Quality standard

Quality statement 5: Meeting a practitioner in adults' services

Quality statement 5: Meeting a practitioner in adults' services

Quality statement

Young people who are moving from children's to adults' services meet a practitioner from each adults' service they will move to before they transfer. [2016, updated 2023]

Rationale

Young people, and their families and carers, may feel unsure about moving to adults' services, especially if they have been with children's services for a while. Meeting a practitioner who will take a lead role in their future care, at least once, from each of the adults' services they will move to can help build a young person's confidence, reduce their concerns and increase their willingness to have new practitioners involved in their care. This can lead to a smoother transition for the young person and more regular attendance at appointments in adults' services, with better outcomes.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Process

Proportion of young people who moved from children's to adults' services who met a practitioner from each adults' service they moved to before they transferred.

Numerator – the number in the denominator who met a practitioner from each adults' service they moved to before they transferred.

Denominator – the number of young people who moved from children's to adults' services.

Data source: Data can be collected from information recorded by health and care practitioners and provider organisations, for example from patient or client records. Data on attendance at a joint transition clinic is included in the National Confidential Enquiry into Patient Outcome and Death transition from child into adult healthcare audit toolkit which can be implemented locally.

Outcome

a) Proportion of young people (and their families and carers) who have transferred from children's to adults' services, who were satisfied with planning for transition and transfer (including their involvement).

Numerator – the number in the denominator who were satisfied with planning for transition and transfer (including their involvement).

Denominator – the number of young people (and their families and carers) who have transferred from children's to adults' services.

Data source: Data can be collected from information recorded by health and care practitioners and provider organisations, for example from patient or client survey. Resources to support this could include the TIER Ready, Steady, Go programme which includes feedback on transition planning in its questionnaires for young people and their families and carers. Also, the National Confidential Enquiry into Patient Outcome and Death transition from child into adult healthcare young person and parent carer survey includes questions on transition planning.

b) Rate of non-attendance at meetings or appointments in adults' services for young people who were expected to transfer from children's to adults' services.

Data source: Data can be collected from information recorded locally by health and care practitioners and provider organisations, for example from patient or client records. For example, NHS Digital's hospital episode statistics (HES) includes data on outpatient appointments and attendances.

c) Proportion of young people attending adults' services after transfer from children's services who continue to engage with services.

Numerator – the number in the denominator who continue to engage with services.

Denominator – the number of young people attending adults' services after transfer from children's services.

Data source: Data can be collected from information recorded by health and care practitioners and provider organisations, for example from patient or client records. For measurement purposes, this could be defined as engagement at 1 or 2 years after transfer or engagement at a specific age (such as 25 years) but can be adapted to fit local service characteristics.

What the quality statement means for different audiences

Service providers (children's and adults' service managers) ensure there are systems in place for young people to meet a practitioner from each adults' service they will move to before they transfer from children's to adults' services. These may include joint appointments, joint clinics, virtual meetings, and pairing of a practitioner from adults' services with one from children's services. Children's services should consider ensuring that practitioners work with the young person to create a personal folder with key information to help with their introduction to adult's services.

Health and social care practitioners from adults' services (such as hospital consultants, nurses, GPs, social workers and mental health workers) meet the young people who will move into their service before they transfer. This meeting should help them to identify the support the young person will need to prepare for adult life and maximise their independence.

Commissioners ensure that they commission adults' services in which practitioners meet young people before they transfer from children's services.

Young people who will move from children's to adults' services meet someone from each of their new adults' services before they transfer, to help them feel more confident about the move.

Equality and diversity considerations

Health and social care practitioners should consider the young person's travel and communication needs and preferences when deciding on the format for the introductory meeting with adults' services.

Service managers should ensure a range of support is available, and used, to help young people communicate effectively when they meet practitioners from adults' services. This could include having a written record of how a young person prefers to communicate, such as a communication passport or 1-page profile, and using different ways to help the young person communicate, such as communication boards, digital communication tools and advocacy. [NICE's guideline on transition from children's to adults' services for young people using health or social care services, recommendations 1.2.11 and 1.2.12]. For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard or the equivalent standards for the devolved nations.