Intended for healthcare professionals

Practice What Your Patient is Thinking

Stepping up to adult services

BMJ 2018; 362 doi: (Published 26 September 2018) Cite this as: BMJ 2018;362:k3886
  1. Lucy Watts
  1. lucyalexandriawatts{at}

Moving from children’s to adults’ services can be difficult. Lucy Watts discusses what might have made her transition smoother

I was born with a complex, life limiting condition. At 14 I became disabled, and at 15 I had started tube feeding, which was a big adjustment. I desperately needed support. A few weeks after my 16th birthday, my mother and I arrived at hospital for what I thought would be another routine appointment with my paediatrician. At that meeting I was told that because of my age I was being discharged from children’s services. As I was wheeled out of that appointment I felt I was no longer a paediatric patient but not yet an adult. It seemed as if I had no team to take over my care; what was I going to do?

Sudden change

The shock was immense. As a paediatric patient, I relied on my mother to do all the phoning, liaising, and advocacy that ensured I got the care and support I required. Inpatient admissions took place on a paediatric ward where my mother could stay with me—making decisions with me, supporting me, and providing much of my care. Even though I was 14 when I became seriously ill, I don’t remember discussions about transition to adult care. Suddenly, I was …

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