Young people with chronic respiratory conditions and/or respiratory complications, including cystic fibrosis, neuromuscular disorders, and bronchiectasis, often experience a marked shift in care approach when transitioningto adult services. The transition from paediatric to adult healthcare represents a critical period for young people, yet current pathways within respiratory physiotherapy remain highly variable, inconsistently resourced, and insufficiently aligned with the developmental needs of adolescents and young adults. Paediatric models typically emphasise family involvement (family centred care), frequent monitoring, and structured support, whereas adult services prioritise autonomy, self‑management, and independent decision‑making. These contrasting expectations can lead to reduced engagement and compliance with home programmes, diminished adherence to airway clearance techniques, and increased vulnerability to deterioration during early adulthood. Clinical challenges are compounded by inconsistencies in physiotherapy respiratory management strategies, including variation in airway clearance education, equipment provision, and access to specialist adult respiratory physiotherapists.

System‑level barriers can further complicate the transition process. Fragmented communication among multidisciplinary teams, incompatible digital records (whether digital or paper-based), and limited service capacity contribute to delays, duplication, and the loss of essential clinical information with a subsequent reduction in healthcare service delivery. Workforce pressures and resource limitations (human or financial), particularly within adult respiratory physiotherapy, create additional constraints that limit the ability to provide personalised, developmentally appropriate transition support. These structural challenges and limitations disproportionately affect young people from socioeconomically disadvantaged backgrounds, amplifying existing health inequalities.

Despite these numerous challenges in transition into adult care, emerging evidence highlights several models of good practice. Structured transition programmes, collaborative clinics, and personalised, targeted physiotherapy‑led education have demonstrated improvements in patient confidence, treatment adherence, and service engagement. Digital tools, including remote monitoring, app‑based reminders, and telehealth consultations, offer promising avenues to enhance continuity and accessibility, particularly for young adults balancing education, employment, community participation and increasing independence. Incorporating patient perspectives is essential, as qualitative studies consistently show that young people value gradual transition processes, consistent messaging, and opportunities to build trusting relationships with adult clinicians before transfer.

This symposium brings together clinical experts, researchers, and patient advocates to examine the challenges that undermine effective transition and to explore evidence-informed strategies to strengthen continuity of care, promote self-management, and improve long-term respiratory outcomes. Presentations will address developmental, functional, perception and psychosocial factors influencing transition readiness, clinical and technical challenges in transferring physiotherapy skills, and system‑level constraints affecting service delivery. Through interactive discussion and audience engagement, participants will explore opportunities to redesign pathways, strengthen multidisciplinary collaboration, and embed patient‑centred approaches within their own practice. This engagement has the potential to improve transition processes, thereby maintaining respiratory stability during early adulthood, whilst empowering young people to manage their long‑term health with confidence and autonomy.

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