A Dynamic Support Register (DSR) is a mechanism to identify children, young people and adults who are at risk of admission to mental health inpatient services without access to timely dynamic support.
The tool is used to:
- risk stratify to identify people at risk of admission to a mental health hospital
- work together to review the needs of each person registered on the DSR
- mobilise the right support (for example: a CETR or a referral to a Navigator for additional support at home) to help prevent the person being admitted to a mental health hospital.
The outcome of the tool will determine whether the person meets any of the following rag ratings:
| Red | There is an immediate risk of admission to a mental health hospital. The person and/or family are experiencing crisis and the risk of admission to a mental health hospital are not being or cannot be managed in the community. Linked processes: A C(E)TR must take placeReferral to the Keyworker Service (aged 0-25), if not already known. |
| Amber | There is an immediate risk of admission to a mental health hospital without urgent intervention. Therefore could be a significantly increased risk of becoming mentally unwell and/or placement/family breakdown. Linked processes: Multi-agency meeting and/or C(E)TR Referral to the Keyworker Service (aged 0-25), if not already known. |
| Green | There are some risks which could lead to the person being admitted or re-admitted to a mental health hospital; these risks are being effectively managed. Linked processes: Clear identification of partners who would need to be involved in a C(E)TRs if required. |
| Blue | A separate section to identify those children, young people and adults who are currently in inpatient services. Linked processes: This rating should be used to identify those requiring commissioner oversight visits and inpatient C(E)TRs. |
The DSR enables systems to identify adults, children and young people with increasing and/or complex health and care needs who may require extra support, care and treatment in the community as a safe and effective alternative to admission to a mental health hospital. Additionally, they play a role in ensuring that people’s needs are included in commissioning plans, financial plans, service delivery and development.
Consent
Individuals cannot be added to the DSR without the person’s informed consent. The date in which consent for inclusion on the DSR is obtained is part of the DSR minimum dataset; consent will be reconfirmed annually.
Referral onto the DSR
As well as being referred by professionals, individuals can now self-refer to their local DSR.
Review of referrals for inclusion on the DSR
Once a referral has been received, the Norfolk & Waveney ICB will work in partnership with colleagues across education and social care to review referrals for the DSR, stratify the risk of a person and consider whether they should be included on the DSR.
The ICB will facilitate regular multi-agency review meetings to manage the DSR, stratify risk and agree appropriate cross-system actions and support. There is a shared process of accountability with a clear structure of escalation for red/amber cases. This will involve named senior managers across health and local authority services.
The risk stratification process will take place within four weeks of receiving a referral for the DSR. The outcome of the risk stratification process will be communicated with the person and/or parent, carer or referrer with an update of what will happen next, even if the person is not eligible for inclusion on the DSR.