Lead Transition Nurse in England

Lead post in the Transition Service at East of England Community Health and Care NHS Trust, coordinating care for young people moving from children's to adult services. The role covers complex transition pathways across health, social care, education and voluntary partners, alongside a specialist caseload of young people with complex needs. Clinical leadership, service improvement and teaching sit alongside the caseload, with regular travel across the locality to acute, community and educational settings. Fit depends on current NMC registration as a children's, adult or dual-registered nurse.

What the job involves

• Lead and coordinate complex transition pathways across children's and adult health services, social care, education, community and voluntary partners
• Act as named Transition Coordinator and primary point of contact for young people, families, carers and professionals
• Manage a specialist caseload of children and young people with complex physical, developmental and psychosocial needs
• Undertake highly complex assessments, develop personalised transition plans, and monitor progress and escalate risks
• Provide professional and clinical leadership and specialist advice, exercising advanced clinical judgement
• Chair and contribute to multidisciplinary meetings, case conferences and care-planning forums
• Provide education, coaching and support to young people, families and carers to build self-management
• Design and deliver training, and provide supervision, mentorship, preceptorship and student education
• Lead service improvement, audit, research and evaluation, using outcome data to improve quality
• Act as specialist safeguarding resource and embed Mental Capacity Act, consent and advocacy in practice
• Maintain accurate clinical records, comply with information governance and GDPR, and report incidents and manage risks
• Travel across acute, community and educational settings as required, and plan a complex workload

What’s required

Qualifications

• Nursing degree or relevant healthcare degree, or equivalent experience
• Continuing professional development relevant to transition care and long-term conditions

Registration & licences

• Current NMC registration as a children's, adult or dual-registered nurse

Experience

• Significant post-registration experience caring for children and young people with complex health needs and long-term conditions
• Coordinating complex transition pathways and managing a specialist caseload
• Working across multidisciplinary and multi-agency teams, including health, social care, education and voluntary sector
• Leading or contributing to quality improvement, audit or service development
• Providing specialist advice, education, supervision or mentorship to colleagues and students
• Knowledge and experience of safeguarding children, young people and vulnerable adults

Skills & knowledge

• Comprehensive knowledge of transition planning, long-term conditions and the health needs of adolescents and young adults
• Knowledge of national legislation and guidance on transition, safeguarding, consent, mental capacity, equality and diversity
• Understanding of clinical governance, quality improvement, audit, risk management and evidence-based practice
• Ability to analyse audit, patient experience and outcome data to improve services
• Excellent clinical assessment, decision-making and problem-solving in complex cases
• Excellent communication, negotiation and interpersonal skills, including sharing sensitive or complex information

Other

• Ability to work autonomously and coordinate complex pathways across boundaries, with strong workload and priority management

Nice to have

• Leadership development, quality improvement, project or change management training
• Postgraduate qualification in a relevant clinical specialty, leadership or healthcare management
• Practice Assessor/Supervisor qualification or recognised teaching qualification
• Experience across both children's and adult healthcare services
• Experience leading service redesign or pathway development
• Experience representing services at Trust or system-wide meetings
• Experience managing clinical resources, including specialist equipment and consumables
• Knowledge of Integrated Care Systems and national transition programmes

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