Committee publication · Engagement document · 1 July 2026
IEP roundtable note: clinicians and providers
From: Health and Social Care Committee
Inquiry: The transition from child to adult health and social care services
Summary
This Independent Expert Panel roundtable summary captures evidence from clinicians and service providers across health and social care on child-to-adult healthcare and social care transitions, gathered on 12 June 2026. Two breakout groups identified systemic barriers: inconsistent timing of transition planning (policy says age 14, practice varies widely), service gaps and eligibility mismatches leaving young people unsupported, weak cross-sector communication, and workforce gaps. Both groups emphasise that existing guidance is not operationalised; implementation relies on individual champion commitment rather than mandated organisational practice.
Key findings
- NICE guidance recommends transition planning from age 14, but evidence shows it should start at age 11; in practice, timing varies widely by service, specialty and geography, with some young people receiving no formal planning until age 16–18.
- Service gaps and eligibility threshold mismatches create 'cliff edges': young people eligible for specialist child services (e.g. eating disorder services) often fail to meet higher adult thresholds, leaving them without care; primary care handover is common but children's services anxiety about safety remains unresolved.
- Electronic systems and data incompatibility between organisations and sectors prevent coordinated care; young people are known to multiple services with no overall coordination or visibility, and care coordinators' roles are often eliminated as 'dispensable'.
- Workforce gaps and financial constraints: youth workers, care coordinators and transition leads are being cut despite evidence of their impact; mandatory time in job plans for transition work does not exist; adult clinicians lack confidence and competence in managing young people's complex procedures.
- Terminology and cultural barriers: use of the word 'transition' disengages adult clinicians; shared decision-making frameworks (e.g. Ready, Steady, Go) exist but adoption is inconsistent and not mandated; young people aged 10–25 remain largely invisible in both children's and adult services.
Tone
ProceduralTopics
Key actors
Health and Social Care Committee, Independent Expert Panel, NICE, NHS England, CQC, Integrated Care Boards (ICBs), General practitioners, Paediatric and adult service clinicians
Notable line
“Policies, guidance, and standards exist, but effective implementation more often than not relies on clinician goodwill.”
Key Quotes
“You can do transition within your routine clinic”
“If you say transition, lots of people disengage... They think transition and transfer are the same things. That is really important that we get that changed.”
“The thresholds for many services in adult care are so much higher than paediatrics. So if you're 15 and 364 days, you can self-refer into an eating disorder service. If you're 16 and 10 days, you can't, and you have to be much thinner in adult services.”
“Care coordination needs clear sight on it by organisations and usually needs networks of champions and focus on core business being care navigation.”
“Young people should be involved in healthcare transition intervention design and their transition process right from the start.”
“The young person doesn't care where one organisation ends and another begins. If health, social care, education and community services don't work together, we risk losing young people not just from healthcare, but from education, employment and wider participation in society.”
“"It's hard to get a business case in paeds for transition as the benefit is seen in adults… therefore really key this is jointly commissioned for both services".”
“They all default to general practice when specialist services end, and via the inverse care law they're concentrated in the most 'under-doctored' practices, so the safety net is thinnest where it's needed most.”
Source · parliament.uk record ↗