Healthcare is mainly divided into children’s services (paediatrics) and adult services. In some places around the country there are adolescent centres which people attend in between children’s services and adult services.
If you're aged 16–18 when you first go to a hospital, you're likely to go straight into adult services, but if you were diagnosed before this time then you'll probably need to move from paediatric rheumatology to adult rheumatology.
This can be both exciting and cause some worry, but being seen in an adult setting is a positive sign of your increasing independence.
The process where you move from one rheumatology service into one aimed at people of an older age is called ‘transition’. Paediatric services are different to adult services but knowing what to expect will help you make the transfer.
Most adult rheumatologists will look after patients who have had arthritis since they were children or teenagers, but this won’t be the majority of their work. You will have the chance to talk to your new rheumatology team about your arthritis and how it’s affected you in the past.
In both settings there will be a team of professionals working together to provide your care – the multidisciplinary team (MDT) – and they share your care with your GP.
Some differences you might notice between the two services are in this table:
|Children's rheumatology department
|Adult rheumatology department
|Consultations are family-focused so you're usually seen with your family
|Appointments are usually young-person focused; you're welcome to take family and friends with you but there's more of an emphasis on the healthcare professionals working in partnership with you
|Often parents or carers are responsible for medicines and treatments but you might be asked questions about your medication
|Questions about medicines and treatments will be discussed directly with you
|A lot of emphasis is put on education and you'll always be asked about school, college or work
||Less emphasis on education and work, but you can ask the team if you need help
|You'll always have your height and weight recorded
||You'll usually have your blood pressure and weight recorded, but height is less often measured
|Appointments are often longer and may be a bit more flexible
||Appointments may be shorter than you are used to
|If you don't come to an appointment, the team are likely to ring or text you to find out why and offer another one
||The team may not contact you if you don't attend an appointment and it's likely to be your responsibility to book another one
|Medicines often supplied by the hospital
||Medicines often supplied by your GP, who shares the care of your treatment with the hospital
|Some discussion of topics such as sexual health, contraception, alcohol
||Topics such as sexual health, alcohol, contraception and planning pregnancy will very often be discussed in more detail
What happens during transition?
The process of transition varies in different places around the country, but it's always centred around what's right for you. If your team hasn’t mentioned it then ask them how transition works in their service and how it could work for you.
You should have transition planning and hopefully will have met your new team and know where the adult clinic is.
You should also have had some practice at, and be comfortable with, being seen alone as well as with your parent, carer or friend. When you're in adult services, you can still choose who comes into the consultation with you.
There may be lots of older people in the adult clinic and not a lot of other people your age unless there's a specific young persons’ clinic in your area.
On your first few visits to the adult rheumatology department you may feel a bit out of place if most people are older than you. Remember that people of all ages with many different problems need to visit healthcare services and the way in which arthritis has impacted on other people could be completely different from how it will affect you.