Dynamic Support Register (DSR)

West Sussex local offer monitor children and young people who have mental health challenges. We have developed the Dynamic Support Register (DSR) to track those most at risk.

The DSR helps us keep track of who could be admitted into medical care. Most people on this list will not need to use a learning disability or mental health hospital service. They will live full and active lives in the community or residential settings.

The list is used by:

  • Special Educational Needs and Assessment Team (SENAT)
  • Disabled Children’s services.

Some of the people on the list will need support and Care. They will receive Educational and Treatment Reviews (CETRs).

The purpose of the DSR

It is important services understand the needs of local people with a learning disability or autism. This helps make sure they receive the right support and avoid hospital admissions.

Key professionals evaluate the risk using the register. It also lets relevant professionals plan for the move to adult services, if needed.

Adding people

Any professional can recommend a child or young person is added to the DSR.

If you are concerned a young person is at risk of admission, contact the West Sussex Joint Commissioning Unit.

Adults at risk of a hospital admission and should also be considered for the local DSR.

For adults with autism:

For adults with a learning disability:


The DSR is a ‘live’ document, updated in real time. It's also reviewed as a whole document on a monthly basis by a team of relevant professionals.

On the DSR each person is ‘RAG’ rated according to their current risk.

The criteria used are as follows:


  • They are at imminent risk of being admitted to hospital.
  • Displaying signs of challenging behaviour that are posing significant difficulties to family and existing support services
  • Young person is placing themselves or others at serious or significant risk of harm
  • Young person has had an unplanned hospital admission in the last year (excluding admission for physical health)
  • They have been managed by a crisis team or similar to avoid a hospital admission in the last year
  • All possible options to support in the community have been exhausted.


  • Child or young person is starting to display challenging behaviour which existing services are struggling to manage.
  • Behaviours are at such a stage that a multidisciplinary team meeting, or a review of their current services, they are likely to be able to be managed
  • The child or young person is living in the community (either at home or in a foster placement). They are displaying challenging behaviours which may lead to a residential placement being sought. There are concerns that there may not be a suitable residential placement available
  • The child or young person is in receipt of/has received all possible service options available in the community


  • The child or young person has previously been in a learning disability or mental health inpatient setting. But are are currently in the community or a residential placement and there are no concerns.


For a child or young person to be included on the DSR they need to consent. A parent carer or guardian needs to consent for children under 16 or when people are assessed as lacking capacity. Consent must be updated annually.

The Lead Professional involved in the case is best placed to seek consent.

The register is held securely by the Integrated Care Board (ICB) Commissioner.


More information

You can read more about DSRs on the NHS page Care, Education and Treatment Reviews (CETRs).