Care and Treatment Reviews – Updates to the CTR policy

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.

Updates to the CTR policy

The policy for Care and Treatment Reviews changed in March 2017. These are the key changes:

  • Greater focus on the quality of CTRs and the values which underpin them
    New measurable national standards by which CTRs are to be carried out
    Clearer emphasis that CTRs are for people with autism, as well as for people with learning disabilities
  • A separate Policy Annex on  Care and Treatment Reviews for children and young people and a change of name to Care, Education and Treatment Reviews, (CETRs) to ensure the young person’s learning needs are also considered, working with key people from education
  • Changes in the frequency of CTRs to:
    • Every six months for people in non-secure hospitals
    • Every twelve months for people in secure hospitals
    • Every three months for children and young people in hospital
  • Post-admission CTRs take place within four weeks of admission other than for children where this is within two weeks of admission
  • CTR panel to follow new key lines of enquiry template
  • Greater emphasis on evidencing recommendations
  • Clearer responsibilities and checklist for providers to gather the evidence required in advance and actively to support the process before, during and after a CTR
  • Recommendations in CTR reports to name people responsible for carrying out each action by a given date, with a responsibility for commissioners to oversee a process of checking, resolving difficulties and ensuring that the person and their family is aware of progress
  • Two new resources for the person having a review: one providing all the information needed in one booklet; the other booklet providing new tools such as a CTR consent form, CTR planning document, CTR feedback form and a template to support the person to record key actions to be carried out in the way they find most helpful
  • New resource for experts by experience

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