Objectives Current processes for the transition of young people with long-term health conditions from children’s or adolescent health services into adult services are disjointed, often falling short of what can be described as a ‘good experience’. Consequences for young people are many, including deterioration in health, disengagement from services, with short-and-long term effects. Following the successful development of an exemplar Model of Improvement for Transition at Leeds Teaching Hospital Trust, a National Transition Nursing Network was implemented across England in 2020, funded by the Burdett Trust for Nursing. This network includes a Lead Nurse for Transition and four Regional Nurse Advisors (RNAs) covering four regions across England. Influence and impact of this network and its approach to evaluation is our focus.
Methods Pre-and post-role implementation data were collected through discussion with, and evidence produced by, organisations on measures which include: evidence of transition lead roles for a whole organisation; number of organisations working through a transition Quality Improvement (QI) process; those with a transition contact; with Transition Executive Lead; QI transition pathways completed; health-based youth workers in post; processes in place to use feedback from young people on service improvements; effective transition governance processes e.g. transition board, steering group, organisational policy and reporting. Stakeholder groups included in the QI process include: hospitals (children’s and adult); community care; primary care; mental health; palliative and hospice care; and learning disability services.
An evaluation of this QI model for transition implementation is also underway, conducted by researchers at the University of Surrey, in collaboration with the Burdett National Transition Nursing Network. The National Transition Evaluation Study utilises a multi-centre concurrent mixed methods design, with qualitative (interviews/auto-ethnography/case studies), and quantitative descriptive (surveys) data collected simultaneously over three phases with: young people, parents, transition champions and key professionals involved in the young person’s transition journey.
Results Reporting on the two years since implementation, there has been an increase seen across all measures, confirming that the RNA role is having a positive impact on transition. Hospitals have engaged well with the QI process, but still transition work needs to be expanded across whole organisations, with sustainability plans needed. Developing a model of care for young people in primary care, those with learning disabilities and those receiving primary care mental health has been identified as a particular challenge, and will be a targeted focus in year three. Sharing knowledge, learning and tools through regional meeting and Community of Practice events has been invaluable, with up to 180 participants at each event.
Conclusions The QI process has provided structure and guidance. As an intervention, the RNA roles have influenced change over time. In this presentation, we will use data to illustrate where change has occurred and indicate what might have influenced that change. We will present our approach to evaluation, used to examine processes, to not only describe what has worked, but why, for who and in what context. This learning is essential to inform both practice, policy and future research.
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