Table 2

Overview of findings from cross-jurisdictional scan for Australia and the UK

AustraliaThe UK
  • ▸ Both countries released high-level strategies and/or pilot programme investments; however, neither government has implemented system-wide policies related to transition of care.25 27–30

Vision, Mission and Principles
  • ▸ Both countries highlight the need for young people to take responsibility for their health and well-being, the importance of patients’ ownership over transition and the value of well-coordinated care.26–30

  • ▸ Both countries highlight the need for:

    • – Specialised supports to optimise accessibility for rural and vulnerable groups.

    • – Appropriate services (ie, culturally sensitive, relevant to a variety of disease and/or chronic conditions).

Definition of Transition
  • ▸ The definition of transition varies slightly; however, both countries’ definitions derive from Blum et al:9 “[Transition is] the purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centered to adult oriented health care systems.”31

Age of Transition
  • ▸ Both countries suggest planning for transition as early as possible (at 13 or 14 years of age); however, the precise age of active transition is expected to vary according to the patient and the condition.

  • ▸ No specific age to initiate the transition process is suggested by either government.26 28 30 31

Targeted Diseases
  • ▸ Australia identifies young people with neurological disorders and chronic disability as requiring special consideration for planning and delivery of transition services.

  • ▸ Australia also notes that some young people may need to transition from paediatric to adult palliative care (ie, those with metabolic disorders or respiratory failure).28

  • ▸ The UK identifies children with disabilities, chronic conditions and mental health concerns as priority populations with respect to transition.21 27

Targeted Investments
  • ▸ Transition care coordinators have been appointed in Australia, and the Agency for Clinical Innovation is working with the New South Wales Transition Care Network to find other ways of improving healthcare delivery and youth's experience with transition.32

  • ▸ The UK invested £19 million in the Transition Support Programme to facilitate better transition programming for children and youth with complex conditions and disabilities. This represented one-time funding, with no sustainable ongoing monies pledged.25 27

Financial Incentives
  • ▸ Australia identified the difficulties associated with episode-based funding models for funding non-episode-based activity (ie, transition); however, no alternative funding models have been proposed.29

  • ▸ Through the Transition Support Programme, England provided 11 regions funding to develop transition initiatives from 2008 to 2011.

  • ▸ After 2011, many of the local transition initiatives were not sustained due to lack of ongoing monies.25 27

Non-Financial Incentives
  • ▸ No non-financial incentives for transition were detailed in either jurisdiction.

Information Strategies
  • ▸ No system-wide information sharing strategies were detailed in either jurisdiction.

  • ▸ No evaluation plans are publicly available.

  • ▸ Evaluations have been conducted for the Transition Support Programme.

  • ▸ Results indicate varying levels of participation and programme quality across England, as many local areas did not have a funding structure after 2011.

  • ▸ The domains of evaluation related to health were limited.25