My Care and Treatment Review (CTR)

On this page you can:

This page is for anyone who is thinking about having a Care and Treatment Review, also called a CTR.

CTRs (or CETRs for children and young people) are for people with learning disabilities, autism or both. They are for people living in the community and in learning disability or mental health hospitals. CTRs help to improve care for people whose behaviour is seen as challenging and/or for people with a mental health condition.

Care (Education) and Treatment Reviews during the coronavirus outbreak

We cannot carry out C(E)TRs in person right now, but it is still important you have your C(E)TR.

This booklet has been written to help you have your C(E)TR in a different way during the coronavirus outbreak. It gives you information to help you before your C(E)TR, on the day, and afterwards. The booklet contains forms that can be filled in and saved on a computer, or the booklet can be printed off.

An easy read version of the booklet is available.

My Care and Treatment Review booklet

This booklet tells you all you need to know about CTRs.

Parents at Bringing Us Together have written a guide for family carers which offers further help and advice about CTRs.

My CTR Planner

This booklet helps before, during and after the CTR.  It is about consent, planning your CTR and what happens next.  You can either fill it in on a computer, or print and fill it in by hand.

Videos about Care and Treatment Reviews

People talk about why CTRs are a good idea and how much difference they can make.

This film shows how a Care and Treatment Review helped Martin leave hospital and live in his own community again:

Who is involved in Care and Treatment Reviews

The most important person in a CTR is you. A CTR panel will meet with you to talk about your care and treatment. There are usually 3 people on a CTR panel, the chairperson, an expert by experience and a clinical expert. You can find out more about the panel and their role in the CTR booklet.

Below you can read more about Jon, Kath and Peter. They are experts by experience, and are people who have a learning disability, autism or both, or a family carer.  They have experience of services and help the panel to see your care from your point of view.


When I first started doing Care Treatment Reviews (CTR) I felt that the CTR should revolve around the person and that we should fit in with the person having the CTR.  For example, if they wanted to change the time, we changed the time. This was a time of possible change for them, so they should always be at the centre.

Most of the people who have had a CTR have actually enjoyed it, because they were being helped to move on in their lives. But each person and every CTR is different, one size doesn’t fit all.

One comment that has been with me from early on in the reviews was when I was interviewing someone who said to me: “I did not know that people outside were thinking about us. Does it mean I might get a life outside?” I was pleased to reply that loads of people were thinking of them.

Now that some of the teams are known to each other, we know the strengths and weaknesses in each other. As a person with a learning disability, I sometimes see things in a different way. I also remind others, that people with learning disabilities can also get mental health problems.

I like to think that experts by experience are helping our peers to move on to a better life. All the support has to be ready in the community but sometimes we may need to go back into hospital, and that should not be forgotten.

My hope is that the people who have moved on into the community, might one day become experts by experience, and help their peers to move into a better independent life.


Being an Expert by Experience is a huge responsibility.  To go into a room full of professionals and be the voice of a community, to represent people who often don’t think that they have a role or voice, is sometimes tricky, but it is worth it.

I help people who don’t think that they have any role in the processes that have such a huge impact on their lives and their families.  We go in to CTRs to try and look at the person’s care and support needs, differently and our focus is on the person not the system.

We come with a wealth of experiences.  I know lots of people with learning disabilities and their families, and while we are a broad and colourful community, we share knowledge of what it feels like to be in a system that thinks differently than we do.

I’ve done quite a few CTR’s now, and have witnessed some amazing teams working to find a way to enable somebody to have a good life. I’ve encountered resistance, which I have tried to meet with respectful presence, sometimes strong words and occasionally passionate debate.  Changing our conversations is key and the CTR process is a part of a necessary cultural shift.


I have been involved in lots of Care and Treatment Reviews (CTRs) over the last few years. My role is to act as the ‘expert by experience’ on the CTR panel. The panel usually consists of 3 people:

  • the chair (who is often a professional)
  • a ‘clinical expert’ (who has a professional background working in the areas covered by the CTR)
  • the ‘expert by experience.

My background is being a proud dad to a happy son who is living a good life in my local community. My son has lots of labels but if anyone really pushes me to use a label then ‘PMLD’ is usually my choice, Profound and Multiple Learning Disability.

My family background led to me being asked to attend CTRs as an ‘expert by experience’, the work is arranged and co-ordinated for me by my friends at Pathways who are based in Accrington.

I have found the CTR process to be really good in many ways. It is inclusive, with the aim of sharing knowledge to work out what a good life should look like for the person. We then sort out the real world practicalities of making that happen.