Care, education and treatment review

Health and care services are being improved. More people with a complex learning disability and/or autistic spectrum condition have the right support to live in their community and close to home. When a child or young person has a complex learning disability and/or autistic spectrum condition, everything should be done to prevent them from being admitted to hospital.

If your child has escalating behaviours we may need to consider setting up a care, education and treatment review (CETR). 

Norfolk and Waveney CCG are responsible for CETR/CTRs. If you would like more information please contact nwccg.cypnavigators@nhs.net.

Read more about care, education and treatment reviews on the NHS website.

Who is a care, education and treatment review (CETR) for?

  • It is focused on children and young people who have been, or may be about to be, admitted to a specialist mental health or learning disability hospital. This could be either in the NHS or in the independent sector
  • It is for children and young people who have a learning disability and/or autism
  • A Care and Treatment Review (CTR) is for adults (age 18+ years-old) who have a learning disability and/or autism

Why should a CETR/CTR be undertaken?

A CETR/CTR should be called:

  • To ensure that any admission to hospital is appropriate. If possible, it should identify and agree alternatives to a hospital admission
  • To review a hospital admission

What questions does a CETR/CTR ask?

A CETR/CTR asks four big questions:

  1. Is the young person safe?
  2. What is the current care like? 
  3. Is there a plan in place for their future?
  4. Do they need to be in hospital for their care and treatment?

A CETR/CTR also has twelve key lines of enquiry:

  1. What are the key areas of concern?
  2. Does the child or young person need to be in hospital?
  3. Is the child or young person receiving the right care, education and treatment?
  4. Is the child or young person being involved in their care, education and treatment?
  5. Are the child or young person’s needs known and met?
  6. Is the right medication being used?
  7. Is there a clear, safe and positive approach to risk?
  8. Are any autism needs being met?
  9. Is there active planning for the future, including discharge from hospital?
  10. Are parent carers, family members and other carers involved?
  11. Are any specific issues for children and young people being addressed?
  12. Are the child or young person’s rights being upheld?

There is a set of personal principles for CETRs and CTRs based around the word ‘personal’. The CETR/CTR panel should always uphold these and CETR standards. 

Commissioners, panel members and people who provide support can find more information in the NHS Care, Education and Treatment Reviews for children and young people: Code and Toolkit.

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