Quality standard

Quality statement 1: Planning transition

Quality statement 1: Planning transition

Quality statement

Young people who will move from children's to adults' services start planning their transition with health and social care practitioners by school year 9 (aged 13 to 14 years), or immediately if they enter children's services after school year 9. [2016]

Rationale

Starting to plan their transition as early as possible can lead to a better experience for young people moving from children's to adults' services. Early planning allows a more gradual process. A sudden move to adults' services with no time for preparation or support can lead to young people, and their families and carers, losing confidence and to stop using services. Early planning, led by the health and social care practitioners but with full involvement from the young person and their family or carers, allows them more time to be involved in decisions and to adjust to changes to their future care. It is recognised that for some young people, those covered by health and social care or education legislation, early transition planning is already a legal requirement.

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

a) Proportion of young people in school year 9 (aged 13 to 14 years) who will move from children's to adults' services who have started planning their transition.

Numerator – the number in the denominator who have started planning their transition.

Denominator – the number of young people in school year 9 (aged 13 to 14 years) who will move 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.

b) Proportion of young people entering children's services after school year 9 and who will move to adults' services who started planning their transition immediately.

Numerator – the number in the denominator who started planning their transition immediately.

Denominator – the number of young people entering children's services after school year 9 and who will move 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.

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 a 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 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 hospital 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 locally 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' health, mental health and social care providers) ensure that systems are in place to identify young people who will move from children's to adults' services and to start involving them and their families or carers in planning their transition by school year 9 (aged 13 to 14 years), or immediately if they enter children's services after school year 9.

Health and social care practitioners (such as hospital consultants, nurses, GPs, social workers, mental health workers, care coordinators or named workers) involve children and young people, and their families or carers, in planning their transition from children's to adults' services by school year 9 (aged 13 to 14 years), or immediately if they enter children's services after school year 9.

Commissioners ensure that they commission services that identify young people who will move from children's to adults' services and start planning their transition by school year 9 (aged 13 to 14 years), or immediately if they enter children's services after school year 9. Commissioners should ensure that the planning involves the young person and their family or carers, as well as the practitioners.

Young people who will move from children's to adults' services work with their health or social care practitioners to start planning for the move by school year 9 (aged 13 to 14 years). For young people who enter children's services after year 9, planning for the move should start immediately. Early planning gives young people time to be involved in decisions and to understand and adapt to changes in their future care.

Families and carers of young people who will move from children's to adults' services are involved from the start in planning for the move. This gives them time to understand and to adapt to changes in the young person's future care. Their level of involvement will depend on the needs and preferences of the young person.

Equality and diversity considerations

It will be important to adapt the timing and approach to transition to reflect the needs of young people with a learning disability or neurodevelopmental needs or both. Health and social care practitioners should ensure that the starting point for transition planning is developmentally appropriate and considers each young person's capabilities, needs and hopes for the future, addressing their biological, psychological and social development in the broadest terms.

Transition support should take into account the young person's maturity, cognitive abilities, psychological status, needs in respect of long-term conditions, social and personal circumstances (including culture and beliefs), caring responsibilities and communication needs. [NICE's guideline on transition from children's to adults' services for young people using health or social care services, recommendations 1.1.2 and 1.2.3, terms used in this guideline and expert opinion]