NHS England has set out how it intends that reviews of care and treatment arrangements for people with learning disabilities are to be embedded across the health and care system.
Care and Treatment Reviews (CTRs) were developed as part of NHS England’s commitment to improving the care of people with learning disabilities or autism. They aim to reduce unnecessary admissions and lengthy stays in specialist hospitals, and have been rolling out since October 2014; over 1,400 people had their care reviewed up to March this year, with hundreds more since.
They bring those responsible for the care of those who are in, or at risk of being admitted to, specialist hospitals around the table with the individual themselves and their families, as well as independent clinicians and experts by experience, to ensure that the care needs of that individual are being met.
Care and Treatment Review: Policy and Guidance (also available in easy read) has been produced by building on the learning from the reviews which have taken place so far, including extensive engagement with people with learning disabilities, their representatives and their families.
The document will help local Clinical Commissioning Groups and NHS England commissioners implement the recommendation from this learning that CTRs should become ‘business as usual’.
The embedding of CTRs across the health and care system aims to:
- ensure people with learning disabilities and/or autism and their families are listened to, and treated as equal partners in their own care and treatment;
- prevent unnecessary admissions into inpatient settings;
- ensure any admission is supported by a clear rationale with measurable outcomes;
- ensure all parties, including local councils, work together with the person and their family to support discharge into the community (or to a more appropriate setting) at the earliest opportunity;
- help people challenge current care and treatment plans where necessary, and;
- identify barriers to progress and to how these could be overcome.
The new draft policy and guidance will be finalised this autumn following feedback from those implementing it. It is the latest piece of work to emerge from the Transforming Care for People with Learning Disabilities programme, which is a joint piece of work between the NHS England, the LGA, ADASS, the Care Quality Commission (CQC), Health Education England (HEE) and the Department of Health (DH).
In line with the priorities of the Transforming Care programme, it is intended that CTRs will involve a significant shift in commissioning towards high quality community-based services over the next 18 months, that will lead to the closure of some inpatient beds and facilities.