187 How to help young people transition from paediatric to adult palliative care services in Oxfordshire: our experiences and lessons learned

<h3>Introduction</h3> An increasing number of young people are transitioning from paediatric to adult palliative care due to advances in medical treatments and technology (Fraser et al., 2021). Young people and their families face many challenges owing to vast differences between adult and paediatric care models. These include the loss of familiar staff, having to build relationships with new teams, and difficulties in accessing adult services due to more limited resources (Benini et al., 2024). <h3>Methods</h3> We describe the collaborative development of a Transition Service by adult (Oxford University Hospitals Foundation Trust) and paediatric (Helen &amp; Douglas House) palliative care services in Oxfordshire. This involved (a) the creation of a Transition Scoring Tool encompassing locomotor, respiratory, neurological and gastroenterological needs, to enable detailed assessment of paediatric patients approaching transition to guide case selection and onward care planning and (b) a collaborative multidisciplinary service design comprising of paediatric and adult palliative care specialists. Recognising the complexity of these young people, the service includes routine adult service follow-up in addition to a formalised annual review of symptom management and advance care planning documents. <h3>Results</h3> We reflect on the caseload held by the Transition Service so far and present our key learning around (a) reciprocal learning between teams; (b) identifying challenges of transitioning for young people with life-limiting illness; (c) exploring the role of adult palliative care services when the paediatric service model is profoundly different and (d) appreciating the difficulties in prognostication and patient selection. <h3>Conclusion</h3> Transition is a vital area of palliative medicine that merits greater attention, especially as the prevalence of young people transitioning is expected to rise. We must recognise that teenagers and young adults are not merely adults, but a distinct cohort of patients that have discreet physiological, psychological and social needs (Stevens &amp; Dunmore, 1996). <h3>References</h3> Benini F, Brogelli L, Mercante A, and Giacomelli L.Transition to adulthood in pediatric palliative care: a narrative review. <i>Children (Basel, Switzerland)</i> 2024;<b>11</b>(7):860. https://doi.org/10.3390/children11070860 Fraser LK, Gibson-Smith D, Jarvis S, Norman P, and Parslow RC. Estimating the current and future prevalence of life-limiting conditions in children in England. Palliative medicine 2021:<b>35</b>(9):1641–1651. https://doi.org/10.1177/0269216320975308. Stevens M and Dunmore J. (1996). Adolescents who are living with a life-threatening illness. Chapter 6 in C. Corr &amp; D. Balk (Eds). Handbook of Adolescent Death and Bereavement. New York: Springer 107–135.