AT A GLANCE
THE CHALLENGE
There were variations in the way young people aged 14 to 25 years transitioned from child to adult mental health services across the trust leading to inequities and different experiences.
Across more than 20 teams, only two dedicated transition staff appeared to be in post with some services relying on the goodwill of staff to take on responsibility for transition. In some areas, transition was discussed at formal multi-agency planning meetings but in others there was a need for greater communication between services as well as more education for staff, families, carers and young people. A large number of young people aged around 18 years old were accessing crisis services – particularly those transitioning into adult mental health services.
WHAT THEY DID
The CLEAR project team carried out five weeks of clinical engagement through 10 focus groups and seven small group interviews with more than 85 mental health team staff. An extra focus group involving the Patient Participation and Engagement (PPE) team provided insights from a patient’s perspective. This information was analysed alongside quantitative data for a 10-year period from November 2011 to identify key challenges and develop new ways of working.
CLEAR RECOMMENDATIONS
A new trust-wide transition patient pathway could be created, with a dedicated team consisting of a part-time transition lead, two care navigators, an administrator with oversight from an existing band 8a manager.
The transition team would be responsible for establishing quarterly meetings where all young people approaching transition into adult mental health services would be discussed. It would oversee and monitor information on patients who are transitioning and lead education around transition across child and adult services as well as in GP practices and schools.
Recommended quick wins included a new patient feedback form for the PPE team to gather information about the transition process, a standardised information pack to support young people through the process, a new health passport recording a young person’s medical history, preferences and values, and joint away days for staff between children and young people and adult services.
FORECAST IMPACT
Improved support for young people throughout the transition process would reduce the need for crisis intervention and inpatient admissions.
A total of 424 young people from the transition cohort were accessing crisis services on an annual basis, this would fall to 381 with a 10% reduction and 297 with a 30% reduction.
Overall, potential productivity savings of between £258,636 and £775,907 could be achieved from a 10-30% reduction in access to crisis services and adult, child and learning disability admissions. The cost of additional staff is estimated at £128,656, resulting in an overall saving after investment of up to £647,251.
Services would be more streamlined and efficient with staff having a regular forum to discuss transition cases and greater understanding of the process. Formalised patient feedback would make young people feel their voices were being heard while leading to service improvements.
