The landscape of transition is complex and variable. There is variability at the level of individuals (whose transition needs may be quite different), at the level of service provision, and in the type of health and social care system. The ability to understand and measure these variables in the process of transition, and how that may relate to the outcome for individuals is important. Such metrics will begin to inform how best to tackle complexity and variation in all these areas. The direction of travel for many adults with long term childhood conditions is largely unknown.
The evidence base for current practice is weak but growing. Guidance needs to be widely applicable—to support a range of individual conditions and circumstances without being so vague as to be unhelpful. Key to informing guidance are outcomes reported by service users (whether patients, their families or others). We must remember that transition from paediatric to adult care needs to include health and social care, psychosocial development, and education. Trying to find a way of measuring process and outcomes will guide the further development of transition planning.
KeywordsGuidelines Outcome metrics Long-term outcomes Service planning Commissioning Transition Transfer
Both ARW and ARJ have had formal roles with NICE relating to transition. ARW is a current member of a NICE standing committee.
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