Transition of care review

Healthwatch Norfolk was commissioned by Norfolk Community Health and Care (NCH&C) to investigate the experiences of young people, their families/carers, and professionals of the move from children’s to adults’ health and care services, known as transitioning, across Norfolk. They received a total of 51 responses to their surveys and interviewed 8 people.  

There is a variation in levels of support experienced depending on the service/specialty that was being accessed. This was more apparent for those with complex health needs accessing multiple services.

They received the most feedback from people who had transitioned from child to adult mental health services. Ensuring consistency of support during transition would lead to the improvement of health outcomes for young people.

There was a mismatch between professionals and public feedback regarding communication and information. Young people and their families/carers felt that the communication from and between the services was lacking, finding that in some cases communication just stopped and young people were left on waiting lists with no support. Whilst professionals felt that they were providing plenty of information, young people and their families/carers told us they weren’t receiving this. The information and communication is not clear for all involved in the transition process and this means that young people and their families/carers are left confused and feeling like the support is not there.

Parents wanted to be more involved in the transition process, with guidance and involvement in transition care plans. This is so they have a better understanding of how they can support their young person. Consideration for including parents more where possible, and maintaining the privacy and independence of young people, would aid in easing the concerns of parents/carers.

Finally, the planning process could be improved by ensuring that these are made with young people and their families/carers in a way that is easy for them to understand. Having heard that complicated paperwork can cause confusion for families, providing support through a point of contact would help answer concerns as plans change with time. Additionally, lining-up children’s and adults services’ systems (e.g., by using the shared-care record) would ensure that all who needed to, had access to records and plans so patients wouldn’t feel like they are retelling their story.

The report contains five recommendations about gathering feedback, improving communication, establishing keyworkers, reviewing the planning process and involving parents and carers.