1. Transition Moving between child and adult continuing healthcare

2. The wider context  Transition for continuing healthcare should be part of wider transition planning for the individual, not separate to it  PCTs should be actively involved in local transition planning at strategic and individual levels, including adult services representation  Transition: moving on well and A transition guide for all services set out wider best practice for transition  Common section on transitions in children's and adult frameworks

3. Bridging children's and adult Frameworks  'Continuing care' has different meaning in children's and adult Frameworks. Important to help young people and families to understand this.  Children's continuing care involves a package of support from PCTs, LA children's services and other partners  Adults: distinction between 'continuing care' and 'NHS continuing healthcare'  'Continuing care' is care provided over extended period of time as a result of disability, accident or illness-includes both NHS and LA social care  'NHS Continuing Healthcare' is a package of continuing (health and social) care funded by the NHS if a person's primary needs are health needs

4. Continuing care and the transition process  Future entitlement to adult CHC should be identified as early as possible in the transition process  PCTs and LAs should have processes in place to ensure young people who may be entitled to adult CHC are identified and referred as early as possible  Some young people not entitled to children's continuing care may be entitled to adult CHC and  Some entitled as children may not be entitled as adults  CHC covers health and social care needs but others (such as education) may also continue to have funding responsibilities

5. Key ages  By age 14: Young people likely to be eligible for adult CHC should be identified by children's continuing care teams (and others) and adult CHC team notified about them  By age 16: Formal referral to adult CHC for screening for possible eligibility via adult Checklist  By age 17: Eligibility for adult CHC should be determined in principle by relevant PCT (using adult process of MDT assessment and completion of adult Decision Support Tool)  18 th birthday Eligibility for adult CHC comes into effect

6. Continuing care and the transition process  If person found to be not eligible for adult CHC, should be informed of their right to request an independent review  Where no eligibility, PCT should continue to participate in transition process to ensure clear handover of responsibility and to consider any need for joint package/joint funding  Where young person is in out-of-area placement, important there is early clarity over responsible adult PCT commissioner-determined via Who Pays principles. Lack of clarity must not delay transition process  In some circumstances, young people receiving children's continuing care are automatically entitled to adult CHC until their eligibility is reviewed

7. Care planning and Commissioning Key aim is to ensure consistent package of support in years before and after transition to adulthood Nature of the package may change because the young person's need or circumstances change but The package should not change simply because adult services and now responsible or because the commissioner has changed Young person (and family/advocate where young person wants this) should be fully involved in assessment and care planning process

8. Care planning and commissioning  PCTs should commission services using models that maximise personalisation and individual control and reflect the individual's preferences as far as possible  Growing role of Personal Health Budgets, including NHS Direct Payments  Ongoing care management and reviewing responsibilities