Principles of Youth Appropriate Care to Support Transition

Six principles, shaped by rangatahi themselves, to guide how paediatric and adult services work together to stop young people falling through the cracks.

For rangatahi across Aotearoa, moving from paediatric to adult health services is often where continuity of care quietly breaks down. Appointments are missed, relationships are lost, and trust is undone. This project set out to change that, starting with the people who know it best: young people themselves.

The result is six Principles of Youth Appropriate Care, co-developed with rangatahi, whānau, and the health workforce, to guide how clinicians and services can deliver transition care that actually works for young people.

Read the full Principles and their Enablers Document here.

What we did

We didn't start with a literature review and work backwards. We started by listening.

Over a series of online hui and focus groups, four youth advisory groups shared their experiences of moving between paediatric and adult care: Te Whatu Ora Waitaha Canterbury Youth Advisory Council, Māngai Whakatipu (School Based Health Services), I.Lead (neurodevelopmental and mental health), and VOYCE (young people in care). We deliberately sought out the voices most often missing from health system design; Māori and Pacific rangatahi, disabled young people, and those with mental health or state care experience.

Alongside this, whānau shared their perspectives through the Child Health Advisory Council and NZCYCN Lived Experience Navigators, and 130 health professionals across primary, secondary, and tertiary settings told us what they need to make youth-appropriate transition care a reality.

The six principles

1. Rangatahi-led, Whānau-partnered Transition Care in Safe, Culturally Grounded Environments

Nothing about us without us. Young people actively involved in decisions, flexible whānau participation, safe and culturally affirming environments, respect for identity and privacy, and strengths-based, trauma-responsive care.

"Please take what I say seriously — don't be insensitive or dismissive or try to rush. Treat me as an individual — I am not just another patient for you." — Waitaha Youth Advisory Council

2. Delivered by a Youth-capable, Relational, and Well-supported Workforce

Relationships matter. Skilled youth-focused practitioners, relatable and respectful communication, holistic understanding of young people's lives, consistent advocacy and support, and national youth health competency standards.

"It really matters when health professionals get us, when they're open, relatable, and actually understand what young people go through." — Waitaha Youth Advisory Council

3. Early, Structured, and Individualised Transition Planning

Start early, plan together. Transition begins years before transfer, with individualised plans and goals, warm introductions between services, coordinated support and navigation, and ongoing follow-up after transfer.

"Don't leave it until the last minute. Start early, make a plan with us, and help us stay connected." — Māngai Whakatipu Youth Advisory

4. Equity-driven, Trauma-responsive, Accessible, and Culturally Affirming Services

Meet us where we are. Removing barriers to access, responsiveness to culture, disability, language and identity, flexible and community-based approaches, trauma-informed care, and a priority on equity and inclusion.

"Don't make us jump through hoops — meet us where we are at." — Māngai Whakatipu Youth Advisory

5. Integrated, Coordinated, and Collaborative Systems of Care

One team around the young person. Services working together, shared care and communication, clear roles and responsibilities, consent-based information sharing, and seamless continuity across providers.

"If you are all part of our care, act like one team. Don't let us fall through the cracks." — Māngai Whakatipu Youth Advisory

6. Continuous Improvement Through Co-design, Feedback, and Accountability

Listen. Act. Improve. Youth and whānau shape services, feedback leads to visible change, transparent accountability, ongoing evaluation and learning, and nationally aligned quality improvement.

"If you are asking for our feedback, do something with it." — Māngai Whakatipu Youth Advisory

What this means for services

The workforce feedback that shaped this project was clear: clinicians already believe in youth-appropriate care. What's missing is the system support to deliver it consistently. Five recommendations translate the six principles into action:

Embed structured transition programmes across primary, secondary, tertiary, health, and education settings — with real coordination between paediatric and adult services.
Invest in workforce capacity, including youth health training and dedicated coordinator roles.
Secure sustainable funding for integrated, cross-sector models of care.
Prioritise equity and cultural responsiveness, with targeted action for young people facing the greatest barriers.
Embed genuine youth and whānau partnership in how services are designed, delivered, and evaluated — not as consultation, but as ongoing collaboration.

Where to from here

These principles offer a strengths-based, aspirational vision for what youth-appropriate care can look like across Aotearoa, one grounded in relationship, equity, and Te Tiriti o Waitangi. They're not a checklist to complete once. They're a standard to build toward, together with the rangatahi and whānau services exist to support.

Read the full Project Summary Report.