The Dynamic Support Register (DSR) is a database that brings together agencies and services involved in commissioning and delivering care and support to local children, young people and adults with learning disabilities and/or autism.

The purpose of the DSR is to identify people who with appropriate, proactive intervention and support can be prevented from unnecessary or inappropriate admission to mental health or specialist hospitals.

The DSR process enables an opportunity for communication where a person’s support needs can be reviewed, and issues escalated where appropriate.

View the NHS England Dynamic Support Register and Care (Education) and Treatment Review Policy and guidance


Who is the DSR for?

The DSR is for everyone with a learning disability and/or autism (whatever their age), who are most at risk of hospital admission or placement breakdown. Inappropriate hospital admissions are sometimes related to placement breakdown therefore it is important to ensure the right level support is identified for individuals, noting that this can change over time.

Appropriate referrals to the DSR will be for people who may be facing specific challenges in their lives, or are presenting as a risk to themselves or others that could lead to an admission to specialist / inpatient services.

For a referral to be accepted a person must either have capacity to give informed consent or where capacity is lacking at the time of referral, a best interest decision has been made. This will be recorded as part of the DSR process. Where appropriate, a person with Parental Responsibility can consent to inclusion of a child or young person. Support will be provided by professionals where individuals would like to understand more about what giving consent means, and how information about them is used.


What are the benefits of the dynamic support register?

Prior to the establishment of the DSR, different agencies, services and teams held their own information about people who they were trying to support. By developing a single register with input from all those involved in supporting an individual, it is easier to make sure people get the right support at the right time in the community and help to avoid inappropriate hospital admission wherever possible.

People who are included on the register will be proactively reviewed to identify as early as possible whether any additional support is needed.

Information from these reviews will also be used to identify key themes, trends and service gaps. This information will not use person identifiable data, but it will help to plan and develop future services.


What agencies and organisations are involved?

Currently the key agencies and services who will collaborate and communicate through the DSR are:

  • NHS BaNES Swindon and Wiltshire Integrated Care Board (BSW ICB)
  • Wiltshire Council
  • Wiltshire Health and Care Community Team for people with a Learning Disability (CTPLD)
  • Avon & Wiltshire Mental Health Partnership NHS Trust – Learning Disabilities Intensive Support Service
  • Oxford Health
  • Swindon Borough Council
  • Bath & North East Somerset Council
  • HCRG Care Group


What information will the register hold?

The information held on the DSR will be the minimum required to facilitate high quality communication of needs and actions, including;

  • Name
  • Date of birth
  • Place of residency
  • NHS number
  • Key professional involvement, their names and contact details
  • Current issues that relate to risk of admission and the risk of escalation
  • What has been tried that could mitigate risk (including positive strategies to improve a person’s quality of life, increasing life opportunities and self-esteem)
  • What could be useful to further reduce risks
  • Action plan moving forwards including recommendations for current and potential future service involvement
  • RAG rating (red, amber, green) based on potential admission risk