DH Policy on transition - Karen Turner

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DH Policy on transition - Karen Turner

NHS Improving Quality held an event in London on 31 July 2013 to progress the children and young people transition to adult services work with a focus on turning the rhetoric into practice entitled “Working to Define a Generic Service Specification for Transition”

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DH Policy on transition - Karen Turner

  1. 1. DH Policy on transition Karen Turner 31 July 2013 1
  2. 2. Transition from children’s to adult services •Moving from children’s to adult services is often a challenge •Young people, at the point of transition, often feel that the system is fragmented and they have to tell their story repeatedly, to different professionals •There is no adult equivalent of a paediatrician •Settings are far from age-appropriate (e.g. hospices and in-patient wards) •Services and professionals do not always take a holistic view of the young person or take into account all of their needs •Improving this transition has been a health policy priority for successive governments 2 DH Policy on transition
  3. 3. Transition and Integration • The transition from children’s to adult services does not currently deliver that person-centred, coordinated care which should result from integration • “I can plan my care with people who work together to understand me and my carer(s), allow me control, and bring together services to achieve the outcomes important to me.” [National Voices/NHS England – A Narrative of Person-centred, Coordinated Care (2013)] • This should be the experience of children making the transition to adulthood 3 DH Policy on transition
  4. 4. Children and Young People’s Health Outcomes Forum • • • Jointly chaired by Christine Lenehan and Professor Ian Lewis. Launched 26 January 2013 Membership brings together a wide range of expertise, commitment and knowledge of children and young people’s issues Tasked with giving independent advice on : – the health outcomes that matter most for children and young people; – how well these are supported by the NHS and Public Health Outcomes Frameworks; – how the different parts of the health system will contribute and work together in the delivery of these outcomes. 4 DH Policy on transition
  5. 5. • Forum recommendations : indicators relevant to transition bands up to 25 to All data should be presented in 5 year age enable effective monitoring of transition • Inclusion of children and young people within existing patient experience surveys (e.g. GP Patient Survey) • Children’s experience of care following transfer from paediatric services to adult services – ensuring children continue to receive the care they need etc • Use of NHS number as a unique identifier to bring together health, education, and social care data 5 DH Policy on transition
  6. 6. Transition from children’s to adult services : levers • • • • 6 The Mandate asks NHS England to ensure smooth transition between children’s and adult services. NHS England is legally required to pursue the objectives in the Mandate. CCGs have a statutory duty to act consistently with the Mandate NICE are developing quality standards and guidance in relation to ensuring quality outcomes in transitions between childhood and adulthood The Children and Families Bill introduces joint arrangements for assessing, planning and commissioning services. Education, Health and Care Plans will set out support services for children and young people from 0-25, with a new focus on improvement outcomes, including future employment and independent living The Care Bill supports transition by giving local authorities powers to access children, young carers of children under the adult statute, and has new protections to ensure services under children’s legislation must continue to be provided after the young person’s 18th birthday, until assessed for adult care and support DH Policy on transition
  7. 7. Transition – young people with poor mental health • • 7 There are wide variations in the way transitions from CAMHS to adult services are handled The Government’s mental health strategy – “No health without mental health : a cross-government mental health outcomes strategy for people of all ages”, published in February 2011, states that care and support for young people going through transition needs to be age and developmentally appropriate, involving careful planning to avoid unnecessary disruptions in care. The strategy also confirms that services can improve transition, by : – planning for transition early, listening to young people and improving their self efficacy; – providing appropriate and accessible information and advice so that young people can exercise choice effectively and participate in decisions about which adult and other services they receive; and – focusing on outcomes and improving joint commissioning, to promote flexible services based on developmental needs. DH Policy on transition
  8. 8. DH Policy Research Programme – research on transition in adolescent health • • • Recent research has established what young people want and how good transition improves outcomes. Such evidence has resulted in a decade of clear guidance to health services on the importance of providing good transitional care in England. This guidance has resulted in improved practice in some conditions, e.g. diabetes and renal transplantation. Despite this, and subsequent initiatives, such as the Transitions Champions programme, there appears to have been limited change in the majority of health services in England Barriers to improved transition lie in both the paediatric and adult healthcare systems and in the relationships between these two systems. Similar problems are experienced in most international health systems The Children and Young People’s Policy research Unit (CPRU), will : – explore the potential movement of the transition point to 24 years of age, and likely effects on the quality of improved disease control and adherence; – examine the implications for health professional training and practice 8 DH Policy on transition
  9. 9. NIHR funded research on transition • A £2m programme to provide evidence to help NHS Commissioners and Trusts allocate resources to facilitate successful transfer of young people with complex health needs from child to adult services • Led by Professor Allan Colver, Professor of Community Child Health, Newcastle University • Aims to identify a small number of key components of transition arrangements for which there is an evidence base; and for which there are outcome measures against which implementation of these components can be judged, using an audit tool, in NHS environments. 9 DH Policy on transition
  10. 10. NIHR funded research on transition • A £2m programme to provide evidence to help NHS Commissioners and Trusts allocate resources to facilitate successful transfer of young people with complex health needs from child to adult services • Led by Professor Allan Colver, Professor of Community Child Health, Newcastle University • Aims to identify a small number of key components of transition arrangements for which there is an evidence base; and for which there are outcome measures against which implementation of these components can be judged, using an audit tool, in NHS environments. 9 DH Policy on transition

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