Building the Right Support:
In October 2015, NHS England, the Local Government Association, and the Association of Directors of Adult Social Services (ADASS) published a paper called Building the Right Support (PDF 174MB).
This is a national plan to improve local health and care services for people with a learning disability, a mental health condition, and/or autism (who display behaviour that challenges). The goal is to ensure people can be supported in their community instead of going to hospital. People should not be forced to use inpatient services to make up for a lack. of community services and support.
The Transforming Care Programme:
The delivery of Building the Right Support is being overseen by the national Transforming Care programme, which is managed by the Transforming Care Delivery Board (TCDB).
Transforming Care Partnerships (TCPs):
At local levels, the programme is run by 48 different Transforming Care Partnerships (TCPs) across England. TCPs are made up of clinical commissioning groups (CCGs) or integrated care systems (ICSs), special commissioners, and local authorities. Each TCP is in charge of local plans to improve health and care.
The Northamptonshire Transforming Care Partnership (TCP) is a coalition between the Northamptonshire Integrated Care System (ICS) and the Northamptonshire local authorities. They work with people with disabilities and their families / carers to agree and deliver local plans for the Transforming Care programme.
Care & Treatment Reviews (CTRs) and Care, Education, & Treatment Reviews (CETRs):
The main way Transforming Care works with people is by using Care, Education and Treatment Reviews (CETRs) with children and young people, and Care and Treatment Reviews (CTRs) with adults.
CTRs and CETRs are a meeting about a person who has a learning disability and/or autism and who is either at-risk of being admitted to, or is currently detained in, an in-patient (usually psychiatric) service. CETRs and CTRs should focus on hospital discharge or avoiding admission. They should ensure people are getting the right support and help they need, and that this is at home, or as close to home as possible.
CETRs/CTRs can be requested at any time. They should be arranged by the commissioner.
In the community, CETRs/CTRs should happen if hospital admission is a risk. This is called a "Blue Light CETR/CTR." Blue Light CETRs/CTRs will often be arranged very quickly and held over the phone.
In Assessment and Treatment Units (ATUs), CTRs should happen every 6 months. In secure services, it should be every 12 months. For children and young people, a CETR should take place every 3 months.