The Road Ahead – Literature review

5. What to expect from services at transition

Transition planning and the role of person centred planning

As we have seen, several agencies play a role in the transition planning process, and consequently there may be several plans made for the young person with learning difficulties. These might include the transition plan, the Connexions Action Plan, and in some places, the Individual Learning Plan. Some young people may also have a Health Action Plan, a Care Plan (from social services), or a separate person centred plan. Rowland-Crosby et al's (2003b) research has shown that young people and families are confused about the nature of the different plans and assessments, and professionals also feel there is a proliferation of plans and consequently a lot of duplication and extra work. As these researchers point out, given the number of different plans, and the likelihood that there will be much overlap, who takes responsibility for delivery and implementation? Connexions PAs should take responsibility for the Connexions Personal Action Plan, but it is unclear whether they are in a position to be able to hold those participating in the delivery of a transition plan responsible or accountable for its implementation (Rowland-Crosby et al, 2003b). The Qualifications and Curriculum Authority (2003) clarify that the most effective transition programmes have a clear focus, coherent provision and a strong emphasis on meeting the needs of individuals within a framework of flexible provision. They have devised a list of questions to provide guidance and evaluative material for schools and colleges so they can measure their progress towards this end.

Several authors have stressed the importance of an holistic, person-centred approach to transition planning that encompasses broader aspects of planning for adult life (Ward et al, 2003d; O'Sullivan, 2001; Bond, 1999). Research shows, however, that current transition planning techniques tend to be focused on limited, short-term goals, and do not take a 'whole life' approach which encompasses young people's previous goals and dreams as well as their new hopes for the future. Clegg at al (2001) found that the process of transition planning may be perceived by some professionals as an opportunity for a 'fresh start'. Parents on the other hand are more likely to see transition as part of the continuity between children's and adult services. The authors recommend that an understanding of the young person's history and a historical perspective should be an essential prerequisite of person-centred planning and stress the importance of valuing continuity.

Person-centred approaches to planning (such as Essential Lifestyle Planning, MAPS and PATH) appear to be the way forward in terms of ensuring that transition plans really reflect the aspirations of young people for their future adult lives (Hudson, 2003). By 2003, all local agencies should have introduced the option of person-centred planning for young people with learning difficulties who will be moving from children's to adult services (Department of Health, 2001). Person centred planning should be facilitated independently of agency assessment for resources and services (Valuing People Support Team, 2003). The Valuing People Support Team's (2003) 'Information Pack for Transition Champions' states that a person-centred approach to planning at transition should:

Although different agencies have their own statutory requirements for planning, these can and should incorporate person-centred approaches and be conducted in person-centred ways (Valuing People Support Team, 2003).

Information provided for young people with learning difficulties to support the transition planning process needs to be culturally-appropriate and tailored to individual needs. This may mean ensuring that information is translated into a community language, put on audio or video-tape, or put into pictures or symbols. In a recent project designed to improve the quality of life of people with 'profound and complex learning difficulties' during periods of transition, Dee and Byers (2003) explored ways of involving young people in recognising and recording their own progress and achievements across services in formats that were meaningful to them.

Other areas of service and policy development in relation to transition

The issue of transition to adulthood for young people with learning difficulties and their families has received some focused attention within a range of service and policy developments.

The 'Valuing People' white paper (Department of Health, 2001) emphasises the need for effective links to be in place between children's and adult services in both health and social care. It also identifies young disabled people at transition as being a priority for person-centred planning (Ward et al, 2003d).

The white paper set in motion the establishment of local Learning Disability Partnership Boards (LDPBs) in all local authority areas. Hudson (2003) explains that LDPBs are a main part of new partnership machinery, along with the Connexions service, for improving services at transition. LDPBs are not statutory bodies and cannot appoint staff or hold budgets, but they are still capable of being important partnership forums. They have a number of important roles including: developing and implementing Joint Investment Plans, overseeing inter-agency planning and commissioning, ensuring use of the Health Act flexibilities, and ensuring arrangements are in place to achieve a smooth transition to adult life for young people. Each LDPB is also supposed to identify a 'transition champion' who will take lead responsibility for transition issues (Ward et al, 2003c).

The SEN Action Programme for England was published in February 2004 and will last over 10 years. It sets out the English government's objectives and priorities with respect to supporting children and young people with special educational needs and disabilities to realise their potential. There is a focus on improving outcomes for children and young people. This includes improving outcomes for young people making the transition between school, further education, work based learning, employment and adult life, with a further focus on (a) improving transition planning and (b) improving post-16 opportunities.

Through the Action Programme, the Department for Education and Skills plans to work across government to:

Russell (2003) states that it is important to ensure that the new DfES SEN Action Programme is used as an opportunity to review transition planning in the light of wider changes, such as the introduction of the 14-19 curriculum (with greater flexibilities for work related options) and a stronger focus on achievement for pupils.

Both the English government and the National Assembly for Wales are in the process of finalising details of their respective National Service Framework (NSF) for Children, which both include a module on services to disabled children. Both Disabled Children's modules have sections on transition.

The draft NSF for Wales (National Assembly for Wales, 2004) has a section called Transition Services (childhood to adulthood). It proposes that there should be one multi-agency plan for each young person which specifies arrangements for continuing support and services including: personal support; housing requirements (including supported housing); education and training; careers including specialist advice; employment; social relationships including leisure activities; short breaks; practical and other skills; financial support (including benefits and direct payments); health needs including genetic counselling and sexual health; continuing care; appropriate transport; communication needs. Two significant 'key actions' of the NSF for Wales are that all young people with learning difficulties should have access to a 'transition key worker' and to opportunities for work experience as part of the transition planning process.

The draft NSF for England (Department of Health, 2003) has a section called Transitions (including from children's to adult services) and proposes the development of inter-agency protocols on transition covering health, social services, education, careers, housing, leisure, transport and benefits/welfare rights. Other issues highlighted include: the involvement of young people and carers in the transition planning process; information provision to families (specialist and mainstream); training for Connexions PAs; implementation of Valuing People person centred planning guidance for young people with learning difficulties; use of direct payments for 16 and 17 year olds; how services will support young people to have a social life, network of friends and relationships including advice on sexuality, friendships, contraception and consent; how services will encourage healthy lifestyles and access to health promotion; arrangements for managing the transition of those with life limiting conditions, high levels of needs and those in residential schools/living away from home; how transition plans will meet the needs of Black and minority ethnic children; and arrangements for addressing the needs of wider family and siblings. Russell (2003) suggests that the forthcoming NSF for England could set standards for transition which could provide a template for the Connexions service and help break down some of the current barriers to effective planning at transition.

There is no doubt that for transition to be a positive and effective experience for young people with learning difficulties and their families, services and professionals must engage in multi-agency working . Hudson (2003) intimates that the scale and complexity of the partnership remit needed to deliver successful transition planning is daunting and will require a level of collaborative sophistication which has not been achieved in the past. In an article which considers the extent to which new service developments in England (e.g. Valuing People, Connexions, Health Action Plans, etc) can address the problems facing young people with learning difficulties at transition, he suggests that what is at stake is not only a better system of support for young people, but also the viability of partnership working as a policy tool for addressing complex issues.