Transition is currently a big priority in health and social care. While the definition of transition is “the process or a period of changing from one state or condition to another,” (Oxford Dictionary 2018), within healthcare it specifically refers to the process of moving from children’s to adult services, including planning, transfer and support throughout (NICE 2016).
Children and young people go through rapid physical, psychological and social changes during adolescence, and may experience many significant transition points between healthcare services, as well as those between schools, university and other educational settings. Thirty percent of children and young people also experience transitions in relationships as a result of parental separation, divorce or remarriage (RCN 2013). These “transition” periods may be associated with a deterioration of health in young people with long term and chronic conditions, due to an impact on adherence to medication or therapy (Campbell et al 2016). The language used, and approach to these periods can be very influential in how young people may engage with health and care services.
How do you talk about change? Is it a gradual process, or a leap of faith?
The Care Quality Commission (2014) found that this period was reported to be unsatisfactory for a considerable number of those experiencing transition.
Developmentally appropriate healthcare (DAH) has been described as a key principle underpinning the practice of care for young people (Farre et al 2016). This involves identifying a readiness for change and increased responsibility, considering all aspects of a young person’s health and wellbeing. Rather than basing decisions about transition on a young person’s chronological age, we can take into account the dynamic aspect of their development.
With Me first, the communication model of shared decision making can help recognise what matters to a young person, so that plans about transition can be made in partnership.
There are many resources and guidance available to support young people and HSCPs with transition, including the NICE pathway (2016)
Allowing preparation planning and time for young people to discuss their shared goals can influence the success of transitioning to adult services, and for young people to have a positive experience of healthcare settings.
by Jessie McCulloch, Lead Practice Educator, Me first
- Campbell F, Biggs K, Aldiss SK, O’Neill PM, Clowes M, McDonagh J, While A and Gibson F (2016) Transition of care for adolescents from paediatric services to adult health services, Cochrane Database of Systematic Reviews, Issue 4.
- Care Quality Commission. (2014). From the pond into the sea: Children’s transition to adult health services. London: CQC.
- Farre A, Wood V, McDonagh JE, Parr J, Reape D, Rapley T. (2016) Health professionals’ and managers’ definitions of developmentally appropriate healthcare for young people: conceptual dimensions and embedded controversies. Archives of Disease in Childhood 2016 DOI: http://dx.doi.org/10.1136/archdischild-2015-309473
- National Institute for Health and Care Excellence (2016) Transition from children’s to adults’ services for young people using health or social care services: NICE guideline NG43, London: NICE.
- Queen’s Nursing Institute (2017) Transition from children’s to adult community services: learning resource, London: QNI.
- Royal College of Nursing (RCN) (2013) Lost in Transition. London: RCN