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Dynamic Support Register (DSR)

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What is the Dynamic Support Register (DSR)?

The Dynamic Support Register (DSR) is a register used across north ast London to identify and support children, young people and adults with a learning disability and/or autism who may be at risk of admission to a mental health hospital.

The DSR helps services work together to:

  • identify people who need additional support
  • provide early intervention
  • reduce the risk of hospital admission
  • ensure coordinated, multi-agency care

Who should be referred to the DSR?

An individual should be considered for the DSR if they:

  • have a confirmed diagnosis of a learning disability, autism, or both
    AND
  • are at risk of admission to a mental health hospital or currently admitted

This may include individuals who:

  • are experiencing escalating needs or crisis
  • are at risk of placement breakdown
  • are at risk of harm to themselves or others
  • are awaiting or require a mental health inpatient bed
  • have recently been discharged from hospital and require ongoing review

The DSR is not a crisis service but supports early identification and coordinated response.

How the DSR works

The DSR uses a colour-coded risk system (RAG) to help teams prioritise support:

  • Red: High risk of immediate hospital admission
  • Amber: High risk if support is not provided promptly
  • Green: Risk is being managed well in the community
  • Blue: Individual is currently receiving inpatient care

All individuals on the register are discussed in multi-agency MDT meetings, where services:

  • review current risk ratings
  • identify what is working and what needs to change
  • agree actions to reduce risk and coordinate care

Local teams are responsible for ensuring that all referrals and self-referrals follow consistent review and oversight processes, and that individuals, families, or carers are kept informed throughout.

How to make a referral

All referrals to the DSR must be submitted via the Digital Dynamic Support Register (DDSR) platform. click here

Consent and Information Sharing

Before a referral can be added to the DSR, informed consent must be obtained from the individual, or from their parent/guardian where appropriate.

  • Where the individual lacks capacity, a best interests decision must be made in line with the Mental Capacity Act 2005.
  • Consent enables relevant services to share information necessary to coordinate care and support through the Dynamic Support Register process.

Forms and Accessible Information

  • Consent must be recorded using the NEL DSR, C(E)TR and Keyworking Consent Form
  • An Easy Read version should be used where appropriate
  • Families, carers, and individuals must be provided with information about the DSR, including its purpose, how data is used, and what support is available:
    • Parent/Carer Information Leaflet
    • Easy Read Information

Note: A referral cannot be submitted without the appropriate consent form completed and uploaded to the DDSR platform. This ensures transparency and safeguards the rights of the individual.

Keyworking Service

The Keyworking Service is a national programme supporting children and young people aged 0–25 years with a learning disability and/or autism who are at risk of hospital admission.

Keyworkers:

  • support young people and families to navigate services
  • coordinate care across health, education, social care, and other agencies
  • attend DSR MDT meetings to provide updates and feedback on cases
  • support the implementation of Care (Education) and Treatment Review (C(E)TR) recommendations

Individuals are allocated a Keyworker based on eligibility through the DSR, prioritising those with the most complex needs (Red, Amber, or Blue ratings). Support is short-term and tailored to the individual’s needs, helping them live safely in the community.

For further information, visit the NELFT Keyworking Service website. https://www.nelft.nhs.uk/nel-keyworking-service

Supporting information and resources

The following documents are available to support referrals:

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