Dynamic support register and care, (education) and treatment reviews
Dynamic support register
A dynamic support register (DSR) is a list of people with a learning disability and/or autism who are at risk of going to hospital if they do not get the right support. This includes children, young people and adults.
A DSR uses a rating system to show the different levels of risk. The ratings are:
- Red: For people who are at high risk of going into hospital straight away
- Amber: For people who are at high risk of going into hospital if they do not get the right care and treatment soon
- Green: For people who are having their risks managed well at home
- Blue: For people who are already in hospital
Ratings help determine the person's needs and makes sure that they get the right care and treatment, such as:
- Going to hospital if appropriate
- Extra support at home to avoid unnecessary hospital admissions. For example, having a care, (education) and treatment review (C(E)RT) or a referral to a transforming care navigator.
A DSR also helps make sure that services include the person's needs in:
- Commissioning plans
- Financial plans
- Service delivery
- Service development
How someone gets added to a DSR
- Professionals can refer someone to go on a DSR
- You can refer yourself to go on a DSR
Download the Norfolk and Waveney DSR self-referral form online
What happens to DSR referrals
The Norfolk and Waveney integrated care board (ICB) receive local DSR referrals. They review all referrals with education and social care workers to consider:
- The persons level of risk of going to hospital
- If the person should go on the DSR
The risk review process happens within four weeks of receiving a referral for the DSR. The ICB will tell the person and/or their parent, carer or referrer the outcome of the review. This will include an update of what will happen next. This is even if the person is not eligible to go on the DSR.
If the ICB decide that the person should go on the DSR, they will:
- Organise regular multi-agency review meetings to manage the DSR
- Review the risks to the person
- Agree appropriate cross-system actions and support
There is a clear escalation structure for people with immediate risks (red and amber ratings). Senior managers across health and local authority services are responsible for the care of these people.
Guidance and resources from NHS England
NHS England have co-produced a set of young people Dynamic Support Register (DSR) and Care Education and Treatment Review (CETR) guides for Autistic young people aged between 16 and 25 years. These leaflets aim to empower young people to better understand the process and benefits of deciding whether to be on a DSR, have a C(E)TR and be actively involved in this process.
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