Care (Education) and Treatment Reviews (C(E)TRs) are part of NHS England’s commitment to transforming services for people of all ages with a learning disability and autistic people. C(E)TRs are for people who have been admitted to a mental health hospital or for people who are at risk of admission. They are undertaken by commissioners to ensure that people are only admitted to hospital when absolutely necessary and for the minimum amount of time possible. Care and Treatment Reviews (CTRs) are for adults and C(E)TRs are for children and young people.

Since 2015, thousands of C(E)TRs have been carried out. They are helping to reduce the number of people going into hospitals. C(E)TRs also seek to improve the quality of care people receive in hospital by asking key questions and making recommendations that lead to improvements in safety, care and treatment. They aim to 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.

C(E)TRs are carried out by an independent panel of people. This includes an expert by experience, who is an autistic person or a person with a learning disability or a family carer with lived experience of services. The panel also includes a clinical expert who is qualified to work in healthcare and the commissioner who pays for the person’s care.

There are lots of helpful tools and resources for everyone on these C(E)TR webpages, and we are currently reviewing, updating and adding to these. There is more about this on our page for commissioners, CTR panels and people providing care, and there is a page of resources for panels that carry out C(E)TRs for children and young people. There are also booklets and a planner written for people having a CTR or C(E)TR. Parents at Bringing Us Together have also written a guide for family carers which offers further help and advice about CTRs.

Updates to the Care and Treatment Review policy

The policy for C(E)TRs was last updated in January 2023 for implementation in May 2023 and now includes the dynamic support register (DSR) to ensure people work together to review the needs of each person on the register. The DSR enables systems to identify adults, children and young people with increasing and/or complex health and care needs who may require extra support, care and treatment in the community as a safe and effective alternative to admission to a mental health hospital. Supporting materials, including the C(E)TR code and toolkit and the key lines of enquiry template have been refreshed in accordance with the new policy. You can view the existing C(E)TR policy on our CTR policy page. We also have a range of tools to help you plan your C(E)TR and for commissioners, clinicians and experts by experience.