Care (Education) Treatment Reviews - elearning for healthcare
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About the Care (Education) and Treatment Reviews programme

Care (Education) and Treatment Reviews (C(E)TRs) are for children and adults with a learning disability, autism or both. C(E)TRs were developed as part of NHS England’s commitment to improving the care of people with learning disabilities autism or both. (Please note, for children and young people, the reviews are called “Care, Education and Treatment Reviews” or CTRs). 

The ‘Care and Treatment Review: Policy and Guidance’ was first published in October 2015. It was revised in 2023. 

At its heart, a C(E)TRs is based on the following important principles: 

  • Person centred and family centred
  • Evidence based
  • Rights led
  • Seeing the whole person
  • Open, independent and challenging
  • Nothing about us without us
  • Action focused
  • Life in the Community

This summary guide is to help everyone involved in C(E)TRs understand their role, and what happens at a review. It explains how the review panel might offer a challenge to services to think differently about the care and support to the person that enables them to remain in their home and their community. 

The reviews follow key lines of enquiry (KLOEs) and always ask for the person: 

  • Am I safe?
  • What is my current care like? What are the key risks and issues?
  • What is my daily life like? What is my current care package?
  • Are my physical health needs being met?
  • Is there a plan in place for my future? What are the views of the person, their family, carers and advocate?
  • Do I need to be in hospital for my care and treatment? How can we support the person in the community?

More information

As part of the Transforming Care Programme, the C(E)TRs Policy was first published in October 2015, with a refreshed policy being published in March 2017, and a new revised policy published in 2023. 

Following the shocking abuse seen at Winterbourne View, a hospital for people with learning disabilities and autism, in 2011. People with learning disabilities, family carers, health and social care organisations came together to form the Transforming Care programme. 

“Building The Right Support” and “The National Service Model” were also published by NHS England and its partners in October 2015. The Service Model states that: 

“Children, young people and adults with a learning disability and/or autism who display behaviour that challenges, including those with a mental health condition have the right to the same opportunities as anyone else to live satisfying and valued lives and, to be treated with the same dignity and respect. They should have a home within their community, be able to develop and maintain relationships and get the support they need to live a healthy, safe and fulfilling life.” 

C(E)TRs are different from other reviews of peoples care. They are about making sure services put children and adults at the centre of their care. They are independent from the person’s day to day care, and the review panel is made up of the commissioner and two independent expert advisors – both clinical and experts by experience. 

C(E)TRs were introduced to help people in hospital, to prevent unnecessary admissions into hospital and where people do need to go into hospital to support there being clearly specified intended treatment outcomes and a discharge plan. 

Please see the following website for information about C(E)TRs: 

NHS England is currently working to develop new elearning sessions to support with C(E)TRs delivery. In the meantime, previous elearning sessions based on the 2015 policy have been retired. 


Project team

  • Mental Health Programme Team, NHSE
  • Learning Disability and Autism Team, NHSE

How to access

Available to all

The Care (Education) and Treatment Reviews (C(E)TRs) programme is freely available to access here.
Please note your progress and completion of sessions will not be recorded and you will not be able to generate a record of completion. If you require evidence of learning, please register and then log in to access this programme on the elfh Hub.

If you already have an account with elfh, then you can enrol on to the Care (Education) and Treatment Reviews (C(E)TRs) programme by logging in to the elfh Hub, selecting My Account > Enrolment and selecting the programme. You can then access the programme immediately in the My elearning section.

Register >

To view the Care (Education) and Treatment Reviews (C(E)TRs) programme, select the View button below. If you already have an account with elfh, you will also be able to login and enrol on the programme from the View button.

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NHS healthcare staff in England

The Care (Education) and Treatment Reviews (C(E)TRs) programme is also available to NHS healthcare staff via the Electronic Staff Record (ESR). Accessing this elearning via ESR means that your completions will transfer with you throughout your NHS career.

Further details are available here.

Not an NHS organisation?

If you are not an NHS health or care organisation and therefore do not qualify for free access elfh Hub, you may be able to access the service by creating an OpenAthens account.

To check whether or not you qualify for free access via OpenAthens, you can view the eligibility criteria and register on the ‘OpenAthens’ portal.

Registering large numbers of users

If you are a HR, IT or Practice Manager and would like to register and enrol large numbers of staff within your organisation for access onto the Care (Education) and Treatment Reviews (C(E)TRs) programme, please contact elfh directly.

Organisations wishing to use their own LMS

For HR departments wanting to know more about gaining access to courses using an existing Learning Management System please contact elfh directly to express interest.

More information

Please select the following link for more information on how to use the elfh Hub.

elfh is a NHS England programme in partnership with the NHS and professional bodies