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P-172 Overcoming the barriers of transitional care – a three-legged race
  1. Helen Finlinson1 and
  2. Cath Markham2
  1. 1St Elizabeth Hospice, Ipswich, UK
  2. 2East Anglia Children's Hospice


An innovation responding to growing need In the UK the number of 16–25 year olds with life limiting conditions has doubled in the last decade (Beresford et al. 2013, p1, Fraser, 2013).

Marsh et al. (2011) reported that ‘many young people die at or just after transition’ and that ‘services stop just when they are needed most’. Giving projects such as this an undeniable urgency.

Stakeholder engagement guides the evolution of services based on local need, correlating with national research.

Developments include

  • New referral pathway for transitional care

  • Multi-agency transitional care MDT meeting

  • Bi-annual open events jointly hosted with children’s hospice

  • A new young adult group-run in partnership with children’s services

  • Parent peer support and user-involvement group

  • Sibling support

  • Development of a short break unit (there is no other young adult short break unit for palliative care in East Anglia).


  • Twenty young adults (14–40years) identified within two years

  • Ten transitional care referrals received from the children’s hospice over the past year.

Ongoing challenges and solutions

  • Small numbers, huge (and diverse) needs (Marie Curie Cancer Care, 2011, p.8)-difficult to justify resources

  • Training and skills needed to provide care

  • Cross boundary working

  • Risk taking and managing staff concerns

  • Parent expert dynamic

  • Communicating the vision, creating transitional care champions (Cartwright and Baldwin, 2006)

  • What to offer now, managing expectations

Ongoing challenges and solutionsKey to success is the partnership working approach with the children’s hospice- sharing resources, increasing sustainability and enabling skill-sharing and training opportunities.

New avenues of income generation have been identified for this service.

We believe we are leading the field in adult hospice led transitional care in the East of England and would welcome the opportunity to share our learning and encourage others to step out and embrace this urgent challenge.

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