At its core the Care and Treatment Review (CTR) has a set of principles that the CTR panel should always uphold. Panel members each have an equal role in making sure these principles are followed:
- Person centred and family centred
- Evidence based
- Rights led
- Seeing the whole person
- Open, independent and challenging
- Nothing about us without us
- Action focused
- Living life in the community
One of the essential components of CTR review is the addition of the independent Panel Members which allows an opportunity for an objective and independent perspective on the care and treatment that is being delivered to individuals in Hospital every 6 months. To ensure that care plans meet individuals’ needs and are being delivered in a person centred and safe way. The CTR Panel involves the CCG responsible Commissioner and two expert advisors –
Expert by Experience: An individual who has learning disability and or autism, a family member or someone who has experience of people undergoing treatment in a Hospital setting or wider experience of learning disability services.
Clinical Reviewer: An independent professional clinician from the field of health care-
Sunderland CCG have always strongly supported the concept of CTR’s, there was recognition from the beginning of the importance and strength of having an objective and independent panel. An independent panel would bring impartiality, scrutiny and when needed challenge to the existing Care Coordination process when reviewing the care and treatment of people in Hospital We have worked closely with our partners to ensure that CTR’s have been undertaken in a person centred approach and to this end early on in the life of the CTR we identified Sunderland People First self-advocacy organisation (SPF) as a key ally and partner to ensure people who have a learning disability could support us in the role of Experts by Experience. Each person who had a learning disability or autism who was acting as an Experts by Experience would be supported by a member of staff from Sunderland People First in this role. Sunderland CCG are also working towards bringing on board Autism In Mind (AIM) as another key ally as an Experts by Experience for individuals with Autism.
NHS Sunderland CCG also undertake Care Education Treatment Reviews (CETRs) these are based on the same principle as CTRs however it’s a way to ensure our children and young people with a Learning Disability and or Autism diagnosis are also cared for to prevent inappropriate hospital admissions or ensuring their stay in hospital is of quality.
For adults and children NHS Sunderland CCG have developed a robust community process to ensure wherever possible they avoid any inappropriate admissions to hospital by undertaking community CTRs / CETRs or Multi-Disciplinary Team (MDT+) meetings.
Please see our Process for further detail and information, also attached is pictures and pen portraits of our Panel Members for information. We have scanned in a copy of a thank you which demonstrates an innovative idea which we implemented in Sunderland, this card is presented to individuals in hospital who have recently had a CTR. On the day of their CTR the panel members in attendance all write a little thank you note and comment around the individual to reinforce what they have done well over the past 6 months whilst in hospital. This has been received extremely well from those who receive it.
“ The CTR processes and checklist co-developed by Sunderland CCG with Experts by Experience can be described as exemplar practice. Ensuring best use of the process and involvement of people and their families . This work has been shared with NHSE National team as part of the policy refresh and continues to be part of North Cumbria and North East Transforming Care Partnership quality assurance ” Julie Bates Strategic Resettlement Hub Lead NHS England