Table 1

Recommendations for best practice

• Transition preparation must be seen as an essential component of high quality health care in adolescence
• Every paediatric general and specialty clinic should have a specific transition policy. More formal transition programmes are necessary where large numbers of young people are being transferred to adult care
• Young people should not be transferred to adult services until they have the necessary skills to function in an adult service and have finished growth and puberty
• An identified person within the paediatric and adult teams must be responsible for transition arrangements. The most suitable persons are nurse specialists
• Management links must be developed between the two hospitals.13 Within the new NHS, contracting and financing issues must be worked out in detail. Local commissioners must be consulted when patients are transferred from one tertiary centre to another
• Large children’s services should develop a “transition map” detailing where and how transfer occurs specialty by specialty
• Evaluation of transition arrangements must be undertaken