Transition

‘Transition’ is where your asthma care is moved from the children’s (paediatric) hospital or asthma clinic, to the adult's hospital or asthma clinic.

A good transition care plan will include information on who to contact if you need support or advice. It will also explain how your appointments will work. The idea behind transition is to help you feel confident and ready to take charge of your own asthma by the time you move to an adult clinic. 

You might have been looking after your own asthma for some time, as a child and young teenager. You may be wondering what all the fuss is about. Or you might feel this time of transition is scary and have lots of fears and concerns. This page has lots of information to help you know what to expect.

On this page:

Who goes through transition?

If you see a GP or an asthma nurse at your GP surgery about your asthma, you won’t go through transition as you would in a hospital setting. But at some point you’ll be included more in the conversations about your asthma. And you’ll be asked to take more responsibility. This will mean understanding your medicines and using your written asthma action plan. Once you’re 16, you can start seeing your GP or asthma nurse on your own, without your parents or carers, if you want.

If you see a consultant paediatrician in an asthma clinic in a hospital about your asthma, you might go through the formal transition process. But not all hospitals offer this.

When is transition?

Ideally, your paediatric team will start to talk to you about transition when you’re about 14. But this age isn’t set in stone. The exact timing varies from person to person. You’ll have conversations with your consultant, GP or asthma nurse about how to get ready for the adult asthma clinics. Most people move into adult services at the age of 16 or 18.

Who’s involved in transition?

You, your family or carers, your paediatrician and asthma nurse are all involved in your transition. Together you can plan the timings of your transfer to an adult asthma clinic. This will take into account other things that might be going on for you, such as exams or holidays. You might be given a ‘key worker’ or ‘transition co-ordinator’ to oversee your transition so you and your family have one point of contact. But all clinics and hospitals do things differently.

What’s the difference between children’s services and adult services?

Adult care settings are different to children’s. You’ll probably notice there’s less focus on family involvement and more on you as an individual looking after your own asthma. As experts in adult asthma, your new team will know all about the issues you may come across as a young adult.

What about my parents/carers?

Try not to forget your parents or carers! They’ve been used to looking after you and your asthma, possibly for many years. It might not be easy for them to let go of that control. It may be especially hard for them if your asthma’s affected you a lot and you’ve needed to go into hospital several times during your childhood.

At first, you may want to include them in your appointments so they have a chance to ask their own questions. Talk to them about what you’re doing. Let them see that you’re managing your asthma well so they know they can trust you to do all the things you need to do to stay as well as possible. You could let them have an updated copy of your written asthma action plan so they know what – if anything – has changed.

Your checklist - questions you might like to ask your doctor or asthma nurse:

  • At what age will I move to adult services?
  • What asthma clinic or hospital will I move to?
  • Is there a transition care package?
  • Will my new team have all my medical records?
  • Will I have a key worker or transition coordinator to oversee my transition?
  • Is it possible to arrange a visit to the adult asthma clinic to meet the team and find out where appointments are held before I move my care there?
  • Can we run through all my asthma medicines to check I’m taking them correctly?
  • Can you check my inhaler technique?
  • Is there a way I can remember to take all my medicines every day?
  • What can I do to make sure I keep track of all my appointments?

For parents and carers

Transition can be a worrying time for parents and carers. You may be concerned about how your child will manage their asthma, and how they’ll cope with moving to a new clinic. You might worry about whether they’ll take in what they’re told during appointments. And you might find it difficult to feel you’re losing control and are no longer in charge of your child’s healthcare. This maybe especially hard if your child’s asthma has been difficult to manage and they’ve been in hospital during their childhood. It’s natural to have these concerns – but worrying too much may make the transition process more stressful for both you and your child. We have some answers to common questions:

How can I help make transition easier for my child?

You could start by letting your child have some control over their health before they officially move to adult services. For example, before their next appointment, you could sit down with them and plan one or two questions they could ask the GP or asthma nurse themselves. You could also ask the GP, doctor or asthma nurse to speak directly to your child, rather than to you, to help them feel as though they’re in control of the appointment.

How can I help them remember to take their inhalers?

One of the best ways to help your child get into a routine is to make it part of something they do already. For example, if they have to take a preventer inhaler twice a day, you could encourage them to use it just before they’ve brushed their teeth in the morning and evening. They could keep the inhaler beside their toothbrush or toothpaste so they see it and are prompted to use it. You could also help them to set goals for themselves.

What can I do if they’re not taking their medicine as prescribed?

If your child is struggling to take their inhalers and any other medicine, talk to them about what gets in the way. Perhaps they avoid taking their inhalers because they prefer to pretend they don’t have asthma. Or maybe they aren’t very organised and simply forget.

Encourage them to think about what stops them and what might help, so you can come up with solutions. For example, if their medicine makes them feel different to their friends, remind them that lots of young people have medical conditions they deal with. Explain to them that taking their preventer inhaler as prescribed is the best way to stop asthma symptoms interfering with life, so they can get on with doing all the things they want to do. If they keep forgetting, you could sit down together and think of ways to help them remember – perhaps they could download a reminder app. If you’re not sure how to help them or need more ideas, speak to their GP, asthma nurse or a pharmacist.

How can I stay involved in their care after transition?

During the transition process, you could arrange an appointment with your child’s new team, so you can meet everyone who will be involved before they move to adult services. After this you can still go to some appointments with them, if your child is happy with that. If they would prefer to go on their own, you could encourage them to make a list of questions they want to ask, and go through this with them before the appointment. You could also set aside 10 minutes for a ‘debrief’, when they tell you what happened in the appointment. However, remember your child may like feeling independent. They may feel more confident about looking after themselves if you can show you’re confident in them.

How can the whole family be supportive?

Even if your child enjoys their independence and wants to manage their asthma on their own, it can be helpful to them to feel the family is still involved. You could encourage your child to keep a copy of their written asthma action plan where the whole family can see it – for example, on the fridge door. This means you will all know the signs that suggest your child’s asthma may be getting worse, and you’ll all know their triggers. It can help them feel supported, and remind them they’re not managing on their own. You could also ask your child if there’s any other support they’d like from the family.

Last updated July 2016