Moving from Child to Adult Healthcare

Over the coming editions of our newsletter, we’ll be shining a spotlight on one of the most important and often overlooked parts of a young person’s healthcare journey: the transition from paediatric to adult services.

As children grow into young adults, their medical care needs to grow with them. This transition can be both exciting and challenging, not just for the young person, but for their whānau as well. Our goal is to guide you through this process, step by step, offering practical advice, real-life stories, and expert insight to help make the shift as smooth and supported as possible.

What is Healthcare Transition? For many young people and their families, the idea of leaving the comfort and familiarity of a children’s hospital can feel daunting. After all, it’s the place where you’ve grown up, known your doctors and nurses by name, and become familiar with the routines. But just like learning to drive or moving out of home, transitioning from child to adult healthcare is a significant and important step on the road to independence. It’s not a single moment or one-time event - it’s a process. Navigating this process successfully begins with the first step of understanding that process.

Why Transition is Necessary

Children’s hospitals and paediatric healthcare teams are uniquely designed for young patients. These environments are built with children and their developmental needs in mind - from the colourfully decorated rooms to the way information is explained. Paediatricians are trained to care for growing bodies, manage conditions that begin in childhood, and work closely with families as key decision-makers. Adult healthcare is different. It’s less about the family unit and more about the individual. The focus shifts from parents managing health on behalf of their child to the young adult becoming the primary person responsible for their care. Adult hospitals are structured around adult diseases, independence, and often assume a level of self-management. So, why change? The key reason is that medical care needs to change as patients grow. The tools, treatment approaches, and specialists in adult medicine are better suited for adult bodies, lifestyles, and long-term care. Transitioning helps ensure that young people continue to receive appropriate, high-quality healthcare as they enter adulthood.

A Process, Not an Event

Think of healthcare transition like learning to drive. You don’t wake up one morning and hop on the busiest motorway in the country without preparation. First, you learn the road rules, then you practice in safe environments, gradually take on more responsibility, and eventually earn your license. Healthcare works in a similar way. Transitioning from a paediatric system to an adult one takes time, planning, and support. The process usually begins in early adolescence - sometimes around age 12 or 13 - with conversations about future independence and health goals. It builds gradually from there, with increased involvement of the young person in appointments, decision-making, and managing their own health. By the time they “graduate” to adult care, they should ideally be ready to take the wheel. Importantly, transition is not the same as “transfer.” Transfer is the actual move from one clinic or hospital to another. Transition is the journey that prepares you for it.

Why This Matters to Families

For many families, the healthcare journey has been shared; appointments attended together, medications managed by parents, decisions made as a team. Letting go of that role can be emotionally challenging. Parents might worry: “Will they remember their appointments? Will they ask the right questions? Will they know what to do if something goes wrong?” These concerns are completely valid. That’s why it’s so important to start the transition process early and take it step by step. The aim is to build confidence and independence over time, not throw young people in at the deep end. Parents and caregivers still have an important role, even if that role looks different to what it used to be. Involving families in the transition process through open communication, gradual shifts in responsibility, and ongoing support makes it far more successful. It also ensures that the young person feels supported rather than abandoned or anxious.

Transition Clinics vs. Direct Handover

Depending on the medical specialty, the transition might be handled in different ways. Some areas of healthcare have dedicated transition clinics where paediatric and adult care teams work together to support patients through the changeover. These clinics often include joint appointments, educational resources, and a structured plan. For example, a teenager with a chronic kidney condition might attend a transition clinic where both their paediatric nephrologist and their future adult nephrologist meet with them. This gives the patient a chance to build trust with their new team before officially transferring. Other specialties might not have formal transition services. In these cases, the process is often a ‘direct handover’ where the paediatric team refers the patient to an adult provider. While this can work well, it may require a bit more preparation and communication from the patient and their family to ensure nothing gets lost in translation.

Regional Differences in New Zealand

In New Zealand, some children with specific conditions are cared for under national services at places like Starship Children’s Hospital in Auckland. These services draw patients from across the country and often involve highly specialised care. However, adult healthcare is usually provided regionally. That means a young person treated at Starship might be transitioned to a different hospital nearer to their home when they reach adulthood. Because of this, transition can look very different depending on where you live. A young person in Christchurch might transfer to a different team and system than someone in Wellington or Hamilton, even if they’ve been treated for the same condition. That’s why local support and planning are so important. Your local District Health Board (DHB), General Practitioner (GP), or adult hospital should be part of the conversation early on, so that everyone is prepared for what’s ahead.

Share Your Story – Help Others Navigate Healthcare Transition

Have you (or your teen) recently made the move from paediatric to adult healthcare services? Whether the experience was smooth, surprising, or a bit of a learning curve - we’d love to hear from you! We’re looking for young people and families willing to share their stories about transitioning to adult care. Your insights can help others feel more prepared and less alone on their journey. If you’re open to being interviewed or featured in an upcoming newsletter (you can choose to remain anonymous if preferred), please get in touch with us office@idfnz.org.nz.

Your voice could make a real difference.