The impact of transition on NHS diabetes service delivery: key audit results spanning 2003–2014

Guidance and implementation The risk is well recognised. Well over 10 years ago, the Department for Education and Skills and the Department of Health jointly published the first of several guidance documents on planning transition, backed up with models of transitional care and recommendations on planning and training.1 In 2012, the Children and Young People’s Health Outcomes Forum (a group of NHS, local authority and academic specialists convened by the Department of Health) reviewed how well the health outcomes that matter most for children and young people were being delivered by the public sector.2 It concluded: ‘Too many health outcomes for children and young people are poor, and for many this is involved with failures in care.’ That same year, NHS Diabetes published a review to identify best practice in transition care to form the basis of a work programme to improve outcomes.3 It defined transition as: ‘The period of time during which there is planned, purposeful and supported change in a young adult’s diabetes management from child orientated to adult orientated services, mirroring increasing independence and responsibility in other aspects of their life.’ Its key findings revealed a lack of confidence among clinicians that the plethora of guidance then available had been implemented (Box 1). Nevertheless, the Care Quality Commission rated diabetes care as one of the better services in its crossspecialty review of NHS transition care, which otherwise too often uncovered disinterest and neglect in the quality of care offered to young people.4