About Care and Treatment Reviews (CTRs).
It says ‘ere https://www.england.nhs.uk/learningdisabilities/ctr/:
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.
This review programme is all about trying to get Assessment and Treatment Unit (ATU) inpatients assessed, treated and returned to their communities as soon as possible. It is something I have been involved with over the past 18 months as an independent ‘expert by experience’ attending these reviews and trying to do my best to make sure patients’ needs are being met and their plan for discharge is not forgotten about. There are many hundreds like me, all trying to make a difference.
How embarrassing being called an expert by experience. It always feels a bit uncomfortable announcing myself as an expert at reviews. After all I am only the parent of a lad with severe and complex needs. That’s just it though, giving parents like me equal status with the professionals around the table means that those with lived experience like you and me can have a voice, be heard and are taken seriously. I love this role as an equal member of the review team, mixing-it with the health professionals and helping to advocate for the patient and their relatives.
So what difference do they make? As you can see from the campaign this week many families have had and are having horrific experiences with ATUs, their son’s and daughters stuck for years as inpatients with no end in sight or worse still, losing their lives. It breaks my heart to hear their stories and it is especially important to me knowing that my own challenging autistic son could so easily be in the same position. I am not sure if our families would share my enthusiasm for Care and Treatment reviews but they are a very significant part of the road to discharge and I know from personal experience that they are helping to change things considerably. I would however agree that change is clearly not happening fast enough.
I should mention that another review framework may also be used for those with a mental health diagnosis. The Care Programme Approach (CPA) is a well established review and assessment system which also looks at the person approaching discharge to identify and provide what they need to return to their community. It is perhaps best covered in another blog. If you want to find out more here is a factsheet from Rethink Mental Health: http://www.rethink.org/resources/c/care-programme-approach-cpafactsheet
To families I say don’t give up hope, things really are changing however bleak it looks now. I share your anxiety, frustration and fears. This is one part of the process, I will share my thoughts about other challenges as the week progresses. My pointy finger of blame is ready to strike any day now.
To NHS England I would like to say this. Please keep CTRs under your direct control and don’t contract them out as planned. There are already reports that the process is being undermined with new Providers slashing allowances by half resulting in experts by experience leaving in droves. This is far too important to gamble with.
If you would like more information, policy and guidance including your right to request a Care and Treatment Review see the following document:
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