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Transition to adult kidney services

'Transition' is how we describe the slow process of transferring you from our kidney service at the Evelina London Children's Hospital, to adult services.

It happens gradually over several years and involves both the children's and adult teams working together.

Graduating from children’s to adult care can seem a scary thought as you move to a new team responsible for your health needs.

At Evelina London we believe in supporting our young people and their families to facilitate their readiness for their move to adult services.

More about your transfer

When does transition begin and end?

13-14 years old

Transition usually starts in early teenage years. We’ll encourage our teenagers to see their health professional for part of their consultation on their own, with parents invited to join for part. Transition is not about parental exclusion but about preparation for the changing roles which come with adulthood.

Turning 16 and the young adult clinic

A young adult clinic (YAC) is held twice monthly in the Guy’s adult kidney clinic and all our kidney patients are invited to this once they reach their 16th birthday. There’s a young adult kidney care coordinator who aims to smooth over the transfer to their service.

Evelina London patients attend the YAC for up to two years before they transfer to adult services. In the early months it’s about peer and parental support with a change of environment and the children’s team will still be responsible for your care until your 18th birthday.

For further information, please discuss with your clinical nurse specialist or contact:

  • Vanda Fairchild, young adult kidney care co-ordinator, Guy’s Hospital
    tel: 020 7188 7188 ext 52722/075 8162 1930
    email: vanda.fairchild@gstt.nhs.uk.

Our young adults with specific learning needs will require additional support during this time which will be discussed on an individual basis.

After your 18th birthday

At your 18th birthday the only major change which happens with your kidney care is the change of responsibility to the adult specialist team and their inpatient services. You’ll continue to attend the YAC until either your 25th birthday or until you choose to attend a regular adult clinic.

Depending on individual needs, transfer to adult care may be to a local service near where you live, or go to university. If you have stable transplant function, you’ll also have the option of choosing to attend the Guy’s adult kidney unit.

MyKidneyCare is our young adult kidney app (developed with support from our Kidney Patient Association).

It can help you learn more and organise your ongoing kidney care and is free to download on iPhone and Android phones.

What will I learn during transition?

You’ll learn:

  • skills you need to independently look after yourself and to successfully use adult health care services
  • about your kidney/bladder condition: what it is; how it affects you on a daily basis
  • what care and treatment you’ve had and what you may need in the future
  • more about the medicines you are prescribed
  • about lifestyle issues such as the impact alcohol, smoking, recreational drugs have on your condition and treatment
  • about family planning and issues about future pregnancy.

You’ll be able to ask questions at any time if there are things you want to know more about, or things that concern you.

Your parents can come to clinic with you for as long as you want them to.

Can I see the doctor or nurse on my own if I want to?

We encourage you to see the doctor or nurse on your own when you feel ready and will be suggesting this from your early teenage years.

We’re not expecting you to have your entire consultation on your own but initially just for short periods during your appointment, with your parents joining the consultation towards the end.

Anything you discuss with your doctor or nurse will be treated confidentially. This means it will not be discussed with any one else without your permission, unless we have serious concerns about your safety.

If I have to be admitted to hospital, where will I stay?

You remain a children’s patient until you’re formally transferred to adult services, at some point near your 18th birthday. Therefore, even if you are attending the young adult clinic at Guys Hospital (between 16-18 years) and need hospital admission you would be admitted to Evelina London Children’s Hospital.

Once you’ve transferred to adult services, you would be admitted to the adult wards at your new hospital. It’s a good idea to visit the adult inpatient wards at Guy’s and St Thomas’ before the need for admission arrives. Please ask for a tour when you are attending a young adult clinic.

If you’re transferring to a different hospital, an informal visit to its adult service can be arranged when you can go for a look around and meet some of the staff, before you decide to move your care there.

What happens if I move away from home when I'm older?

If you go away to university, it’s important for you to have a doctor near your university who knows about your condition and can help you if you become unwell.

Your routine care can usually remain either at the Guy’s young adult clinic or at your local adult kidney unit, who will work with you to arrange routine follow-up appointments during holiday times.

Who can I contact to talk about transition?

If you'd like more information about moving to adult kidney services, contact a member of your specialist team:

  • Emma Rigby, Nephrology Clinical Nurse Specialist (CNS) - 020 7188 6714
  • Pernille Rasmussen, Chronic Kidney Disease CNS - 020 7188 4605
  • Carmen Barton, Matron, Dialysis – 020 7188 4526
  • Grainne Walsh, Transplant CNS – 020 7188 4590
  • Cathy Gill, Senior Play Specialist – 020 7188 4590

Download our app

My Kidney Care app

MyKidneyCare is our young adult kidney app (developed with support from our Kidney Patient Association).

It can help you learn more and organise your ongoing kidney care and is free to download on iPhone and Android phones.

©  Guy's and St Thomas' NHS Foundation Trust
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