Introduction Moving from Paediatrics to an Adult setting is difficult for any patient and family. Having been involved with a particular young adult, I was made very aware. Moving from paediatrics palliative care to adult care is huge. Being admitted to an adult ED or AMU will be traumatic and scary and I wanted to improve the experience and support the admitting teams in the acute hospital.

Method I have recruited keen colleagues across the Trust. I started with the acute interface (ED and AMU) teams and have senior representatives from as many specialities as possible. I have created a bespoke MDT with ED, AMU, respiratory, gastroenterology and nutrition teams, general paediatrics, paediatric palliative care and critical care consultants, Learning disability CNS, safeguarding, Quality matron and ED resuscitation lead nurse, and the local adult community and hospital SPC consultants, and paediatric CNS (2) from the local children’s hospice. We are forging links with another local DGH for them to join the MDT and the Critical Care Network want us to present an overview to them in December 2023. We have OPDs for a joint multi- speciality review for the patients and families to reduce burden.

Results Ad hoc plus quarterly meetings, lasting an hour. We discuss on average 4 patients with on average 1–2 new patients. We have developed a new chapter on the electronic records with sub-chapters including a bespoke proforma, ACP and ReSPECT documents and OPD letters. We have an alert system on the records.

Conclusions The MDT is a dynamic, focussed MDT. The disease complexes are dissimilar to the ‘usual’ palliative diagnoses which reinforces the integration of Paeds and Adult care for these patients. The motivation and desire to help has been refreshing and feedback from all involved is heartening. Being able to access expertise outside of the actual MDT meeting and having these new links has been a boon and will further improve the patient and family experience and care. My vision is an opportunity for families to attend the Trust proactively and create an information hub. Teaching is planned from the Paediatric Palliative Care team.