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G487(P) Designing the optimal model for transition from child to adult services for young people with disabilities and/or developmental difficulties

Aims Transition into adulthood for young people with disabilities and/or developmental difficulties is problematic, and continues to lead to poor experiences and outcomes. We aim to inform an optimal model for transition by exploring professional’s experiences of transition from child to adult services including barriers, facilitators and potential improvements. Methods A qualitative methodology, utilising semi-structured interviews, was conducted and an opportunity sampling strategy identified 40 professionals across primary and secondary care, education and social services within five neighbouring local authorities in Wales. Interviews were recorded and transcribed before commencing the six-phase, nonlinear, thematic analysis procedure outlined by Braun and Clarke (2006). Results Participants identified a number of key barriers, facilitators and improvements. Barriers include external pressures conflicting with clinical priorities, child and adult services functioning through two different models, late identification of young people needing transition support, poor engagement and disjointed working between agencies and parent/young person anxiety around transition. Facilitators comprised of the presence of a specialised transition support officer, collaborative transition planning, good relationships between agencies, implementing a person-centred approach and assuming a shared responsibility for transition. A number of recommendations and potential improvements to transition were also identified; preparing parents for the cultural shift to adult services which focus solely on the needs of the young person, and not the family; increasing the number of specialised transition support officers; a review of statutory responsibilities, anticipatory support for parents, timely information sharing, and meaningful data sharing between agencies. Conclusion Multiple factors prevent transition from being optimal. Across agencies, professionals are mutually unaware of each other’s procedures thus families, unsurprisingly, become anxious. Joint training events for transition would enable a collective understanding of professional roles and service provision, promoting accurate communication of information from services to families. A new communication model utilised by professionals, parents and young people is necessary to improve support and empower its users during the transition process and a counselling service would address parental/caregiver and young person anxiety, providing a holistic model of support.