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Care (Education) and Treatment Reviews

Care, (Education) and Treatment Reviews (C(E)TRs) are part of NHS England’s commitment to transforming services for people of all ages with learning disabilities and/or autism. C(E)TRs are for people whose behaviour is seen as challenging and/or for people with a mental health condition. They are undertaken for individuals living in the community or in learning disability and mental health hospitals.

Community C(E)TRs

C(E)TRs are held in the community when individuals are struggling with their emotional wellbeing or mental health which puts them at risk of being admitted into a mental health or learning disability hospital. They bring together the individual, their family/carers and all professionals involved in their support including community nurses, social workers, consultant psychiatrist, clinical psychologist, occupational therapists, commissioner, care providers, GPs and other professionals. If the person is in formal education, Special Educational and Disabilities professionals and education providers are also invited.

The purpose of a Community C(E)TRs is to listen to the individual, their family/carers and all involved professionals, review the support provided for the individual and family/carers, identify the nature of difficulties being experienced and make recommendations with the aim of preventing a hospital admission if possible.

Inpatient C(E)TRs

C(E)TRs also help to improve the quality of care and treatment people receive in hospital by asking key questions and making recommendations that lead to improvements in safety, care and treatment. They reduce the amount of time people spend in hospital and bring people together to help to sort out any problems which can keep people in hospital longer than necessary. They do this by helping to improve current and future care planning, including plans for leaving hospital.

Overall aims and objectives of C(E)TRs

The C(E)TR panel includes a health commissioner, an expert by experience and an independent clinical advisor.

These are the key questions asked at a C(E)TR:

  • Is the person safe?
  • Are they getting good care and treatment?
  • What are their plans for the future?
  • Can care and treatment happen in their own home and their own community?
  • What plans are in place to safeguard the person from Covid-19 related risks?

The overall aims and objectives of the C(E)TR process (in line with national guidance) are to:

  • Support people with learning disabilities and/or autism of all ages; and ensure they and their families/carers are listened to and are equal partners in their own care and treatment pathway.
  • ·Prevent people with learning disabilities and/or autism being admitted unnecessarily into inpatient learning disability and mental health hospitals.
  • Ensure any admission is supported by a clear rationale of planned assessment and treatment together with defined and measurable outcomes.
  • Ensure all parties work together with the person and their family to support discharge into the community (or if the only option, to a less restrictive setting) at the earliest opportunity. Local authority involvement in all C(E)TRs is best practice, ensuring that relevant issues can be fully addressed and all solutions explored for the safe discharge of individuals into community-based settings.
  • Support a constructive and person-centred process of challenge to current care, education and treatment plans where necessary.
  • Identify barriers to progress and to make clear and constructive recommendations for how these could be overcome.

More information on C(E)TRs can be found here.