Care, (Education), and Treatment Reviews: A Different Kind of Meeting
If you haven’t had a Care, (Education), and Treatment Review or C(E)TR before, you might be questioning what it is, what to expect and how it will actually help you.
That’s exactly how I felt before experiencing one. I remember wondering, how would this be different to any other meeting? Would it really change anything?
And yet, it did.
What are C(E)TRs and who are they for?
C(E)TRs are meetings to look at the care and treatment someone currently needs but also what they might need in the future. It’s a chance to review what’s working, what isn’t and what needs to change.
These meetings are for autistic people and/or people with a learning disability. Specifically, people who are either:
at risk of being admitted to a mental health or specialist hospital
or are already in hospital.
Adults have Care and Treatment Reviews (CTRs). Meetings for children and young people explore educational needs and are called Care, Education, and Treatment Reviews (CETRs).
Sometimes a person may need to be in hospital. However, C(E)TRs aim to reduce unnecessary hospital admissions or, when admission is necessary, reduce the length of time someone stays in hospital. The aim is to make sure people get the right care and support, with a focus on identifying support to help someone stay well at home.
Who is involved in the meeting?
C(E)TRs are facilitated by people not involved in someone’s everyday care. This independent panel includes: a person with direct lived experience of being Autistic and/or having a learning disability, or, from being a family carer; a clinical expert; and a person from the authority who is responsible for paying for the care and treatment someone needs.
Importantly, the panel meets with and listens to the person. They also speak to their family members or carers if the person would like them to be included; an advocate if they have one; and education, health and social care professionals involved in their care. The panel uses all of the information they gather, along with their experience, to create an action plan of recommendations.
What makes a C(E)TR different?
Everyone’s experience will be different. I felt my CTR had a different dynamic to other meetings. I valued the independent panel, especially there being someone with lived experience, and that it was about problem solving, ‘thinking outside the box’ and creating a clear plan.
The panel listened to my reality and my hopes for the future. It was the first time someone with lived experience had been involved in my care and treatment in a clinical setting. And I am almost certain that if this had happened sooner, it would have helped to bridge the gap between myself and professionals around me. Conversations felt like they slowly started to shift from being ‘about’ me and ‘doing to’ me towards being ‘with’ and ‘alongside’ me.
Creating a positive experience
C(E)TRs often take place at stressful times. Here are five thoughts on what can help make them as supportive and accessible as possible:
Arranging C(E)TRs as early as possible e.g. not waiting until someone has reached the point of crisis.
Not just being asked but being supported, to understand and share what small changes (or reasonable adjustments) would help before, during and after a C(E)TR.
Health and social care professionals having a good understanding and feeling confident about C(E)TRs.
Time and support to prepare and making the process as predictable as possible.
Clear information in a way that fits a person’s communication and information needs, including how the recommendations are shared at the end.
The ‘how’ matters
Because ‘how’ a C(E)TR is facilitated could make the difference between it feeling empowering or it feeling overwhelming.
If a person doesn’t have time to prepare, or it’s held in an environment that doesn’t support their needs, or conversations move on too quickly, it risks becoming rushed, confusing, and inaccessible. How recommendations were reached could feel unclear, and someone may not feel at the very heart of their C(E)TR.
And the ‘how’ extends beyond the C(E)TR day. If the recommended actions are not followed up or there isn’t clear responsibility for who should make them happen, the process might feel like a ‘box to be ticked,’ rather than a day that made a difference.
The potential to change lives
C(E)TRs can help open up possibilities and change lives, but a C(E)TR isn’t just about the action plan. Facilitated well, it can help someone feel truly heard and valued.
The meeting design highlights the value of bringing together and listening to the experiences and expertise of many different people. It takes time and care. Yet, when all of these different voices and perspectives are welcomed and valued, a C(E)TR can become a genuinely meaningful opportunity, and so much more than ‘another meeting.’
To find out more about C(E)TRs, visit NHS England’s webpage to find Plain English and Easy Read policy and guides about the dynamic support register and Care (Education) and Treatment Reviews.
