Lynne Neagle AM: Dawn has a question on transition.
Dawn Bowden AM: Yes. Thank you, Chair. We've heard, not necessarily just in the context of this report, because we've heard similar evidence around transition arrangements in another committee report when we did the suicide prevention, and I've in fact only recently—well, just this week, actually—met with community mental health teams in my constituency, and there is still some concern about transitional arrangements from children into adult services. Now, I know we had the—. The transition guidance was published a couple of years ago now, and the programme was involved in developing that guidance. But what's your assessment of the impact that it's had? Because we clearly are still seeing people falling through the gaps, aren't we?
Carol Shillabeer: Yes, thank you for that. You're absolutely right; we developed that guidance and we are currently in the process of the evaluation of that. And, in particular, I know that the children's commissioner is very focused on transition, not just around children in receipt of emotional mental health support, but children in paediatric wards, and there is a working group with Welsh Government looking at this.  The children's commissioner has used our guidance to put that on the table to say, 'Well, if this works, this needs to be considered as a model for using elsewhere'. But the big question there is 'if'. So, we do want to get evaluation. If I were just to give an estimate of where I think this will land, I think it will have made improvements, but there may well be some further work to do in enhancing, supporting, auditing that every child is supported in line with that guidance. So, I talked about community practice and clinical audit: is this something that we make, then, a mandatory audit, each year, that we do that double check? Because it's one of those things where we know when a child is 14, 15, 16, 17, so what's stopping us? If indeed the evaluation says it's not happening everywhere, it's not happening early enough, what is stopping us? We really need to get underneath that. So, my sense will be it will show us, it will be better, but there's some further work to do, and following that up in terms of audit and making sure that we've got a systematic approach to dealing with those who haven't had the guidance fully implemented, because it can make a real difference.
Dawn Bowden AM: Yes, and it seems to me—you've just talked about having a systematic approach, and it does seem to me that it is a systematic process, isn't it? So, it shouldn't be difficult. I know we're talking about in the health service things shouldn't be difficult and they are, and one of the gripes—I had a meeting with the community health team—was the problems of the new IT systems and so on—let's not go there at the moment. But, really, this is just about referring children and having a smooth transition from the service being provided to them as a child and then just shifting it over to the adult services. It shouldn't be difficult. It's really difficult to get my head around why that is such a problem and why that needs to be so difficult.
Carol Shillabeer: Can I add one other dimension in, which I think is going to be quite interesting? We talk about transitions being an issue—and we know it's not just in mental health, but it's elsewhere—then you start to think, 'What if we could reduce transitions?', so you reduce the number of transitions and you manage them better. We are doing a piece of work with Government on the potential to explore what a 0-25-type service would be. We know that in different places they have approached that—in Australia and places in the UK. There are probably some pros and cons, but should we be moving to a 0-25. That is moving the transition at the age of 25, but at least it's not at the eighteenth birthday. What's the argument around what adolescent, young people and young adults services are, for example? That piece of research and understanding—
Dawn Bowden AM: You could probably have a gradual transition, then, couldn't you?
Carol Shillabeer: Quite potentially. I've got some people who have joined my own health board who've worked in that 0-25-type service, and we're catching up—'Tell me what was good about it? Tell me what was not so good about it? What did the young people themselves think about that?'. Because if we can manage down the numbers of transitions, there really should be no excuse not to get transitions right, then.
Dawn Bowden AM: Okay, thank you. Thank you, Chair.

Summary: Carol Shillabeer answered a question from Suzy Davies, indicating the intersection between the Together for Children and Young People programme and the Outcomes for Children Group programme. Next, in response to Dawn Bowden, Shillabeer talked about the development of transition guidance and the endeavor to reduce the numbers of transitions and manage them better.