Go back NHS Birmingham and Solihull Integrated Care Board

AACHC Lead Transition Nurse

The closing date is 19 August 2025

BSol ICB is excited to bring you this opportunity for two experienced and ambitious practitioners to join our team as Lead Transition Nurses in Continuing Healthcare (CHC).

This pivotal role focuses on supporting young people aged 14 to 25 with complex health needs as they move from children's to adult services. You will lead on planning and coordinating seamless, person-centred transitions, ensuring care is tailored, safe, and effective.

Working across health, education, and social care, you'll collaborate with multidisciplinary teams to develop and implement robust care plans. You'll also build strong relationships with internal and external partners, ensuring compliance with national frameworks and local policies.

As a key advocate for young people and their families, you'll champion their rights, promote independence, and help shape transition pathways across the system.

Main duties of the job

Lead Transition Nurseswithin Birmingham and Solihull ICB ensure safe, effective, and person-centred transitions for young people with complex health needs moving from children's to adult services. They provide clinical leadership, coordinate care, and support service development.

Key responsibilities include:

• Clinical Leadership: Lead complex transition cases, conduct holistic assessments, and develop personalised care plans to ensure continuity from paediatric to adult services.
• Coordination: Act as a central contact, liaising across health, social care, education, and voluntary sectors to support integrated pathways and resolve transition barriers.
• Education & Support: Educate and empower young people and families, deliver staff training, and promote independence and self-management.
• Service Development: Contribute to local policy, audit outcomes, and lead quality improvement aligned with national guidance (e.g., NICE NG43).
• Strategic Leadership: Collaborate with ICB partners, represent young people's needs in planning forums, and report on transition outcomes.
• Safeguarding: Identify and manage risks, ensuring appropriate referrals and multi-agency collaboration.

About us

Birmingham and Solihull Integrated Care System brings together local NHS, councils and voluntary, community and faith sectors to better serve our communities. With a population of circa 1.55 million, our vision is for BSOL to be the healthiest place to live and work, driving equity in life chances and health outcomes for everyone. For a chance to be part of the fantastic opportunity we have as an Integrated Care System, apply for this role today.

As a member of our system, you will actively demonstrate system values in all that you do. You will be driven to address health inequalities and create an environment that is inclusive for all people.

In return, NHS Birmingham and Solihull can offer you the opportunity to thrive and develop in a team that is supportive, ambitious and inclusive. You will have plenty of opportunities to build your skills and experience, with a chance to work with colleagues across our five Provider Trusts, two Local Authorities, voluntary organisations, Integrated Care Board (ICB) and NHS England to truly effect change and add value.

We know that diversity fosters creativity and innovation, and we are committed to challenging discrimination, promoting equality of opportunity for all, being a fair and inclusive employer, and creating a place of work in which all of us feel we belong.

Job responsibilities

Job Title:Lead Transition Nurse Continuing Healthcare (CHC)

Band:7 Reports to: AACHC Clinical Service Delivery Manager Location:NHS Birmingham and Solihull Integrated Care Service (ICS) Community-based with some remote workingHours:Full-time (37.5 hours per week)

Job Summary

The Lead Transition Nurse in CHC is responsible for leading and coordinating the transition of young people with complex health needs from childrens services to adult Continuing Healthcare. The post holder ensures that transition planning is timely, person-centred, and compliant with the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. They act as a clinical expert, service coordinator, and advocate for young people and their families, working across health, education, and social care systems.

Main Duties and Responsibilities

1. Clinical Leadership

• Lead on the assessment and review of young people approaching adulthood who may be eligible for NHS Continuing Healthcare.
• Provide expert clinical advice and guidance to CHC teams, childrens services, and adult services on transition planning.
• Ensure that assessments are completed in line with the National Framework and that eligibility decisions are robust and defensible.
• Support the development of personalised care and support plans that reflect the young persons needs, preferences, and aspirations.

2. Transition Coordination

• Act as the named nurse for transition within the CHC team, coordinating multi-agency input to ensure a smooth and safe transition.
• Work closely with childrens continuing care teams, education providers, local authorities, and adult health and social care services.
• Develop and maintain a transition register and ensure timely identification of young people requiring CHC assessment.
• Facilitate joint planning meetings and case conferences with professionals, young people, and families.

3. Service Development and Quality Improvement

• Contribute to the development and implementation of local transition pathways and protocols.
• Monitor and evaluate transition outcomes, identifying areas for improvement and leading quality improvement initiatives.
• Support the development of tools and resources to improve transition planning and communication.
• Participate in audits, service reviews, and inspections as required.

4. Education and Training

• Provide training and support to CHC staff, childrens services, and adult services on transition processes and CHC eligibility.
• Promote awareness of the National Framework and the importance of early transition planning.
• Support young people and families to understand the CHC process and their rights, including access to advocacy.

5. Safeguarding and Risk Management

• Identify and manage clinical and safeguarding risks during the transition process.
• Ensure that safeguarding concerns are appropriately escalated and managed in line with local policies.
• Promote a culture of safety, dignity, and respect in all aspects of care planning and delivery.

6. Strategic Engagement

• Represent the CHC team in local and regional transition forums and working groups.
• Work with commissioners and system partners to ensure that transition planning is embedded in commissioning strategies.
• Contribute to the development of integrated care pathways and joint commissioning arrangements.

Person Specification (Summary)

• Registered Nurse (Child, Adult, LD, or MH) with current NMC registration.
• Significant experience in childrens or adult continuing care, complex case management, or transition planning.
• In-depth knowledge of the National Framework for NHS Continuing Healthcare.
• Excellent communication, negotiation, and interpersonal skills.
• Experience of working in multi-agency settings and leading complex care planning.
• Experience in service development or quality improvement.
• Knowledge of SEND reforms, EHCPs, and the Mental Capacity Act.

Person Specification

• Registered Nurse (Child, Adult, LD, or MH) with current NMC registration.
• In-depth knowledge of the National Framework for NHS Continuing Healthcare.
• Excellent communication, negotiation, and interpersonal skills
• Experience of working in multi-agency settings and leading complex care planning
• Educated to degree level in nursing or a related health discipline, or equivalent level of experience and training
• In-depth understanding of transition processes, person-centred care, and safeguarding
• Experience in leading or coordinating care planning for individuals with long-term or complex conditions
• Knowledge of SEND reforms, EHCPs, and the Mental Capacity Act
• Ability to travel across the ICB area as required.
• Ability to manage complex caseloads and lead multi-disciplinary planning

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

NHS Birmingham and Solihull Integrated Care Board

Full-time,Flexible working,Home or remote working,Compressed hours