Achieving NICE transition-related standards of care for young people with long-term conditions A quality improvement project

S Barrow, O Wilkey , North Middlesex Hospital

Diagnostics Fishbone Diagram

Moving from paediatric to adult services is a difficult time for young people with complex health needs. Evidence suggests that effective transition between services can improve longterm outcomes. There has recently been a drive to refine and improve the transition process through the NHS Long Term Plan.

Aim

This quality improvement project aimed to better achieve the NICE Quality standards for transition for 6 sub-specialties in one paediatric department, across a nine-month period as part of the transition paediatric improvement plan.

Measurement

An initial gap analysis was undertaken using 11 NICE quality transition-focused standards of care to demonstrate current performance of services for transition for 6 sub-specialties: allergy, asthma, diabetes, epilepsy, HIV, and sickle

Change Ideas

• Regular transition workshops and progress meetings

• Implementation of the Ready, Steady, Go, paperwork

• Time-bound action points for each sub-specialty

• External talks from a transition improvement manager

• Joint transition clinics between paediatric and adult services for certain sub-specialities

• Application for funding for a new epilepsy transition specialist

Results Run Chart

Discussion

• Initial baseline measurement in April 2021, showed: 36% of standards were unmet , 18% of standards were partially met & 45% of standards were met across the 6 sub-specialties.

• Following implementation of change ideas, met standards increased to 58%.

• Specialties such as asthma & epilepsy showed significant improvement in partially meeting or meeting standards.

Reflections & Learning

• This QI project has enabled one paediatric department to better achieve NICE transition standards of care for young people with long-term conditions.

• Further work is needed to ensure young people & their families are actively involved in the design, delivery, & evaluation of services for transition (standards 1&2).

• Continuous work is required to ensure that transition-related standards of care are met for young people when moving to adult healthcare services.