Care and Treatment Reviews

Care and Treatment Reviews (CTRs) are part of NHS England’s commitment to transforming services for people with learning disabilities, autism or both. CTRs are for people whose behaviour is seen as challenging and/or for people with a mental health condition. They are used by commissioners for people living in the community and in learning disability and mental health hospitals.

Since 2015, thousands of CTRs have been carried out. They are helping to reduce the number of people going into these hospitals. For example, of the 552 community CTRs recorded between April 2016 and January 2017, the outcome was a decision not to admit in almost three out of four (403) reviews. For example, of the 1904 community CTRs recorded between April 2016 and May 2018, the outcome was a decision not to admit in more than three out of four reviews. And of over 350 children and young people who have had a community CETR since 2016, 79% resulted in a recommendation not to admit the child to hospital.

CTRs also help 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 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.

CTRs are carried out by an independent panel of people. This includes an expert by experience, who is a person with a learning disability or autism 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 tools and downloads for everyone on these CTR/CETR pages. In September 2018 we added a new booklet for health and social care providers, to support people at every stage of their C(E)TR. 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 CETRs for children and young people. There are also booklets and a planner written specially for people having a CTR or CETR. Parents at Bringing Us Together have also written a guide for family carers which offers further help and advice about CTRs.

Pathways report

In 2017 NHS England asked Pathways Associates to look at how well our new care and treatment review policy was working for people with a learning disability, autism or both. Their report is called ‘Effectiveness of the new care and treatment review policy’.

Pathways work shows what a positive difference a care and treatment review can make to a person’s life and we welcome the recommendations made in the report. We will use these recommendations in our work to improve care and treatment reviews now and beyond the end of March 2019.

Updates to the Care and Treatment Review policy

The policy for CTRs changed in March 2017. You can view the latest policy and find out about how these changes will affect you on our CTR policy page.  We also have a range of tools to help you plan your CTR and for commissioners, clinicians and experts by experience.

Watch videos about Care and Treatment Reviews