Young Person Information: Transition to Adult Diabetes Service – What’s it all about?

Transition to Adult Diabetes Service

Introduction

As a young person, you might be wondering what will happen with your diabetes care once you become an adult. This booklet will discuss what transition is and what you can expect going forwards.

What is transition?

As you get older, you may find yourself wanting more freedom and independence and with this your diabetes management will naturally become more your responsibility. This can be both an exciting but also daunting time for both you and those who care for you.

In healthcare, we use the word ‘transition’ to describe the process of preparing, planning, and moving from children’s to adult’s healthcare services. Transition is a gradual process that gives you, and everyone involved in your care, time to get ready to make the move.

Through the process of transition, your diabetes team and your parents/carers will support you to develop independence and support you in taking on more responsibility for your own health and well-being in preparation for moving to adult services. This may include supporting you to build communication and decision-making skills that will help you make the best-informed choices about your health.

So, what will transition look like?

There is no exact time or age that is right to move to adult services, but most young people move between 16 and 19 years of age.

We will begin to talk about transition early, usually around 13 years of age, and we will do this by getting you to complete a series of age-specific questionnaires at your clinic appointments to identify your understanding of your diabetes management and areas in which you may need support to prepare you for transition.

These documents are called: Set up, Get up and Go.

Between your 17th and 19th birthday we will begin to introduce you to the adult service. By this stage, we hope that you will feel confident and ready for your care to be transferred to the adult team.

This will be a slow process, and your final 5 appointments may look like the following (MDT means Multi-Disciplinary Team, so all the professionals that are involved in your diabetes care):

If appropriate to do so, we may encourage you to be seen independently at your clinic appointment, whilst also allowing your parent/carer the opportunity to be involved. Allowing you this opportunity will help you to build confidence to take responsibility for your own diabetes management. It may also encourage wider discussions about your diabetes care and general wellbeing that you may not want to discuss with your parents/carers present.

Remember – anything discussed with your health care professional will remain confidential unless we are concerned for yours or someone else’s safety.

So, who will support me in the Adult Service?

This will always be a worry for young people, and we want to reassure you, you will continue to be supported in the adult service.

Whether you have your insulin via multiple pen injections throughout the day or via insulin pump therapy, your care will be transferred to the hospital’s adult diabetes team.

At your appointment you will be allocated a named key worker from the adult service who will be your new named Diabetes Specialist Nurse who covers the geographical area you live in. At your appointment, your allocated adult nurse will provide you with their contact details and who to contact if they are away from the office. They will also discuss your preferred contact methods and details.

Say Hello to the Worcester Adult Diabetes Team:

Say Hello to the Kidderminster Adult Diabetes Team:

Say Hello to the Redditch & Bromsgrove Adult Diabetes Team:

Say Hello to the Adult Community Diabetes Dietitians:

We run group education sessions. These are a great way to update your knowledge and skills and meet other people with type 1 diabetes.

The courses we run at present are: –
Carb counting course – 2 x 1.5-hour virtual sessions
DAFNE course (injections) – online learning with 6 x 3-hour weekly virtual group sessions
DAFNE Closed loop essentials – 4-5 hours self-directed online learning
DAFNE Closed Loop Optimisation Course – currently in development
Insulin pump annual update sessions – 2-3 hours virtual or face-to-face

To express interest in any of these courses, please email:
[email protected]

In addition, other courses may be helpful for you including;
Living well with diabetes courses – a 5-week virtual course based on Cognitive Behavioural Therapy (CBT)

• Boosting mood and living well with diabetes
• Calming anxiety and living well with diabetes

Self-refer via our website https://www.talkingtherapies.hwhct.nhs.uk/home
Alternatively, you can call: 0300 013 57 27 between 9.00am and 5.00pm Monday to Friday.

So, what are the differences between the Children’s and Adult Services?

	Children’s Service	Adult’s Service
Clinic appointments	3 monthly clinic appointments with Nurse, Doctor, Dietician +/- Clinical Psychologist Blood tests to be completed at clinic appointment.	6-12 monthly Consultant clinic appointments with your doctor. You would be expected to attend your GP surgery for blood tests prior to the above consultation.
Diabetes Specialist Nurses support	Paediatric Nurses to make contact and review in between clinics to offer support. Paediatric Diabetes Nurses available to call Monday-Friday 9am-5pm except Public Holidays to help with queries	Adult Nurses would expect the young person to reach out to them if they are encountering any diabetes related worries or queries. Diabetes Nurses (depending on shift pattern) available to call Monday-Friday 9am-4:30pm except Public Holidays to help with queries or concerns.
Dietetic Support	Dietetic support offered 3 monthly at clinic appointments and 1:1 appointment available on request.	Dietetic support isn’t available on a 1:1 basis but there are various structured educational programmes available such as Carb counting workshops and DAFNE on request or through referral from your diabetes nurse or GP.
Psychology support	Clinical psychologist available on request for emotional and mental health support around living with diabetes.	No clinical psychologist available. Diabetes team may be able to refer you to Talking Therapies or advise you to seek further support from your GP for further sign posting.
Out-of-hours support	Open access to the Paediatric Ward (Riverbank) 24/7 for advice or admission. Call 999 for emergencies.	111 for advice or 999/A&E for emergencies through GP referral or self-referral.
Prescriptions	As a child you are entitled to free prescriptions.	As an adult (18 years plus) you are also entitled to free prescriptions because of your Type 1 diabetes. You MUST claim a “Medical Exemption Certificate” first – you can request this at your GP surgery which will be sent off and once approved, you will receive your certificate which is a small card to keep in your wallet or purse. This expires every 5 years and would need to be applied for again to avoid fines.

More information
If you have any questions or concerns about transition, please talk to your Paediatric Diabetes Nurse Specialist, Clinical Psychologist and/or any member of the paediatric diabetes team. Or you could contact Amy Lumley (Paediatric Transition Nurse):

Useful Information and Links:
Digibete – https://www.digibete.org/digibete-app/
Together Type 1 Community – Together Type 1 | Diabetes UK
‘Onside’ for health and wellbeing support – https://www.onside-advocacy.org.uk/yourspace
National Children and Young People’s Diabetes Network Introduction – National Network

SEREN CONNECT Leaflets
Learning to Drive and Type 1 diabetes: Eng-SEREN-Connect-1-Learning-to-drive-and-driving-safely.pdf
Drinking Alcohol with Type 1 Diabetes: Eng-SEREN-Connect-3-Drinking-alcohol-with-Type-1-diabetes-.pdf
Other Leaflets also available:

Please ask your Paediatric Diabetes Specialist Nurses for information about further education sessions or any physical copies of the leaflets below.

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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