Transition from child to adult health care services

Until the age of 18, services for children and young people with long-term health conditions are provided by child health and social care services. From 18, they're usually provided by adult services.

Before a young person turns 18, they will start a transition to adult services.

Where someone has a long-term health condition their care may be transferred to an adult health service or overseen by their General Practitioner (GP) once they leave children's services.

There are not usually like-for-like health services for adults, and criteria is often different, so it is important to understand how on-going needs will be supported.

The term 'transition' describes the purposeful and planned process of supporting young people to move from children's to adult's services.

Transition begins at an age to suit each young person but professionals should consider introducing the idea of transition around the age of 14 and then to prepare the young person and their family and carers for what to expect at key stages of the transition journey, for example, legal changes that happen at age 16 and financial changes happen at 18.

Herefordshire and Worcestershire Integrated Care System (ICS) have developed a range of resources to support transition from children's to adult's services:

How the transition to adult's health care services may look

13-14 years

  • Children's health practitioners should have begun to talk to the young person and their family about moving on in the future to adult services
  • The young person and their parent carer will be introduced to the concept of shared decision making and confidentiality
  • When ready, the young person can be seen on their own for a few minutes during clinic

14-16 years

  • The young person will have different issues addressed in bite-sized pieces
  • They will be invited to be seen on their own for longer when in clinic
  • The parent carer will continue to be fully involved
  • Duplicate clinic letters will be offered to the young person
  • They will agree some goals for the future

In addition, young people with a learning disability and/or autism will be offered an annual health check with their GP.

16-18 years*

  • The young person will begin to conduct the whole clinic session on their own
  • Parent carers will continue to be involved
  • A referral letter will go to the adult team and the young person will meet the adult team
  • Any ongoing issues will be highlighted to the adult team, ideally before transfer
  • A transfer letter will be written

*16-18 years may include up to the age of 25 years for young people with an Education, Health and Care Plan (EHCP).

18+ first adult clinic

  • Issues continue to be addressed in bite-sized pieces
  • Clinic letters will be sent to the young person and any issues will be addressed
  • The young person and health practitioners will continue to agree goals with the young person

Making decisions when young people have special educational needs and disabilities (SEND)

When a young person reaches 16 years old, they have a right to make their own decisions. This is something which is stated by law in the Mental Capacity Act.

People make decisions every day - some are small like deciding what food to eat and some are big like choosing where to live or whether to go to college.

Some people can make all decisions themselves, some can make a few and some people find it hard to make any decisions at all and need someone else to do it for them.

People with learning disabilities or special educational needs can sometimes find it hard to make decisions. The ability to make decisions is different for everyone.

The Mental Capacity Act helps to address this. It applies to everyone older than aged 16 and starts with the assumption that everyone older than 16 is able to make their own decisions.

Find out more about the Mental Capacity Act and the role of parent carers.

Transition to hospice or palliative care

A young person's transition journey may involve moving on from services provided by a children's hospice.

Hospice UK is the national charity for hospice and end of life care and has information that you may find useful.

Hospice and specialist palliative care services in Herefordshire

Under 18 - Acorns Children's Hospice

Acorns Children's Hospice (0-18) provides a holistic range of services for children and young people up to the age of 18 who are life limited, and life threatened.

The services are available 24 hours a day, 365 days a year across three hospice sites in Birmingham, Walsall and Worcester.

Acorns for the Three Counties, based in Worcester, supports families from Worcestershire, Herefordshire, Gloucestershire and South Warwickshire.

Herefordshire 18+ - St Michael's Hospice

St Michael's Hospice's professional staff and trained volunteers are committed to improving the quality of life for their patients and their families and carers.

They offer day services (including specialist clinics), inpatient services, a Hospice at Home Service and support for families and carers (including financial advice and practical support).

Hospice at Home Service

For patients who wish to stay at home, St Michael's Hospice provide a Hospice at Home Service.

Hospice care staff visit you at home to offer support and discuss your care.

Towards the final stages of your illness, they can arrange for hands-on nursing care in your home at times when you and your family need it.

You can self-refer to St Michael's Hospice, or a referral can be made on your behalf by a health and social care professional or family member. For more information, see the St Michael's Hospice making a referral page.