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Dynamic Support Register

Building the right support and the C(E)TR policy and guidance (2017) asked that local health commissioners work with their local partners, including social care and education, to develop and maintain a register of all people with a learning disability and autistic people, including those considered to be at risk of admission to a mental health hospital. This is now known as the dynamic support register (DSR)

Coventry and Warwickshire’s DSR brings together health, social care, education and other system partners to support people with a learning disability and autistic people.

The goal of the DSR is for people to have good quality support at the right time and in the right plan. It also aims to prevent unnecessary hospital admissions for people with a learning disability and autistic people.


If you would like to refer yourself or someone else to the Dynamic Support Register, please complete the self-referral form.

Please note that if you, or the person you are referring needs an urgent or immediate response from mental health, please look here: Find Help Now | Coventry and Warwickshire Partnership NHS Trust 

The DSR Team does not provide an emergency crisis response service and works 9am – 5pm Monday to Friday.

If you are referring yourself or someone close to you:

  • We will contact you within 5 working days to take further information to understand the current needs and help us to manage your referral information submitted will be shared with colleagues from health and social care to discuss current needs, levels of risk and potential sources of support.
  • If the person is added to the DSR, their information with organisations who may be providing support, depending where you live including:

- Coventry City Council or Warwickshire County Council
- Coventry and Warwickshire Integrated Care Board
- Coventry and Warwickshire Mind
- Fine Futures

When referral decisions are being made, it is important that all relevant information about the DSR is shared with the person the referral is for, plus those with parental responsibility and services that support them.

Information about the DSR is available in various formats to ensure that the person can understand, retain and weigh up information about this decision, so that they are able to give informed consent. Consent can be withdrawn at any time.

If a person is assessed as not having the capacity to give informed consent, a best interest decision can be made under the Mental Capacity Act to be referred to the DSR.

It is important to know that not consenting to join the register will not affect the person’s current support.

For a referral to be accepted it is essential that:
1. The person has capacity to give informed consent or;
2. A best interest decision has been made on behalf of them if they don’t have capacity.
and
3. Have a diagnosis of a Learning Disability or Autism

NHS England’s guidance on the Dynamic Support Register and risk stratification is outlined in the Dynamic support register and Care (Education) and Treatment Review policy and guide (2023)

This guidance says that each health and care system’s DSR should use a Red/Amber/Green (RAG) rating or similar locally agreed process to stratify the needs of those on their DSR.  This is to ensure early identification of people whose needs may require a comprehensive response and to keep sight of those whose needs may escalate and require an enhanced, different or more specialist response.

We have adopted the definitions of Red/Amber/Green from the national policy, which are outlined below. 

Healthcare professionals will undertake a Clinical Support Tool (CST) to decide which of these RAG ratings applies best to each person on the DSR, and what support they need at the time of referral.

RAG Rating Defintion
Green
  • There are some risks that could lead to the person being admitted or re-admitted to a mental health hospital; but currently these risks are being effectively managed. Linked process:

Linked Processes: 

  • clear identification of partners who would need to be involved in a C(E)TR if required
Amber
  • There will be an immediate risk that the person will be admitted to a mental health hospital without urgent intervention.
  • There could be a significantly increased risk of the person becoming mentally unwell and/or placement/family breakdown

Linked processes: 

  • multi-agency meeting and/or C(E)TR
  • referral to the keyworker service (0–25 years), if not already known to this service
Red 
  • There is an immediate risk that the person will be admitted to a mental health hospital.
  • The person and/or their family are experiencing a crisis and the risk of admission to a mental health hospital are not being or cannot be managed in the community.

Linked processes: 

  • a C(E)TR must take place
  • referral to the keyworker service (for people aged 0–25 years) if the person is not already known to this service
Blue
  • This rating identifies children, young people and adults currently in inpatient services.

 

The information held on the DSR will be:

  • Name
  • Date of birth
  • Where you live
  • NHS number
  • Key professional involvement, their names and contact details.
  • Current issues that can lead to a hospital admission.
  • What has been tried that could help (including positive strategies to improve a person’s quality of life, increasing life opportunities and self-esteem).
  • What could be useful to reduce risks further.
  • An action plan moving forwards including recommendations for current and potential future services.
  • Current diagnosis of a Learning Disability and Autism
     

NHS England have published a set of guides for Autistic young people aged between 16 and 25 years about the Dynamic Support Register (DSR) and Care Education and Treatment Reviews (CETRs).

These leaflets are aimed 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.

They are available to view at DSR CETR Young Person Guides.