Care and Treatment Reviews – Treatment Pathway / Tools

Last modified: February 28, 2019
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NHS England Care and Treatment Reviews HomepageHere you will find all the current information and resources for CTRs from NHS England:

CTR and CETR Pathways – For policy and guidance, including policy and guidance on CETRs for children and young people, go to: 

Person-Centred Plans

Good planning supported by comprehensive information is vital in order to provide high quality support in any setting. The following list is an example of the person-centred documents that should be available and up to date:

•Person-Centred Care Plan;

•Positive Behaviour Support Plan and other Care Plans;

•Risk assessments;

•Communication Passport;

•Hospital Passport;

•Health Action Plan;

•Mental Capacity Assessment;

•Ministry of Justice documents (where appropriate);

•Activity Planner;

•Discharge Plan (if in hospital); and

•Education Health & Care Plans or SEN Support Plans.

Positive Behaviour Support

Positive Behaviour Support (PBS) is a structured approach to supporting people when there are challenging behaviours. It moves the focus away from what is challenging to supporting positive behaviours. Challenging behaviours are assessed to identify what they mean for the person and then support is given to develop alternative skills to meet this purpose(2).

(2) PBS4 factsheet:

A Behaviour Support Plan is created to help understand and manage behaviour in children and adults who have learning disabilities and display behaviour that others find challenging.

What is a Behaviour Support Plan? 

A Behaviour Support Plan provides carers with a step-by-step guide to ensuring that the person has a great quality of life. It also enables carers to identify when they need to intervene to prevent an episode of challenging behaviour.

A good Behaviour Support Plan is based on the results of a functional assessment and uses PBS approaches. The plan contains a range of strategies which not only focus on the challenging behaviour(s), but also identify ways to ensure that the person has access to things that are important to them. The strategies used are referred to as Proactive Strategies and Reactive Strategies.

Proactive strategies are intended to make sure the person has the things they need and want on a day-to-day basis, and also includes ways to teach the person appropriate communication and life skills.

Reactive strategies are designed to keep the person and those around them safe from harm. They provide a way to react quickly in a situation where the person is distressed or anxious, and more likely to display challenging behaviour. 

A good Behaviour Support Plan has more proactive strategies than reactive ones. This helps to ensure that the focus of the plan is not just on the challenging behaviour, but also provides ways to support the person to have a good life. The person will be enabled to learn better, more effective ways of getting what they need.

Further Information

Information Sheet: Positive Behaviour Support Planning: Part 3—Positive-Behaviour-Support-Planning-Part-3-web-2014.pdf

PBS4: Resources factsheets

Helen Sanderson Associates: Person-centred Practices:

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