Background
Twelve million people aged 10–25 live in England (1/5 of population) yet delivering an effective transition from paediatric to adult services often remains variable and dependent on local champions rather than system design, with many gaps in services particularly when paediatric service provision ends at 16 and adult provision starts at 18.
Transition is often under-resourced, not formally commissioned, with limited ownership between paediatric and adult services and deprioritised against competing system pressures. NHS England published guidance in April 2026 setting out how health systems should improve the transition of young people from children’s services into adolescent and adult services.
RCPCH would like to see transition services where young people are not left without care, are developmentally appropriate, and are co-produced by children and young people.
Key messages from the non-inquiry session
To ensure effective transition, RCPCH notes the following:
- Delivery and design of transition services must take a rights-based approach and be underpinned by the United Nations Convention on the Rights of the Child (UNCRC)
Children and young people would like to see early and age-appropriate involvement in their own planning, direct engagement, clear communication, relationship-based process, peer support, joint working, holistic and mental health support, and consistent and equitable systems.
This includes starting transition earlier where appropriate, tailored to developmental readiness. Planning should begin well before the relevant paediatric services are due to end, while remaining flexible to individual need.
- Staff capacity is key to transition planning
This requires protected time within job plans for the whole multidisciplinary team to enable identification and implementation of transition planning.
There should be an identified staff member for transition in both the relevant adult and paediatric services, with a local shared agreement around budget and funding for this role. Dedicated transition coordinator roles should be commissioned and funded where appropriate.
- Collaborative working and buy in from both adult and paediatric services
This is vital for successful transition planning. Clear national expectations and guidance must be introduced to reduce postcode variation in transition quality: for example, creating a Transition Oversight Board to bring stakeholders from each team together to highlight gaps and improve accountability has been successfully working locally.
- Training for staff working with young people
Training for staff working with young people who are transitioning into adult services would support the transition pathway. This should include mandatory training for staff in paediatric, adult and GP services focused on developmentally appropriate healthcare, consent and confidentiality, and direct communication with young people, with staff capacity and budget to deliver and attend training. Ideally this would form part of relevant core curriculum.
- Enhanced capacity for data capture and identification of transition planning
This may include administrative support for resources to monitor and review the population on waiting lists and to identify gaps in provision. Robust digital mechanisms to capture and follow through the transition journey would support this.
- National roll-out of resources to support children and young people with their transition
This should acknowledges the whole life transition they are often experiencing at this age. Ready Steady Go is a good example that could be scaled up.
Wider College work on transition
In May 2026, RCPCH posed the longstanding question of ‘Should paediatric care extend to all children and young people at least until their 18th birthday?’ at the 2026 RCPCH Conference.
The suggestion to extend paediatric care routinely to a young person’s 18th birthday was supported by over 75% of those in the room, a proportion that increased as the session went on. However, it was agreed that this is not a straightforward solution, as often when young people transition to adulthood and there is no equivalent adult care. For instance, those with complex neurodisabilities supported by community paediatric services may find no comparable specialist provision as adults. Adjusting thresholds would not resolve this, only delay it. There is a need for greater engagement with adult-facing professionals, particularly GPs and primary care teams to address this gap .
The session at conference was chaired by Leonora Merry, Director of Communications and External Affairs at the Nuffield Trust, an independent health and social care think tank. Together with RCPCH Officer for Health Services, Dr Ronny Cheung, Murray has co-authored a blog where you can read more about how the session unfolded: Too old for paediatrics, too young for adult services: the problem that must be solved.
Next steps
If you are interested in hearing more about our policy and advocacy work and staying involved in topics including transition, register for the Paediatric Influencing Network.
For further information, please contact the Health Policy team on health.policy@rcpch.ac.uk.