moving to adult services?
- What do I need to know before I move to the adult service?
- When can I start getting more involved in my health care?
- How will my condition affect my future, such as my education and employment prospects?
This information is for you if you are aged 18 or over and have a long-term health condition, which affects your movement. It provides advice on how to find help if you have a need for physiotherapy.
- Adult physiotherapy and occupational therapy services will not contact you to check how you are doing and they will not automatically arrange regular reviews. This is different from the Children’s team who will usually do this for you.
- Adult physiotherapy and occupational therapy are happy to see you if you ask for help with a specific problem (see examples below)
- Treatment with adult physiotherapy or occupational therapy might involve a one-off appointment or a few sessions over a short period of time.
- At the end of your short period of treatment sessions you will be discharged. A new referral will need to be made if you have any new problems or any further need to see adult physiotherapy or occupational therapy.
How to get help/ How do I make a referral?
- It is important that you seek out help yourself if you think you need it. If you leave the problem it may get worse and harder to resolve.
- Make an appointment with your GP if you do not know which service you should ask for help from. The GP will advise you who can help.
- You can make a referral to community physiotherapy / occupational therapy (CARS) yourself. Please ring 01895 486127. You do not need the GP to make the referral for you.
- If you need a referral to neuro outpatients or musculoskeletal physiotherapy, you should ask your GP to refer you.
There are a number of different local adult physiotherapy and occupational therapy teams who you might need to see:
It depends what problem you have as to which service you need. If you are not sure you can ask your GP. However, it can be helpful to have an idea which service you need.
Musculoskeletal Physiotherapy - 01895 279369 https://www.cnwl.nhs.uk/services/community-services/hillingdon-msk
- I am in pain, but I do not have a neurological condition
CARS Physiotherapy (Community Adult Rehabilitation Service) 01895 486127 https://www.cnwl.nhs.uk/services/community-services/hillingdon-community-rehabilitation-team
- My home equipment needs mending or replacing; e.g. standing frame, walking frame or sleep system.
- I have a neurological condition (e.g. cerebral palsy) and my muscles are tighter / I am in pain / finding it harder to walk than I used to or I am falling more often and I cannot leave home. Please request the neuro team.
Neuro Outpatient Physiotherapy Tuesday- 01895279488. Thursday and Friday- 01923 844697
- My portable equipment needs mending or replacing e.g. splints, gaiters or walking aids
- I have a neurological condition (e.g. cerebral palsy) and my muscles are tighter / I am in pain / finding it harder to walk than I used to or I am falling more often and I can attend a clinic.
Social Services Occupational Therapy - 01895 556633 firstname.lastname@example.org
- My hoist, slings or static seating needs modification
Wheelchair services 0208 4272881 Harrowhillingdon.email@example.com
- My wheelchair needs modification
- My supportive equipment needs servicing e.g. powered standing frame.