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Have you approached voluntary agencies? They often seek adopters for "hard to place" categories of children, which includes siblings. They also seek adopters who are open to wider age range, special needs, and other requirements.

The consultants letter is really important, so highlight that. You can also google typical life expectancy for different conditions. All of us have a risk and none of us come with guarantees. I was diagnosed with cancer not long after adopting a sibling group - and I'm a single adopter. (OK now). So agencies have to have a realistic margin of risk that they will accept. They usually have their own medical advisers who input at some stage in the approval process. Your letter is useful evidence for that step.

Sometimes agencies will suggest doing the medical bit before the rest of the approval process.

When you say voluntary agencies, do you have any information on these? We have so far tried Adopt South West and Barnardos.

We gave both of these agencies the consultants letter and it didn't seem to help with our case.

I don’t know what the replies of the agencies have been but my thinking is that they may be concerned with the unpredictability in terms timing and result of the kidney transplant. During this time and transplant, your wife’s health is more than likely to be the primary focus for both of you, so maybe they feel it would be better to get through that and once it’s done, you can focus on the adoption.

I’ve got a stable chronic condition and a letter from my consultant supporting this was enough for them. I think the local authorities/voluntary agencies want see that the condition of present that stability.

Adopt South West is a Regional Adoption Agency (RAA) and Barnado’s is a Voluntary agency. First4Adoption gives a good distinction between the different types of adoption agencies. You can have a look at Consortium of Voluntary Adoption Agencies online and search for the closest Voluntary Adoption Agencies. Depending on where you live, the local authority or a RAA may be the one dealing with adoptions.

I ended up choosing my neighbouring local authority as it seemed a better fit for me.

Thank you very much for your help. I will use the information you have provided for me and start communications with potential adoption agencies.