Background to the young adults and adolescents transition project

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There is evidence that poorly planned transition may be linked with an increased risk of young people dropping out from medical care and poor health outcomes. However, there is also evidence that age-appropriate adolescent services improve outcomes by improving attendance and retention of young people in clinical services.

What do we mean by ‘transition’?

During adolescence rapid biological, psychological and social developments take place. These developments drive transitions in nearly all parts of young people’s lives. The World Bank has identified the key adolescent transitions as:

  • from dependent child to autonomous adult
  • from primary to secondary and later education
  • from education into the workforce
  • transition into responsible and productive citizenship
  • transitions in health from dependent recipients of children’s healthcare to adults responsible for their own healthcare.

Young adults’ health outcomes and experiences

  • The 2012 annual report of the chief medical officer identified that long-term conditions outcomes are poorer in adolescents and young people compared with older adults
  • While there has been considerable attention given to transition, the implementation of transition services is variable
  • Young people aged 16–24 consistently report poorer experience of NHS care than older adults
  • The particular needs of young adults who find themselves acutely unwell for the first time haven’t been sufficiently considered
  • There are enormous risks for young people who are not adequately supported during the transition process. For example, one study found that 35% of young renal transplant recipients had lost their transplants by 36 months after transfer to adult renal care.

Transition and health

There is evidence that poorly planned transition may be linked with an increased risk of young people dropping out from medical care and poor health outcomes. However, there is also evidence that age-appropriate adolescent services improve outcomes by improving attendance and retention of young people in clinical services.

Long-term self-management behaviours for chronic conditions are usually initiated or heavily shaped during adolescence. These behaviours track strongly into adult health – therefore during adolescence there is an important window of opportunity to influence the trajectories of chronic conditions throughout later life.

For young adults and adolescents (whether those transitioning from paediatric services or those acquiring long-term conditions in late adolescence) receiving developmentally appropriate care is essential in order to have the best possible chances for good health and wellbeing throughout the rest of their lives.

The chief medical officer’s annual report recommended that effective and timely transition planning should be a routine part of all long-term condition management for children and young people.