Transforming Care

What is Transforming Care?

Transforming Care is a national programme sponsored by NHS England and the Association of Directors of Adult Social Services.  The programme is looking to drive improvements in care and support for people with a learning disability and/or autism who may have concerns about their emotional wellbeing and mental health or who may be behaving in ways that make it difficult or challenging for the family and / or professionals to manage.

The Transforming Care work has 3 aims:

  • Making sure there are better services in the community so less people need to go into hospitals
  • Making sure people don’t stay in hospitals longer than they need to
  • Making sure people get good quality care and support in hospital and in the community.

It is about providing care that is local and meets the individual’s needs to avoid the need to be admitted to a specialist Mental Health hospital – unless this is absolutely in the best interest of the young person or Adult.

Who is it for?

Transforming Care is about improving the lives of children, young people and adults with a learning disability and/or autism.

What’s available for me and my family and how do I access it?

There are support services in your local community for children and adults who are currently in hospital or at risk of going into a Mental Health hospital because of mental health problems, learning disabilities, or challenging behaviour.  If you or someone you know who has LD and or Autism and are worried about their Mental Health and/or their behaviour, then the range of support available includes the following:

  • You could speak to your school SENCo or teacher about your concerns and difficulties and they may be able to offer support and advice
  • You could ask health service professionals such as your GP, or if you are working with other professionals then your Paediatrician, Health Visitor, Speech and Language Therapist or Nurse.
  • If you are known to the Children and Young People with Disabilities Social Work Team you could speak to your social worker who may be able to provide some support and guidance.
  • If you are known to the Emotional Wellbeing and Mental Health service (EWMHS), you should make contact to discuss your concerns. If you are not known to EWMHS then you can make your own referral – the process / contact points are included below.

Care, Education and Treatment Reviews (CETR)

One of the steps that may be of value where the situation is becoming very unmanageable is to have a multi-agency review of the care and support being provided.  This can either happen when someone is already in a hospital because of a mental health problem or due to their challenging behaviour or ideally can happen earlier to help prevent the need for hospitalisation.

This is an all-day review by a panel consisting of a chair (a health commissioner), a clinical expert and an expert by experience (a parent / carer who has experienced similar challenges for their children). The panel meet with the young person and their family/carer, as well as the health, education and social care professionals involved in their care. After hearing views of the young person and their family/carer and reviewing their care in accordance with the Key Lines of Enquiry (KLOEs) set in the CETR national policy, the panel makes recommendations which are shared with the child or young person and their family/carer and the professionals. These recommendations are passed to the young person’s care coordinator who will incorporate them in their ongoing care plan and to respective health and social care agencies to be incorporated in the young person’s care and support plans. The CETR aims to strengthen community support to prevent unnecessary admission to hospital.

Who is eligible?

All children and young people with a confirmed diagnosis of learning disability (LD) or autism (ASD) who are at risk of being admitted into a specialist mental health or learning disabilities hospital on account of their mental health should have a CETR.  Children and young people who have LD &/or ASD and are receiving intensive or crisis mental health services should be included on the “at risk of admission register”.  The register is managed by the local Clinical Commissioning Groups (CCG) and parents will be asked permission for the child’s name to be included on this list to assure that they receive a 6 monthly review of their support plans through the CETR.

Who requests the CETR?

For an eligible child or young person, where they meet the criteria above, requests can be made from; clinical health or Emotional Wellbeing and Mental Health (EWMHS) teams, education or social work professionals. Families and young people can request a CETR through the professional in the EWMHS service.

Useful Links

Contacting the EWMHS service

There is just one main EWMHS number to remember.

Call 0300 3001600 to access the EWMHS during working hours 9am-5pm, Monday – Friday.

For the out of hours Support Service, please call the general NELFT switchboard on 0300 555 1201 to be put through to NELFT’s EWMHS Support Service.

For any further information about the new EWMHS, please visit:

For all general enquiries for the EWMHS project team, please email:

For all referral emails, please email:

All general enquiries will be replied to within five working days and all referrals will be screened by a specialist EWMHS health professional within two working days.

Care, Education and Treatment Review: Code Toolkit   

Transforming Care Information and guidance about Care and Treatment Reviews (CTRs)

Community CETR Workbook

Getting it right for people with learning disabilities going into hospital because of mental health difficulties or challenging behaviours: What families need to know