J Neurol Neurosurg Psychiatry 74:1011-1013 doi:10.1136/jnnp.74.8.1011
  • Growing up with chronic neurological problems
  • Editorial

Transition from paediatric to adult medical services for young people with chronic neurological problems

  1. C Tuffrey1,
  2. A Pearce2
  1. 1North Bristol NHS Trust, Frenchay Hospital, Bristol, UK
  2. 2Community Child Health Department, North Bristol NHS Trust, Southmead Hospital, Bristol
  1. Correspondence to:
 Dr C Tuffrey, 9 Greenhill, Neston, Corsham, Wilts SN13 9RN, UK;

    Some form of structured transition to adult orientated services is required for many young people with chronic disease

    A dolescence is a time of great change for all young people. As independence increases, adolescents may have difficulties in their relationships with adults and may engage in risk taking behaviour. Young people are often not registered with a general practitioner and seek medical services only when in an emergency.1 These issues also affect many youngsters with chronic disease but may have a more serious impact on future health and psychosocial functioning. Neurological conditions can have a profound effect on an adolescent’s self esteem and sense of identity,2 and many young people with neurological disabilities do not have the social skills to seek out and maintain services themselves.3

    Transition to adult care has become a major issue across the paediatric subspecialties and will continue to present a challenge to all health care providers over the coming years.1 With improved care, diseases of childhood are becoming diseases that begin in childhood and continue into adult life.4,5 It has been reported internationally that the transfer to adult services for children with all chronic illnesses has been overlooked,6–8 despite increasing acknowledgement of the need.5,9,10 Although scattered local services are being developed in a piecemeal fashion, there have been no national initiatives to date in the United Kingdom11 and little rigorous evaluation of these services has been published.12,13

    A distinction needs to be made between the physical transfer to adult services and the process of transition from the paediatric to adult settings. Neither paediatric nor adult services may be appropriate to the needs of adolescents.2 Adolescent medicine is a relatively new specialty in the United Kingdom, although more established in north …