The Risks of Failing to Implement Regular Monitoring Upon Transition from Paediatric to Adult Care

The Risks of Failing to Implement Regular Monitoring Upon Transition from Paediatric to Adult Care

Setting The Scene

The patient had been diagnosed with a congenital cardiac condition as a child and had annual reviews at a children’s hospital to monitor their condition. The condition posed a continuing risk to the patient into adulthood, and they were advised they would need regular follow-up upon transition to adult care.

Follow-up was not instituted at the hospital the patient was transferred to for their ongoing adult care. The patient later suffered an aortic dissection.

An Increasing Litigation Risk for Healthcare Providers

TMLEP would like to highlight the litigation risk posed and the potential for claims in respect of cases of paediatric patients with complex health conditions which require ongoing monitoring upon their transition from paediatric to adult care.

It is recognised that with medical science rapidly advancing, increasingly, conditions which might once have been “considered to be confined to childhood…must now be thought of as diseases that begin in childhood but continue into adult life.” [1] With more children entering adulthood with a complex physical health condition[2] requiring ongoing monitoring in adult services, the risk of litigation in this area, should healthcare providers not implement the required monitoring, given the potential for serious complications, is something which providers should be aware of.

TMLEP would like to highlight the Care Quality Commission’s (CQC) 2014 transition report[3] and the National Institute for Health and Care Excellence’s (NICE) 2016 guidelines[4] [5] which considered the issue of transition.

References

  • 1. Viner R. Transition from paediatric to adult care. Bridging the gaps or passing the buck?. Archives of Disease in Childhood 1999;81:271-275
  • 2. Review – Preparing children and young people for transition into adult care. Nursing Times 07 October 2019. Accessed on 13 December 2019 at https://www.nursingtimes.net/roles/childrens-nurses/preparing-children-and-young-people-for-transition-into-adult-care-07-10-2019/
  • 3. From the Pond into the Sea: Children’s Transition to Adult Health Services. Care Quality Commission 2014. Accessed on 13 December 2019 at https://www.cqc.org.uk/sites/default/files/CQC_Transition%20Report.pdf
  • 4. Transition from children’s to adults’ services for young people using health or social care services. NICE [NG43] 2016a. Accessed on 13 December 2019 at https://www.nice.org.uk/guidance/ng43
  • 5. Transition from children’s to adults’ services. NICE [QS140] 2016b. Accessed on 13 December 2019 at https://www.nice.org.uk/guidance/qs140
  • The TMLEP Clinical Risk and Patient Safety Publishing Group . (2020). The Risks of Failing to Implement Regular Monitoring Upon Transition from Paediatric to Adult Care. TMLEP Clinical Risk Case Studies. 3 (9), 1.

Important Note

This article is intended to raise awareness to clinical risk issues in an effort to reduce incidence recurrence and improve patient safety. This is not intended to be relied upon as advice. Facts have been altered to ensure this case is non-identifiable, albeit clinical learning points remain applicable. To request an independent clinical review, please contact admin@tmlep.com or call +44 (0) 203 355 9796.