Learning Disability and Autism Dynamic Support Register

The Dynamic Support Register (DSR) is a list of children, young people and adults with a learning disability and/or autism with the most complex needs who are at risk of admission to a mental health hospital.

Sometimes, people experience changes in their circumstances, environment, health, or support needs that increase the risk of crisis and risk of admission to a mental health hospital.

Recognising these risks early and working together across services helps ensure the right support can be put in place at the right time so people can live well where they live and only go into hospital if they really need to

The dynamic support register is not a crisis or support service.

If you need help in a crisis, see below the support section at the bottom of this page.

What is a Dynamic Support Register

A Dynamic Support Register (DSR) is a list of autistic people and people with a learning disability with the most complex needs who need support because they are at risk of being admitted to a mental health hospital or are already in a mental health hospital.

The register or list helps services work together to support people to stay well at home and avoid preventable admission to a mental health hospital.

The aim is for organisations responsible for delivering and commissioning services in health, social care and education to respond early and quickly to prevent further deterioration or escalation that could lead to a crisis and when needed to arrange a care (education) and treatment reviews.

What the DSR is not

a waiting list
a crisis or emergency service
a replacement for a professional assessment or treatment
a guarantee of a specific level of support

If you need urgent help, please see the crisis support section at the bottom of this page.

Who is the register for?

The referral criteria to be added to the dynamic support register are

Children, young people and adults with a confirmed diagnosis of learning disability (also called an intellectual disability), autism or both AND
At risk of being admitted to a mental health hospital or are already admitted to a mental health hospital.

We have a dynamic support register for each of our six boroughs (Croydon, Kingston, Merton, Richmond, Sutton and Wandsworth) in South West London.

Why is it important?

It gives broad oversight of the person’s care with the primary intention of preventing avoidable hospital admissions and placement breakdowns as well as facilitating discharge from inpatient settings. It also helps inform local population need for commissioning.

Oversight There are regular meetings of commissioners and professionals to ensure oversight of people on the list.

Helps identify risks early – There is a focus on people who are most at risk of hospital admission or placement breakdown.

Prevents avoidable hospital admission – Facilitates the sharing of information with relevant professionals and commissioners across health, social care and education with services being able to respond to prevent escalation.

Collaboration – Provides a forum for communication and joined up working across social care, health and education where people may require a multi-agency response.

Helps Inform Service developments – anonymised insights and data from the dynamic support register can help inform future service planning.

How to be added to the DSR

People will only be added to the DSR if their needs show they are at risk of going into a mental health hospital or have been admitted to a mental health hospital and they meet the criteria for the DSR.

There are a range of factors that may place someone at risk of admission to a mental health hospital that are carefully considered.

Professionals

If you are a professional in health, social care or education, you can refer people onto the register in your borough.

Professionals can only make a referral using digital form via this link SWL ICB – DSR: Dynamic Support Register

For queries or further information – please email [email protected]

For indivduals, families and carers

You can make a self-referral to the DSR. If you make a self- referral, we will also need to contact a health or social care representative who knows you well for further information.

For Self-Referral Please email us at [email protected]

Please include:

name
date of birth
address
name of your GP surgery
best way to contact you (email, phone, letter, or something else)
If you or the person you are referring has a learning disability, or are autistic

You can also ask a professional who knows you to help you make a referral or do it for you. This could be:

Social worker
Mental health worker
SENCO
SEND case officer
Advocate

If you believe someone you support or care for could benefit from being on the Dynamic Support Register, speak with your social worker, school Special Educational Needs Co-ordinator (SENCO), or a healthcare professional. They will assess their needs and, if appropriate, refer them to be included on the register.

How we use and protect your information

The Dynamic Support Register is managed by NHS South West London.

Only trusted professionals can see or update it
It may be shared with health, education, and social care teams
A version with no names is shared with the wider NHS team to help improve services
All information is kept safe and follows the law (Data Protection Act 2018 and GDPR).
It is used to record what support the person is getting and what’s been done to help them.

Find out more about DSRs on the NHS website

Care Education and Treatment Review (CETR)

A Care, Education and Treatment Review (CETR) is a meeting for children, young people and adults with a learning disability and/or autism who are at risk of admission to, or are currently in, a mental health hospital.

The purpose of a CETR is to make sure the person is receiving the right care and support. The person and their views are central to the review.

CETRs bring together professionals and an independent panel to look at whether care and treatment are working well and what changes might be needed

There are two types of CETR:

Inpatient CETR – for people already in hospital, to review care and support discharge planning.

Community CETR – for people at risk of admission, to help prevent unnecessary stays in a mental health hospital.

Who is invovled?

The meeting is chaired by the responsible commissioner or someone delegated by the commissioner to act on their behalf.

CETRs are carried out by a panel.

The panel includes:

an independent clinical expert who is qualified to work in healthcare
an expert by experience, who is a person with a learning disability or autism or a family carer with lived experience of services
a commissioner who is responsible for paying for the person’s care

When will a CETR be arranged

A CETR may be arranged if the person meets the criteria :

has a diagnosis of learning disability and/or autism and
is currently in a mental health hospital
or is at immediate risk of admission to a mental health hospital

Consent must be obtained before a CETR takes place. For children under 16, parental consent is required. For those aged 16 and over, consent or a best interest decision is needed.

What a CETR does and does not do

Inpatient CETRs

seek to improve the quality-of-care people receive in hospital
make recommendations that lead to improvements in safety, care and treatment.
aim to reduce the amount of time people spend in hospital

Community CETR

seek to ensure system partners are working with people and families to provide the right care, education and treatment to avoid the need for an unnecessary admission to a mental health hospital.

A CETR does not:

guarantee any specific level of support or make funding decisions
replace regular multi agency meetings
need to take place before discharge from hospital can happen
decide whether a person should be admitted, transferred or discharged from hospital, this is the responsibility of clinician teams

For Further Information contact:

Please note this is not an urgent service and we aim to respond within 5 working days: [email protected]

If you need urgent help in a crisis

If you or someone you care for is in immediate danger, call 999.

If you need urgent mental health support, contact: