The aim of a CETR is to facilitate a process of exploring alternatives to hospital admission. If this is not possible, it will continue whilst the child or young person is an inpatient, through their assessment and treatment, and their discharge.
There are three different types of CETR:
- Community CETR - takes place when the child or young person is living in the community (this could also include if they live in a residential placement)
- Post-admission CETR
- Inpatient CETR - takes place when the child or young person is in a specialist learning disability or mental health hospital
A community CETR will take place when it is highlighted that the child or young person is at risk of being admitted to hospital. The aim of this CETR is to seek alternatives to hospital admission, exploring what other services or options are available to keep the child or young person in the community; this will include exploring the option of a Personal Budget.
Sometimes in an emergency situation it is not possible for a community CETR to take place. A community CETR should not be used to hold up the process of admitting someone to hospital if this is needed.
A post-admission CETR will only take place if no community CETR took place. It will take place within 2 weeks of admission.
An Inpatient CETR will take place every 3 months whilst the child or young person is in hospital. The CETR will be solution-focussed, looking at ways to overcome any barriers to the child or young person being discharged, and will agree any actions and timelines for this happening, as well as making it clear who is responsible for those actions taking place.
There are principles which sit at the heart of CETRs which the CETR Panel should always uphold. These are:
- Person-centred and family-centred
- Evidence based
- Rights led
- Seeing the whole person
- Open, independent and challenging
- Nothing about us without us
- Action focussed
- Living life in the community
The CETR must include:
- 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 CCG 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/appropriate:
- Social Worker
- SEND key worker
- School representative
- Youth Offending Team
- Advocate
- VCSE organisations who the young person is known to/involved with
- CAMHS
- Virtual School
- Adult social care/Transitions team (if young person is over 14 years old)
The process uses ‘Key Lines of Enquiry’ (KLOE) which helps to put together a summary and feedback for the child or young person which says:
- Am I safe?
- What is my current care like?
- Is there a plan in place for my future?
- Do I need to be in hospital for my care and treatment?