GOSH lies in caring for patients up to 18 years, adolescent expertise is limited, as it is nationally. Conversely, UCLH has a unique expertise in complex and specialist adolescent care, which could assist the transition planning for those children with the most complex needs. Based on our data, children with motility and functional-GI disorders commonly require a transition plan spanning multiple adult services and require the expertise of the adolescent MDT including psychology, social work, youth work, psychiatry, physiotherapy and occupational therapy. A commissioned joint transition service between GOSH and UCLH would facilitate best practice and provide an exemplar of clinical care for young people with complex health problems.

O11 Figure 1 Current algorithm for the management of paediatric Achalaosia *Secondary care has the option to refer initially to paediatric gastroenterology or paediatric surgery

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