Transition from children’s to adult services

Increasing numbers of children with longterm conditions are surviving into adulthood because of improved healthcare, and research has demonstrated a steady increase in the number of children living into adulthood with a life-limiting condition (Fraser et al, 2012).

Adolescence is a time of moving to independent use of healthcare. Successful management of ongoing conditions can reduce the need for emergency care and improve outcomes. Continuity of care is vital in longterm conditions such as diabetes, kidney disease and epilepsy as well as mental health (Royal College of Nursing, 2004; Singh, 2009; Allen et al, 2010; Brodie et al, 2011; Joint Commissioning Panel for Mental Health, 2012; Hepburn et al, 2015). Good transition programmes have been shown to result in statistically significant improvements in young people’s health outcomes (Crowley et al, 2011).

However, there are very few data on young people’s journeys through the transition from child services to adult services. A CQC report on children’s transition to adult health services reported only a quarter of young people in child and adolescent mental health services transitioned to adult services at 18. Of thus, up to half then disengage from adult services. (Care Quality Commission, 2019).

Transition to adult services is also less than satisfactory for a range of physical health conditions. Chart 7.10 presents the CQC table summarising current gaps in transition services for cancer, epilepsy, and autism in addition to mental health. 

Evidence is growing that elements of successful transition programmes are patient education and specific transition clinics (Crowley et al, 2011). Northumbria Healthcare NHS Foundation Trust and Newcastle University recently completed a five year programme of research on transition (Colver et al, 2019). The team concluded that key elements of good transition programmes included commitment from senior providers and commissioners, trust-wide approaches to transitional health care, joint work between adults’ clinicians, children’s clinicians and general practitioners in planning transition procedures, appropriate parental involvement, specific promotion of young people’s confidence in managing their own health, and opportunities to meet the adult team before transfer.

All data correct as of 1st November 2021