Transition for Children with Complex Health Needs and Long Term Conditions

The provision of a community health transition service for young people who have complex needs and long term conditions from children’s services to adult services

Coronavirus (COVID-19) 

Referral criteria

The service is available to young people who have a Southampton City GP and are aged between 14 and 19. The young person may have a statement of educational needs, although increasingly children who may have significantly complex health needs may be on school action or school action plus where schools are being required to provide services from within their own resources. The transition service is also available to these young people. Depending on the expertise within the school, there may be widely differing approaches to highlighting and dealing with the young person’s complex needs and knowing where the young person will receive their health services after they leave the school health system. The health transition service provides expertise in transition planning for these young people.

If the young person has a Statement of Educational Need, there is also likely to be a history of complexity of involved services. The young person may be eligible for a multi agency core assessment which could form the basis of a transition plan. Each of the involved services will be considered in the transition plans and reviewed for the continued need into adult services.

Referral is directly to the Senior Transition Nurse Specialist. Referrals may be made by Health Professionals or other agencies. It is likely that the young people being referred are already within the system of requiring complex needs health services and the transition process dovetails with the services already in place.