1. Forging links between Children’s and Adult Hospices - A Working Model Neil Williamson – Transition Coordinator / Family Support Manager.

2.  How the partnership came about – a brief history. The tale of 7 hospices.  What do young people and families want when in transition. Feedback from the Marie Curie Transition project East London hub.  How does the model work currently.  What are the Challenges of working between children’s and adult hospices.  What are the next steps in meeting do we intend to meet the challenges faced by supporting young people into the adult hospice setting.  Questions and Answers.

3.  2008 YAG (social group began).  Neil asked what’s out there!!  2009 Met Diane from St Josephs.  Gave a presentation to all staff.  First YAG at St Josephs.  2010 Summer Scheme (lift off).  2010 first young adult to stay at both hospices in one stay.  2011 Marie Curie project, created a true partnership.  Developed the model for respite and end of life care.  First End of life patient.  2012 – 2013 – building up the client base. Big Lesson’s – Gently, gently, slowly, slowly. Not being afraid to challenge and ask, why do you do that? Above all else be positive, positive, positive. Pushing your luck.

5. Patchwork quilt – The hospices are different patches and realising and using this to the advantage is key.

6. The only Disability is in having no relationships! - Judith Snow

7.  It took a lot of negotiation to move the goalposts of the terminal palliative patient expected in adult services.

12.  We have 2 regular meetings.  A monthly panel meeting to discuss:  new referrals.  18+ young adult group (P’tship)  Upcoming stays.  Training planned.  Quarterly Steering Group meeting to look at:  Service development.  Evaluate the last 3 months.  Senior management feedback.  Multi disciplinary catch up and moving actions forward.

13.  Different working models:  Shift patterns.  Staffing levels/dependency.  Different focus of care.  Different nursing roles.  Young adult centred:  Young peoples anxiety/family anxiety around coming to a new hospice.  An older client group, a need to try to bring young people together.  Going out and managing this expectation through good planning.  Organisational culture:  Different processes of moving forward.  Adults tend to be bigger. (house/hospital).  Diagnostic categories and triage.  A lack of respite priority services.  Clinical challenges:  A different client group.  Different skill sets.

14.  Medical cover.  Multi Disciplinary is often very strong.  Chaplaincy, welfare advice, social work often heavily involved.  Often more provision for a bed space during deterioration, end of life and emergency.  Often community services are available.  More acute care is often available.

15.  Developing systems of work which combat the triangle –  Shwarz rounds bringing up issues such as – Sexuality, parental involvement.  Regular training for staff and identified training, seminars on young adult issues.  Transition nurse involvement to support staff with challenges in caring for young people.  Volunteer recruitment and selection for young people.  Drop in sessions for young people, a social group, other opportunities for events to encourage young people.  An open forum to talk about expectation from both services and a positive working relationship to work through problems.