Differences in care

Paediatric to adult healthcare

There may be differences between the services that you receive at a children’s hospital and the services that you will receive when you reach adult healthcare.

Below is an outline of some of the main differences you may come across, and some helpful hints and key questions to ask.

Sometimes change can be challenging but hopefully these tips can help make your transition to a new hospital an easier experience. This is an exciting stage of your life as you become an adult and take charge of your health.

	Paediatric services (family focused)	Adult services (patient focused)	Some tips
Independence and self-management	Questions are more likely to be directed at your parents/carers.	Questions are directed at you and you are expected to know and be able to explain all your information.	If you are unsure about your health, your condition or treatment, don’t be afraid to ask your new doctors. Write your questions down. Be confident and honest. Practise having solo or part solo appointments with your doctor in the paediatric service.
	Your parents/carers book appointments for you.	You book your own appointments and keep track of them, rescheduling if required.	Book your appointments well in advance. Ring the receptionist and reschedule if you can’t make it so it’s important to know who to contact. Keep a track of your own appointments.
	You are on your family’s Medicare, healthcare and health insurance accounts.		Get your own Medicare card (or a copy of your family’s card) especially if you are seeing your doctor without your parents/carers present or in emergency situations.
	Your parents/carers may have to pay for your appointments if you are a private patient or see a GP where there may be a gap payment.	You may have to pay for your own appointments if you are a private patient or see a GP where there may be a gap payment.	Ask what your out-of-pocket expenses will be if you are a private patient or see a GP where a gap payment may be required.
	Your parents/carers may take you to all your appointments.	You may need to travel to your appointments on your own.	Allow plenty of time to get to your appointment. Parking may be difficult or public transport may run late.
	Your parents may tell your doctor your current symptoms and ask or answer questions on your behalf.	You will be expected to answer your doctor’s questions. If you are on medications or use special equipment, you will need to know what they are, how to collect them and order more when they run out.	Strive to be independent to the best of your ability, but keep your parents/carers informed to a degree that you are comfortable with.
Information	Doctors give information and use language that you can understand. If you don’t understand you can always ask your parents. You may be used to seeing one or the same doctor/s each time.	Adult services should use language that you understand, particularly about your condition or treatment. You may be seeing different doctors each time.	If you don’t understand something that your doctor tells you, ask him/her to explain it to you and be clear about how they can help you.
Environment	The Royal Children’s Hospital (RCH) is familiar to you and you know your way around. You will mainly have children and young people around you.	Adult services are new and initially, things are unfamiliar. You will learn your way around but ask someone for directions if you are unsure. You may find there are a lot of older people around you.	If possible, visit and familiarise yourself with the new healthcare service. Make sure you know how to get there before you transfer.
Links to services	You may have been linked to services within the hospital i.e. tests, programs, other service providers.	You are be more likely to be referred to services outside the hospital. These services may also have different expectations of you now that you are an adult.	Know how to get to your appointment and know where to go. Request services as close to home as possible. Book appointments in advance and keep track of them. Know if there is a difference in what is expected of you in these services.
General Practitioners (GPs)	You may not need to see your family GP very often or you may not have one, as you may be used to seeing a general paediatrician and/or your individual specialists only.	You may need to see your GP more often to help you manage aspects of your healthcare and perhaps take over some of the role that your paediatrician may have previously assisted you with.	Make sure that you have a good GP that you trust and feel comfortable with.
Costs	Most services at the RCH are usually free or cost less than in the adult healthcare system.	Adult services may charge extra for items such as equipment and medications.	Be aware of any extra costs before you transfer and have financial supports in place if available.

Points to keep in mind

You can always have someone with you at your appointment or you can be seen on your own.
Write down a list of questions or a description of your symptoms with you, so that you don’t forget. You may like to make a note of this in your phone.
If possible, make a longer appointment (if you have a lot to talk about). GPs can offer longer appointments.
If you don’t feel comfortable with your doctor, it is okay to change. The first service may not be right for you. You have the right to ask for another referral.
Your say is important. Be confident expressing how you are feeling and ask questions if you need to. If you don’t ask, you won’t know.
Your new healthcare team want the best possible health outcomes for you, just the same as your previous team.
Know how to manage your healthcare to the best of your ability and practise this before you move to adult healthcare services.
Your parents/carers may still have an important role in helping you manage your condition when you are unable to.

Questions to ask

Travel

How will I get to the adult hospital?
Where will I park and can I access parking concessions?
Where do I get off public transport?
How long will it take to get there?
How much will it cost?

New hospital/service

Does the building have easy access (especially if I use mobility aids)?
What are the opening hours of the new hospital?
Do I connect with and feel listened to by the hospital staff?
Has the hospital had experience with young people with similar conditions to mine?

Appointments

Who do I contact?
When is my next appointment or do I have an appointment?
How do I reschedule an appointment and how much notice do I need to give?
How often will my appointments be?
How quickly can I make a time to see my doctor if I need an appointment?
Are there additional charges and if so, what payment options are there?

Links to services

What services or support networks are there for young adults?

The Royal Children's Hospital Melbourne

Transition Support Service