CTR guidance and tools for commissioners, panels and people providing care

Many people are involved in supporting a person through their Care and Treatment Review (CTR) including commissioners, CTR panel members, family carers, providers andĀ other professionals.

The CTR is about much more than what happens on the day. It is about planning ahead to gain the person’s consent and a decision about whether they wish to invite people such as family carers, advocates and anyone else important to them. Or properly involving others in this if the person is under the age of 16 or does not have capacity to decide.

It is about gathering all the documents needed for the CTR and supporting the person to get ready for their CTR. It is about involving the person and family carers meaningfully and in the way that is best for them on the day. It is also about sharing the CTR report with all those who took part.

The follow-up is just as important too – making sure the recommendations become embedded in the care process, and are carried out by named people within a given time. It is important that the person and their family know what is happening.

This page includes:

CTR/CETR Code and toolkit

The CTR/CETR Code and Toolkit is for everyone involved in supporting the person throughout the CTR, including the CTR panel members and commissioners. The first part of the document is a code of practice which sets out national standards for CTRs and the principles which underpin them. Each standard has a set of criteria by which it can be measured.

The ‘toolkit’ section includes practical tools to make this happen:

  • specifications for CTR/CETR expert panel members
  • details of documents to be provided
  • a checklist for providers
  • commissioner checklist
  • model agenda for the day
  • role of the chair
  • hospital discharge steps and standards – advice, helpful links and a stepped guide designed to improve the process and support the involvement of children, young people and adults and their families.


For commissioners and CTR /CETR chairs

The commissioner or CTR chair should ensure that the person having a CTR is given a copy of ‘My Care and Treatment Review’ and ‘My CTR Planner’ before the day. These booklets work together to provide information and help with consent and planning. They are available with or without symbols.

New templates based on key lines of enquiry replace the 2015 ones. These include a range of community and hospital templates for children, young people and adults. These templates have been adapted in response to feedback, to make them better suited to the panel’s needs.

There are also 6 new workbooks for CTR and CETR panel members. These are based on the key lines of enquiry used in a CTR/CETR. They help each panel member gather information which helps the chairperson complete a template document and the CTR report. There are workbooks for each type of CTR/CETR.

For CTR /CETR experts by experience

This booklet for CTR experts by experience is in line with the revised policy 2017. It describes the role and how experts are involved on the CTR panel and the key points of the revised policy, principles and standards. It also gives practical help and advice.

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

Important information for providers

Health and social care providers have a vital role making sure that CTRs are carried out well. From how the person is supported before, during and after their CTR, to the preparation of materials for the CTR, embedding the CTR into the care process and ensuring that any actions required of the provider are carried out well. C(E)TRs – the role of health and social care providers contains many useful tips and tools to help providers do this.

Reporting on CTRs in the Mental Health Services Data Set (MHSDS)

It is mandatory for all providers of NHS-funded specialist secondary mental health services to submit data about these services to the Mental Health Services Data Set (MHSDS). This applies to both NHS and independent providers. Details on all patient CTRs (and CETRs) should be captured in the MHSDS. This will enable NHS England to monitor whether the care and treatment of patients is being reviewed in line with national guidance. Please refer to the CTR booklet and/or the separate information on how to submit CTR data as part of MHSDS reporting.