Lead Transition Nurse

Job overview

We are looking for an enthusiastic and compassionate Transition Nurse Specialist to lead and coordinate care for young people moving from children's to adult services. Working across health, social care, education and community partners, you will ensure seamless, person-centred transitions that support independence, self-management and positive long-term health outcomes.

You will manage a specialist caseload of young people with complex needs, act as a key point of contact for families and professionals, and provide expert assessment, care coordination and clinical leadership. The role offers the opportunity to influence service development, reduce health inequalities, improve patient experience and deliver education and support to patients, families and healthcare professionals.

This is an exciting opportunity for an experienced nurse with excellent communication, leadership and partnership-working skills who is passionate about improving outcomes for young people as they transition into adult services.

"(Should we receive a high number of applications we reserve the right to close this vacancy at any point after 22/09/2026)"

Main duties of the job

Coordinating complex transition pathways across multiple agencies and services.

Providing specialist assessment, care planning and case management.

Supporting young people and families to develop confidence, independence and self-management skills.

Working collaboratively with multidisciplinary teams to ensure continuity of care.

Leading service improvement, education, audit and quality initiatives.

Promoting safeguarding, patient advocacy and equitable access to services.

This role involves working across a range of acute, community and educational settings, with regular travel required across the locality.

Detailed job description and main responsibilities

Clinical Leadership and Care Coordination

Provide professional and clinical leadership for the Transition Service, ensuring the delivery of safe, effective and person-centred care.

Lead and coordinate complex transition pathways across children's and adult health services, social care, education, community services and voluntary sector partners.

Act as the named Transition Coordinator and primary point of contact for children, young people, families, carers and professionals throughout the transition journey.

Manage a specialist caseload of children and young people with complex physical, developmental and psychosocial needs.

Undertake comprehensive assessments and develop personalised transition plans that support independence, self-management and achievement of agreed outcomes.

Monitor progress throughout the transition process and ensure timely escalation of concerns or emerging risks.

Specialist Practice

Undertake highly complex assessments involving clinical, psychological, social and environmental factors.

Exercise advanced clinical judgement and autonomous decision-making in the planning and delivery of care.

Provide specialist advice and consultancy regarding transition planning, complex case management and best practice.

Act as a specialist resource in safeguarding, ensuring concerns are recognised, escalated and managed appropriately.

Ensure Mental Capacity Act principles, consent processes, advocacy and safeguarding responsibilities are embedded within practice.

Partnership Working

Develop and maintain effective relationships with multidisciplinary, multi-agency and cross-sector partners.

Chair and contribute to multidisciplinary meetings, case conferences and complex care-planning forums.

Facilitate effective communication between children's and adult services to ensure continuity of care.

Support integrated working across acute, community, primary care, social care and education settings.

Education and Development

Provide education, coaching and support to young people, families and carers to enhance knowledge, confidence and self-management skills.

Design and deliver specialist training programmes for healthcare professionals and partner organisations.

Support workforce development through supervision, mentorship, preceptorship and education of students and staff.

Maintain expert knowledge of transition policy, legislation, professional standards and evidence-based practice.

Service Development and Quality Improvement

Lead and contribute to service improvement initiatives, audit, research and evaluation activities.

Monitor transition outcomes and use data to improve service quality, patient experience and clinical outcomes.

Identify service gaps, health inequalities and opportunities for pathway redesign and innovation.

Contribute to the development of policies, guidelines, standard operating procedures and integrated care pathways.

Support business planning, workforce development and delivery of Trust and Integrated Care System priorities.

Governance and Information Management

Maintain accurate, timely and legally compliant clinical records.

Ensure compliance with Information Governance, GDPR, professional standards and Trust policies.

Analyse activity, performance and outcome data to support clinical governance and service improvement.

Report and manage incidents, complaints, risks and safeguarding concerns appropriately.

Resources and Professional Responsibilities

Ensure the safe and effective use of equipment and resources.

Promote cost-effective use of financial and physical resources.

Plan and manage a complex workload, balancing competing priorities and service demands.

Travel across healthcare, community and educational settings as required to support service delivery.

Undertake any other duties consistent with the grading and responsibilities of the post.

Applicant requirements

You must have appropriate UK professional registration.

This post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service.