Care and Treatment Reviews

Care and Treatment Reviews (CTR) have been developed as part of NHS England’s commitment to transforming the services for people with learning disabilities and/ or autism who display behaviour that challenges, including those with a mental health condition.

The CTR ensures that individuals get the right care, in the right place that meets their needs, and they are involved in any decisions about their care.

NHS England has published final CTR policy and guidance (CTR policy and guidance in easy read also available) that outlines what a CTR is, the required standards, and how they should be done, along with a toolkit for commissioners and easy read leaflets for people with learning disabilities and/or autism, and their families or carers.

What a CTR covers

The CTR focuses on four areas: is the person safe; are they getting good care; do they have a plan in place for their future and can their care and treatment be provided in the community. They are carried out with:

  • people receiving care in a specialist learning disability or mental health hospital – to see if they can move to a community setting;
  • people who are at risk of being admitted to a specialist hospital – to see if there are any other options to prevent an admission;
  • for people who do need specialist hospital care – to ensure they have a care plan with clear outcomes from the start, that focuses on transferring them back to a community setting as soon as they are ready, to prevent unnecessarily lengthy hospital stays.

The CTR team involves the commissioner and two expert advisors – an individual or family member with experience of learning disability services (an ‘expert by experience’) and an independent clinician – to ensure that care plans meet individuals’ needs. It also involves those who are providing their current care. Following the CTR, the review team makes recommendations, with follow-up checks to ensure the activity is being delivered.

Person-centred approach

The individual and their family are central to any decisions about their care, and an ‘expert by experience’ brings their ‘lived experience’ to the review team. Find out more about role from ‘experts by experience’, Di Lofthouse and Phil Palmer.

Di Lofthouse

Phil Palmer

Individuals and anyone involved in their care have a ‘right to request’ a CTR if they are concerned about their care and treatment in specialist hospital setting.

Find out more

Care and Treatment Review webinars

A series of NHS England webinars were held for commissioners and other agencies to help implement Care and Treatment Reviews (CTRs). Information was presented by NHS England’s Best Care Now team, plus guest speakers, including opportunities for sharing information and open discussion.