What is a Dynamic Support Register?

A Dynamic Support Register is sometimes called a DSR.

The Dynamic Support Register (DSR) is a digital database that aims to bring agencies and services involved in commissioning and delivering care and support to local children, young people and adults with a learning disability and autistic people.

The aim is to identify people who with robust, timely, proactive monitoring intervention and support can be prevented from unnecessary or inappropriate admission to mental health or specialist hospitals.

With close links to the Transforming Care Programme, the DSR provides a collaborative forum for communication where a person’s support needs can be reviewed, and issues escalated where appropriate.

Click here for a leaflet that explains more, and click on the links below for more information.

The information held on the DSR will be:

  • Name
  • Date of birth
  • Where you live
  • NHS number
  • Key professional involvement, their names and contact details
  • Current issues that can lead to admission to a mental health hospital
  • What has been tried that could help (including positive strategies to improve a person’s quality of life, increasing life opportunities and self-esteem)
  • What could be useful to reduce risks further
  • An action plan moving forwards including recommendations for current and potential future services

The organisations that have signed up to work together on the DSR are:

  • NHS South Yorkshire ICB
  • Sheffield, Rotherham, Barnsley and Doncaster Local Authority/Social Care
  • Police/Youth Offending Service
  • Voluntary Sector
  • Education
  • CAMHS/Mental Health Services
  • Forensic Outreach Liaison Service (FOLS)
  • Continuing Health Care
  • Special Educational Needs (SEND)
  • Autism Specialist Services
  • Local Trusts providing Learning Disability and Autism Services
  • Local Hospitals (General)
  • Specialist services e.g. Eating Disorders

Each agency has signed up to the DSR information sharing agreement. This agreement stipulates that the agencies will share information that is relevant, appropriate and proportionate in line with information governance policy.  

The DSR will keep adapting to meet the needs of NHS England and in response to feedback from everyone who has contact with the DSR.

We will work with all local authorities in South Yorkshire to include on DSRs’s children and young people who are in 38/52-week residential schools and colleges.

They may be placed at a distance from home and their needs are likely to be significant when they return home or their education or placement changes.

Their level of risk should be determined using the risk stratification process.

For a referral to be accepted it is essential that:

  • the person must either have capacity to give informed consent or
  • where capacity is lacking at the time of referral, a best interests decision has been made on their behalf
  • where appropriate, a person with Parental Responsibility can consent to inclusion of a child or young person to be included in the DSR.

Information about the DSR is available in various formats (easy read/plain text) to ensure that it is provided in a way that maximises a person’s ability to understand, retain and weigh up information about this decision to be able to give informed consent. Consent, once given, can be withdrawn at any time.

If a person is assessed as not having the capacity to give informed consent (and no one holds parental responsibility, or a court of protection appointed personal welfare deputyship), a best interests decision can be made under the Mental Capacity Act for inclusion on the DSR. 

It is important to know that not consenting to join the register will not affect the person’s current support. Although the benefit of inclusion on the DSR will be the multi-agency collaboration and communication, scrutiny of the current support provided and the potential to access other appropriate agencies as part of the DSR process.

Self-Referral

To refer yourself, your child or someone you are supporting (e.g. carer) please click here to complete a self-referral.

 

Professional Referral

If you are a professional, please click here to complete a referral.

A child, young person or adult must agree to:

  • go on the DSR
  • have a Care (Education) & Treatment Review

This is called consent.

You will be asked for your consent each time you are offered a C(E)TR.

If someone is under 16 years old their parents or guardian would need to give consent for them to:

  • Go on the DSR
  • Have a C(E)TR

The child or young person should be asked if they give their consent too

If someone does not have the capacity to make their own decisions:

  • a best interests decision will be taken on their behalf
  • a record will be made about the decision
  • local health and care services must make sure that if you do not agree to a C(E)TR:
  • it will not affect the care and treatment you receive
  • you can change your mind at any time
  • you have the right to get support from an advocate to support your decision
  • other types of reviews of your care can be looked into.

If you give your consent you are agreeing to share your information with people involved in your care and treatment.

The consent form is available here.

What happens after a person is added to the DSR?

People on the DSR will be BRAG-rated. This is a bit like a traffic light system. It is based on the level of risk of admission and/or their need for more support.  A referral will not be accepted without completion of the BRAG tool. 

  • Green for people who are having their risks/needs managed well at home
  • Amber for people who are at risk of going into a mental health hospital if they do not get the right care and treatment soon
  • Red for people who are at high risk of going into a mental health hospital straight away
  • Blue for people who are already in a mental health hospital

 

In South Yorkshire we are piloting a new dynamic support register BRAG risk stratification tool – all ages, which will continue to change as part of our pilot work, please click here to check the rating and access to the rating tool.

We are keen to hear your views and if you are interested in becoming involved in the review of this tool, please feel free to join in one of our review workshops.  You do not need to book a place just follow the link to join: