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Dynamic Support Register

The Dynamic Support Register (DSR) and Care Education and Treatment Reviews (CETRs) work together as a mechanism to help keep children and young people who are autistic and/or who have a learning disability out of mental health hospitals where possible, and instead seek to agree and provide support within the community and home environment. For children and young people who are autistic and/or who have a learning disability in a mental health hospital, CETRs are used to review the quality of care and treatment provided regularly, and this also includes preparation for discharge. 

The DSR is a register for people who are at risk of being admitted to a specialist learning disability or mental health hospital. The information held on the DSR is shared with a small group of lead professionals from relevant Social Care, Education, and Health services. Together these professionals review the children and young people on the register to think about what more support might be needed. Being on the DSR may mean a community CETR would be a helpful next step. Children and young people on the DSR will be placed in different priority categories according to their level of risk.

DSR and level of risk

There are four levels of risk. These are as follows:

Any inpatient admission should be based on very clear reasons why certain needs can only be met in hospital. Inpatient services should not be used due to a lack of local services and support. The aim of a CETR is to avoid an unnecessary admission wherever possible or for those that are inpatients to ensure there are clear plans and steps to support discharge so that people do not remain in hospital longer than necessary.

An inpatient CETR reviews the following for a person:

  1. Is the person safe?
  2. What is their current care like?
  3. What is the person’s daily life like?
  4. Is the person’s physical health needs being met?
  5. What are their care plans for the future? This includes their educational needs and related support provision.
  6. Does the person need to be in hospital for care and treatment or can this be provided in the community?

For more information, please see the DSR and CETR Family Guide, and Policy:

What is the Keyworker service?

The Key Working Function has been developed as a response to the NHS England & NHS Improvement Long Term Plan (LTP) commitment that eligible children, young people and inpatients with a learning disability, autism – or both – with the most complex needs will have a designated Key Worker.

The Key Worker service in Birmingham and Solihull is being delivered by Barnardo’s and aims to provide dedicated key workers for children and young people with a learning disability and/or autism diagnosis, aged 0-25 with a focus on 14-25s, who are already in hospital or crisis and at risk of admission. The team will provide support to children, young adults and families, helping them to access the right help at the right time across complex systems. Find out more.