Care, Education and Treatment Reviews (CETRs)
Dynamic support register and Care (Education) and Treatment Review policy and guidance
A new policy has been published which aims to prevent unnecessary hospital admissions for people with a learning disability and autistic people. The policy includes new guidance on the implementation of dynamic support registers (DSRs) and updates to the Care (Education) and Treatment Reviews (CETRs). The easy read and plain English versions of the policy have been co-produced with people with a learning disability and autistic people.
The new guidance will support local NHS services to better understand the needs of people with a learning disability and/or people who are autistic in their area, so that they can make sure people receive the right support. By understanding people’s needs and recognising early signs that might lead to a crisis it means that extra support can be put in place quickly, so the person doesn’t end up going into hospital (or to other out of area placement) unnecessarily.
To support systems in the implementation of the dynamic support register (DSR) and Care (Education) and Treatment Review C(E)TR policy and guide we have published an updated code of practice, and key lines of enquiry templates and easy reads.
The code of practice highlights the processes and core principles that bring the policy into real life, including the dependencies between each element that make it one systemic approach to supporting autistic people and people with a learning disability in their community.
We have aligned the process for dynamic support registers, Care (Education) and Treatment Reviews and oversight arrangements into one framework guide to help systems develop a process in their local areas that works for their system and joint commissioning arrangements.
The principles highlight the spirit in which a Care (Education) and Treatment Review should be undertaken and serves as a useful reminder to panel members and commissioners of the values that they should hold at the forefront of any review.
The key lines of enquiry templates have been updated based on stakeholder feedback to ensure they capture relevant information that can best support care planning. There is an increased focus on physical health, advocacy and quality of life.
A new toolkit and workbooks are under development. Please continue to work with the existing toolkit and workbooks in the interim.
This infographic describes how the new policy will support people with a learning disability and autistic people to get the right care at the right time in the right place and how it interacts with other policies.
Watch these films to find out how the policy has been coproduced and how it will help to prevent unnecessary admissions for people with a learning disability and autistic people from the perspective of a:
- A CETR panel member and autistic person: in this film Conor talks about how the policy has been strengthened by being coproduced with people with lived experience.
- A family carer: in this film Yvonne talks about how the policy has been strengthened by being coproduced with people with lived and learned experience.
- A provider: in this film, consultant clinical psychologist, Dr Ceri Woodrow talks about how the policy will help the system better support the needs of people with a learning disability and autistic people.
- National Clinical Director, Roger Banks, Learning Disability and Autism Programme, NHS England: in this film Roger talks about how the policy enables a whole system approach to supporting people with a learning disability and autistic people.
Watch Ashlee’s story to see how the DSR helps her stay well at home
Dynamic support register e-learning
Cheshire and Wirral NHS Foundation Trust has developed a web-based training tool in the use of the dynamic support register for health and social care staff. The training includes information about risk scoring people with a learning disability and autistic people and case studies from people who have been supported through the tool.
Case studies
- Cheshire and Wirral Partnership: Dynamic support database (DSD) and clinical support tool
- Cheshire and Wirral Partnership: Dynamic support tool – physical health (DST-PH) for people with intellectual disability
- Doncaster: Doncaster proactive, monitoring and support group – sharing good practice
Webinars and presentations
- Cheshire and Wirral Partnership – Dynamic support database
- Cheshire and Wirral Partnership – Dynamic support for physical health
- Doncaster – Doncaster’s approach to the dynamic support process
- North Cumbria and North East – Dynamic support register and system standards
For copies of webinars and presentations please contact england.strategiccommissioning@nhs.net
Additional useful links
- Children and young people
- Children and young people key workers
- Host commissioner guidance
- Learning disability and autism – framework for commissioner oversight visits to inpatients
For further information please email england.CTRDSR@nhs.net