Care, Education and Treatment Reviews (CETRs)
Care, Education and Treatment Reviews (CETRs) are for a child or young person up to the age of 18 who is either:
- facing admission to a specialist learning disability or mental health hospital
- is a patient already
This includes people under the care of NHS England or North Central London Integrated Care Board (NCL ICB).
After age 18, they'll come under the adults’ policy and process, which is very similar to the children’s process in many respects.
What a CETR does
A CETR aims to find alternatives to hospital admission and explore what other services or options are available.
If nothing else is possible, the CETR will continue while the child is an inpatient, through to hospital discharge.
The CETR is made up of a panel of independent experts, which could include a clinical reviewer and an expert by experience.
Types of CETRs
There are 3 types of CETR.
Community CETR
Community CETR is when the child or young person is living in the community or in a residential placement. A community CETR happens when they're at risk of being admitted to hospital and it aims to find alternatives so they can stay in the community. This will include exploring the option of a Personal Budget.
Sometimes in an emergency situation, it's not possible for a community CETR to take place. A Local Area Emergency Protocol (LAEP) meeting, arranged with local agencies, might happen instead. However, the LAEP will not include independent experts and clinical experts.
Post-admission CETR
A post-admission CETR will only take place if no community CETR took place. It will take place within 2 weeks of admission.
Inpatient CETR
Inpatient CETR is when the child or young person is in a specialist learning disability or mental health hospital.
An inpatient CETR will take place every 3 months while the child or young person is in hospital. It'll be:
- solution-focused
- looking at ways to overcome any barriers to the child or young person being discharged
- agreeing on any actions and timelines
- making it clear who's responsible for those actions taking place
Who is involved in a CETR
The CETR must involve:
- the child or young person (if they choose to attend)
- family members (if the young person wants them to be there)
- the responsible commissioner (usually the local Care Commissioning Group if a community CETR, or NHS England if a post-admission or inpatient CETR)
- responsible clinician or senior nurse
Other people or services who may be helpful or appropriate include:
- social workers
- school representative
- youth offending team
- advocate
- voluntary and community sector organisations who the young person is known to
- child adolescent mental health service
- adult social care and transitions team, if the young person is over 14 years old
Who can request a CETR
Anyone, including the child or young person, or their family, can request a CETR.
But CETRs cannot happen without the consent of the child or young person. If this is not possible, perhaps because of their age or if they've been assessed as lacking capacity, their parent or carer may give consent.
In Camden, CETRs take place as part of normal case management process and reviews where possible. If you want to request a CETR for yourself or for your child, you need to speak to either:
- social worker
- health professional leading on the care
- the SEN department
They'll discuss the request with you and can take it further for you.