EP 557 Establishing Formal Paediatric Colorectal Transition Services
Fahima Haque, Paige Delahaye-Camden, Sally HallamAbstract
Introduction
The CQC report ‘from the pond to the sea’ described children and families with complex surgical conditions experiencing a loss of clinical expertise and negative interactions whilst transitioning into adult services; professionals describe a lack of training and fear increased demand overwhelming their services. Effective transition of patients is a key recommendation from NICE (2016) and the Paediatric General Surgery and Urology ‘Getting it Right First Time report’ (2021).
Aim
To define the local need for transition from children’s colorectal surgical services to adult with a view to establish formal transition pathways.
Methods
Retrospective audit of young people (16-25) referred into colorectal surgery at a large tertiary centre over 12 months. We identified those with pre-existing colorectal conditions known to the Children’s Hospital who did/did not follow a transition pathway.
Results
272 young adults were seen; 49 (18%) had preexisting colorectal conditions: 10(20%) anorectal malformation / Hirschsprung’s, 12(24%) IBD, 7(14%) chronic constipation). Of these 31(63%) followed a formal transition pathway, and 18(36%) did not. Failure of transition negatively impacted clinicians understanding of complex cases and the faith of patients/families in the abilities of their new team.
Conclusions
There is an unmet need for local transition clinics. An MDT approach and comprehensive handover between services is required. Locally we require ∼2 transition clinics per year in colorectal/IBD - likely mirrored across the UK. Collaboration between paediatric and adult surgical services is essential to establish this service and develop the knowledge required regarding complex patients.