Transition: The journey from paediatric to adult care

The journey from paediatric to adult care takes place during adolescence. It is a complex process requiring a team effort from a variety of specialists. 

In February of 2023, a workshop was organised by the ERN RARE-LIVER Transition of Care working group, funded by the Networking Support Scheme of the European Joint Programme on Rare Diseases. 

The workshop resulted in various inputs, priorities and actions. As a result, the group decided to prioritise practical actions. To reduce the number of actions, the group will be subdivided into three subgroups responsible for communication, organisation, and education, respectively. Each subgroup will identify a maximum of three actions to tackle in 2023-2024. 

A Transition of Health (ToH) template has been developed by the ERN RARE-LIVER Transition Working Group to support patients moving from paediatric to adult liver services. The template aims to improve the communication and information transfer from paediatric services to the adult department, facilitating a smoother transition of care for patients. It provides a structured framework for sharing essential medical history, treatment plans, and psychosocial information, ensuring adult care teams can deliver personalised and continuous care.

It is available for download and can be used in everyday clinical practice to support patient management and facilitate communication between healthcare teams.

Transition of Healthcare Template