Transforming Care and Care, Education and Treatment Reviews

Transforming Care is a national programme. It is looking to make improvements in care and support for children, young people and adults with a learning disability and/or autism who;

  • have concerns about their emotional wellbeing or mental health
  • behave in ways that make it hard for their family to manage

The work aims to make sure:

  • there are better services in the community, so fewer people need to go to hospital
  • people do not stay in hospitals longer than needed
  • people get good quality care and support in hospital and in the community

It is about care that is local and meets the person's needs. It helps avoid admission to a specialist Mental Health hospital unless it is in the best interest of the individual.

What is available for me and my family and how do I access it?

There are support services in your local community for children and adults who are currently in hospital or at risk of going into a Mental Health hospital because of mental health problems, learning disabilities, or challenging behaviour.

If you or someone you know who has a learning disability and or Autism and you are worried about their mental health and/or their behaviour:

  • you could speak to your school special educational needs co-ordinator (SENCo) or teacher
  • you could ask health service professionals such as your GP, or if you are working with other professionals such as a Paediatrician, Health Visitor, Speech and Language Therapist or Nurse, you can speak to them
  • if you are known to the Children and Young People with Disabilities Social Work Team you could speak to your social worker
  • if you are known to Southend, Essex and Thurrock Children's and Adolescent's Mental Health Service (SET CAMHS), you should make contact to discuss your concerns. If you are not known to SET CAMHS you can make your own referral. The process and contact points are included in the useful links section

Care, Education and Treatment Reviews (CETR)

One of the steps that may be valuable if the situation is becoming very unmanageable is to have a multi-agency review of the care and support being provided. This can either happen when someone is already in a hospital because of a mental health problem or due to their challenging behaviour or ideally can happen earlier to help prevent the need for hospitalisation.

This is an all-day review by a panel made up of a Chair (a health commissioner), a clinical expert and an expert by experience (a parent / carer who has experienced similar challenges for their children). The panel meet with the young person and their family/carer, as well as the health, education and social care professionals involved in their care.

After hearing views of the young person and their family/carer and reviewing their care in accordance with the Key Lines of Enquiry (KLOEs) set in the CETR national policy, the panel makes recommendations which are shared with the child or young person and their family/carer and the professionals. These recommendations are passed to the young person's care coordinator who will incorporate them in their ongoing care plan and to respective health and social care agencies to be incorporated in the young person's care and support plans.

The CETR aims to strengthen community support to prevent unnecessary admission to hospital.

Who is eligible?

All children and young people with a confirmed diagnosis of learning disability (LD) or autism (ASD) who are at risk of being admitted into a specialist mental health or learning disabilities hospital on account of their mental health should have a CETR.

Children and young people who have LD and/or ASD and are receiving intensive or crisis mental health services should be included on the `at risk of admission register`. The register is managed by the local Clinical Commissioning Groups (CCG) and parents will be asked permission for the child's name to be included on this list to assure that they receive a 6 monthly review of their support plans through the CETR.

Who requests the CETR?

Clinical health or Children's and Adolescent's Mental Health Service (CAMHS) teams, education or social work professionals and families or young people can request a CETR through the professional in the SET CAMHS service for an eligible child or young person as stated in the criteria.

Useful links

Call 0800 953 0222 to access Southend Essex and Thurrock Children's and Adolescent's Mental Health Service (SET CAMHS) during working hours 9am to 5pm, Monday to Friday. For the out of hours support service, call NELFT on 0800 995 1000.

For further information about SET CAMHS visit the NELFT website.

For referrals email:

Care, Education and Treatment Review policy and guidance, code and toolkit

Community CETR Workbook

Getting it right for people with learning disabilities. Going into hospital because of mental health difficulties or challenging behaviours: what families need to know.