Dan Wood Consultant in Adolescent and Reconstructive Urology University College London Hospitals Honorary Consultant Urologist Great Ormond Street
Some definitions What does transition mean? ‘C’ing the issues Other issues DW UCLH
Latin Adolescere (to) grow Presents Challenges DW UCLH
“An increasing number of chronically ill children are surviving into young adulthood. Achieving a seamless transfer is becoming one of the greatest challenges facing both children's and adult services.” Fiona Smith Adviser in Children's and Young People's Nursing Royal College of Nursing DW UCLH
Friday November 7 th 2008 Tranisition clinic - GOSH DW UCLH
Change consultation
Different environment New personnel Information loss Different medical approach Potential for conflicting messages DW UCLH
Building for the rest of your life Regular checks Baseline New team members Watch for problems ?Need for travel??? DW UCLH
Change consultation confidentiality
Parents in vs. parents out New issues Embarrassment We have to look to build a trust They will grow up DW UCLH
Change consent consultation confidentiality
No consent is just me All complex decisions need time …and discussion Important role of our CNS Choices – this can be difficult DW UCLH
For straight forward procedures – usually no problem Able to sign for themselves May raise issue from the past Should be a process not an event DW UCLH
Change concordance consent consultation confidentiality
With freedom comes responsibility Some have difficulty with this Unsafe? Difficult Usually finite DW UCLH
Change conjugation concordance consent consultation confidentiality
Permission Ability Fertility Concerns DW UCLH
Change conjugation concordance consent consultation conflict confidentiality
With me With you With others With themselves DW UCLH
Listen Understand Explain Give time Re-Explain Empower DW UCLH
Future surgery Continence Other diseases Children (1/70 – 1/100) Historical comparison DW UCLH
Several studies – 45 ladies 49 deliveries May need Caesarian section All likely to need shared care Prolapse is a problem but treatable DW UCLH
Regular reviews Good communication with GPs Follow-up bloods Scans Expertise Outcomes - ?database DW UCLH
Some definitions What does transition mean? ‘C’ing the issues Other issues DW UCLH
Any Questions? DW UCLH