Dynamic Support Register (DSR) and Care, Education and Treatment Review (CETR).

Dynamic Support Register (DSR)

The Dynamic Support Register (DSR) is a list of young people who have a diagnosis of autism or a learning disability which is categorised according to their needs and risk of admission to a mental health hospital.

 BLUEConfirmed diagnosis of LD or ASC and: In a Tier 4 Mental Health Hospital.
 REDConfirmed diagnosis of LD or ASC and: At immediate risk (within 48 hours) of admission to a Tier 4 Mental Health Hospital or 52-week specialist or unregulated placement.
 AMBERConfirmed diagnosis of LD or ASC and: discharge from a Tier 4 Mental Health Hospital. at imminent risk (within 2 weeks) of admission to a Tier 4 Mental Health Hospital or 52-week specialist or unregulated placement. breakdown in home placement that may lead to an inappropriate admission to Tier 4 Mental Health Hospital or 52-week specialist or unregulated placement. Risk that T4 hospital admission may be needed without intervention
 GREENConfirmed diagnosis of LD or ASC and: risk of home placement breakdown alongside a significant escalation in need and support from statutory services (Health, Education and Social care). consideration that if YP needs are not met appropriately in the community, future admission to a Tier 4 Mental Health Hospital and/or 52 week specialist or unregulated placement may be considered. 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.

The DSR gets sent every month to the learning disability and autism programme (LDAP) clinical commissioning team who help to ensure professional services to work together to manage a child or young person’s care effectively and ensure positive outcomes.

With consent, any professional working with a child across health, education and care, can, with the right consent, refer a child or young person for consideration for the DSR. Parents can also refer their child, or a young person can self-refer if 16 or over.

Care, Education and Treatment Review (CETR)

Care, Education and Treatment Reviews (CETRs) are arranged for children and young people with a learning disability and/or autism who are either already in a specialist mental health or learning disability hospital or are at imminent risk of admission.

The purpose of a CETR is to make sure the right care and support are available to avoid inappropriate hospital admission or, if the child or young person is already in the hospital, to help make ensure good quality care and make sure they do not stay in hospital any longer than necessary.

Where a person is at the point of ‘crisis’, action is urgent and it is unlikely a community CETR can be set up quickly enough to direct this.

However, even in urgent circumstances an assertive, fast and measured review needs to be undertaken to safeguard against the person being admitted unnecessarily to an inpatient service.

A multi professional meeting, known as a Local Area Emergency Protocol (LAEP) is set up to engage the person, their family and all those around them to think creatively about what potential alternative supports and interventions could be put in place.

This does not constitute a community CETR and should not be referred to as such.

CETRs are carried out by an independent panel. This includes an expert by experience, who is a person with a learning disability or autism or a family carer with lived experience of services.

The panel also includes a clinical expert who is qualified to work in healthcare and the commissioner who pays for the person’s care.

Accessing support

If you are a professional, a parent or a young person with an autism or learning disability diagnosis, and think you meet the criteria, please email the keyworker team on: