Table of Contents

The prevalence of Type I diabetes is rising amongst adolescents in Europe, placing them at greater risk of psychiatric disorders and of health problems arising from complications of the condition itself. At the point of transfer to adult services, adolescents with diabetes are at risk of disengaging with services and at increased risk of health problems. There is some agreement regarding the factors that make up a good transition process but as yet only a small number of studies evaluating healthcare services in this area. The principles of transition have been well documented in the literature, but a key element in designing and accommodating transition services involves change in healthcare systems. The present study aimed to explore this from the point of view of nine health professionals who were involved in implementing a new ‘Transition Pathway’ service. Individual interviews were carried out and analysis was conducted using a qualitative ‘Framework’ approach. Overall themes emerged which described the importance of three elements; first, the compatibility of the Transition Pathway tasks with existing roles and skills; second, its sustainability in the long-term and the factors that would support this and third, the need for those designing and delivering it to be accountable to the people it is designed for. These findings are discussed within the context of the literature on managing organizational change in the public sector and recommendations are suggested for those factors which need to be considered when implementing transition services locally.

Keywords: Adolescents, diabetes, transition, qualitative, healthcare organizations.