Moving on Up 16+….. Transition Clinic:

Information for young people and parents/carers

What is Transition?

Transition means a process of change and in the world of diabetes care, it means moving forward from the child and adolescent diabetes service, to the adult diabetes service. The transition clinic is a stepping stone between the two services. This process takes many years as it is not as simple as telling you that it’s time to move on. In order to make the move a successful one, we will help you to develop certain skills and knowledge to manage your diabetes independently.

When does it all start?

At the age of 16, you will be invited to attend the diabetes transition clinic. The clinic staff will help you book these appointments. At the Age of 19, you will transition over to adult services, we hope that your time in the transition clinic will have helped you feel confident and independent enough for this.

When and how will the transition clinics run?

The clinics are held twice a month on a Thursday afternoon between 13:30 and 16:30. Both Doctors and Educators will be present in clinic.

We also hope to offer education programmes, however we will inform you of these.

We would also be really grateful if you could download your meter or pump at home before you come to clinic – if you can’t do this, ask your keyworker for help.

Your appointment may also be your Annual review if this is due. In this case, we will ask for a blood test and urine sample, and you can also request a Dietitian and psychology referral.

How will the clinic work?

This clinic will not feel dramatically different to what you are used to; however you will get to meet some new faces such as an adult doctor and an adult Diabetes Specialist Nurse (DSN) or Diabetes Specialist Dietitian.

What do I need to do?

We need you to be involved to ensure your transition process is a success! There are six key areas that we need to look at in each stage of the transition process as well as looking at your diabetes knowledge and skills. This is because life is not just about managing your diabetes. We want you to live a full and happy life, with your diabetes, so this means learning other skills too!

The following are skills that we will discuss in your diabetes clinics:

Self-advocacy

• Taking responsibility for your actions, making your own decisions and asking questions.

Independent health care behaviour

• Understanding your diabetes management, when to get help, and where to go to get it.

Sexual health

• Understanding good sexual health and discussing any questions you may have with health care professionals.

Psychosocial support

• Where to get help and support. Discussing difficulties and issues that may affect your ability to cope living with diabetes.

Educational and vocational planning

• Discussing issues around education and employment and how diabetes will fit into this.

Health and lifestyle

• General issues around health, not necessarily related to diabetes and getting help on how to manage these issues.

There is a lot to think about, with many areas to cover, but they do not all have to be done at once. That is the whole point of the transition process - you will determine how fast the process is and go at your pace, with guidance from your team.

What you can expect from us

As a young person, developing your skills and responsibilities, you have certain rights whenever you seek medical advice and support. Therefore whenever you meet with members of your health care team, we will endeavor to:

Take you seriously and treat you with respect;

• Give you privacy and maintain your confidentiality within the limits of this (i.e. if you are at risk we have a duty to protect you and we will discuss with you the options we have for this);
• Offer you clear information about your diabetes and give you the opportunity to be involved in the decisions about your care;
• Give you the opportunity to ask questions about your diabetes, your care and other things that are important to you.

Before you are transferred to the adult clinic, you will be shown around the area and given the adult contact details.

The key worker

A key worker is someone who can help support and guide you through the next few years as you grow and develop your own diabetes management skills and knowledge. They may not know all the answers, but they will be able to help you find someone who does. They will work with you to develop your plans for your diabetes care over the next few years. Your key worker will be one of the Paediatric Diabetes Educators. If you are unsure who your keyworker is, please ask at your next appointment. You can contact your keyworker via phone or email. You can also come in and see your keyworker if you need any advice or support with managing your diabetes – just ask and they will book an appointment with you as unfortunately we are unable to offer a drop in service.

Your key worker will also be able to support in managing your diabetes at college/ work.

Clinical Psychology

• Dealing with feelings relating to diabetes; Such as fear, sadness or anger, feeling different
• Supporting you to live with and manage diabetes
• Coping with treatments that you feel worried about
• Problems getting on with other people or worries about school
• How diabetes affects family life and the impact on Brothers and Sisters
• Difficulties sticking to your treatment plan

Please let the team know if you would like to chat with the psychologist.

Youth Service

Our Youth Worker offers 1-2-1 support and activities throughout the year. The Youth service is flexible, some examples of what a Youth Worker does includes:

• Meeting for a catch up in a local coffee shop.
• Attending clinic with you.
• Organising trips like going to a pantomime or meeting up for pizza.
• Offering general advice or support.

Please let us know if you would like to get in touch with our Youth worker.

What We Expect From You

You will begin to take on a greater responsibility in order to manage your diabetes. In order to do this, the child and adolescent diabetes team would hope that you will:

• Understand your diabetes and its management
• Follow the management plans agreed between you and the diabetes team
• Be honest about how you feel your diabetes management is going and any problems you may have
• Ask for help when needed
• Attend your appointments and let us know if you cannot attend so we can rearrange them.
• If you wish for your parent/ carer to continue to have involvement in your care you will need to tell us so that we can add this to your notes.

Contacts/Further information

Please feel free to contact the team anytime you have a concern.

CUH paediatric diabetes team

• Email us for non-urgent queries
• 01223 274638 – leave a message for urgent queries
• Hours: Monday-Friday, 9am-5pm

Out Of Hours diabetes support

• 01438 285000 for clinically urgent queries that cannot wait until when the CUH paediatric diabetes team are back at work.
• Hours: Monday-Friday, 5pm-8am. At the weekend and bank holidays 8am-8am cover.

This is a regional service for which diabetes teams rotate cover. You will reach a hospital switchboard who will take your phone number and the child’s name, then a diabetes practitioner “on call” will phone you back.

Weston Centre Reception (for changing appointments):

Tel: 01223 348576