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Recognition of emerging adulthood in UK rheumatology: the case for young adult rheumatology service developments.

Current available evidence is persuasive of the need to improve the transition and transfer of young people with chronic rheumatic disease to adult-centred rheumatology services [1, 2]. Recent years have witnessed the arrival of long-awaited governmental support for this in the form of several major documents including the National Service Framework (NSF) for Children, Young People and Maternity Services [3, 4] and Transition: Getting it Right [5]. These have been further supported by important documents from professional bodies including the Royal College of Paediatrics and Child Health [6] and the Royal College of Nursing [7]. Although transition starts ideally in early adolescence, it does not finish until the young adult is participating fully in adult health care. Much of the research in transition has been paediatrically driven and it is now timely to start addressing what happens following transfer to adult-centred care. This article proposes one way forward—that of developing rheumatology services specifically for 16to 25-yr-olds—and presents the evidence to support it. Unfortunately age criteria is a wellrecognized barrier within adolescent health developments. In the following discussion, the term adolescent will refer to 10to 19-yr-olds (as defined in the National Service Framework for Children, Young People and Maternity Services, NSF) [3, 4] and the term young adults to incorporate late adolescence and the early twenties i.e. up to the age of 25 yrs.