Introduction to Dynamic Support Register and Decision Support Tool

Dynamic Support Registers

DSRs are the mechanism which:

  • Identify those with a Learning Disability, Autism, or both at risk of avoidable hospitalisation / placement breakdown through a process of risk stratification
  • Allow early intervention
  • Facilitate multi-agency monitoring and response
  • Trigger timely community care and treatment reviews for additional support, when needed.

Primary aim:

Support proactive intervention and to keep people in the community through:

1. Avoiding out of area placements

2. Avoiding inappropriate admissions

3. Planned inpatient admissions.


This process should be understood and applied equally to people with a Learning Disability and Autistic people who are open to mainstream services, but not principally Learning disability and autism services.

Reasonable adjustments are appropriately applied within mainstream services (Equality Act, 2010).

Policy and Guidance from NHSE 2023

Introduction to DSR CTR (Care and Treatment Review)

DSR Resources

Easy Read Patient Booklet on DSR

Easy Read Patient Booklet with photosymbols

Inpatient care and treatment review process

If your patient has a documented diagnosis of a Learning Disability and / or Autism Spectrum Disorder, you must ensure the local place lead is aware of the admissions within 28 days.

Click on the link below for further information and placed based contact details:

Inpatient care and treatment review

Inpatient care and treatment review code and toolkit

he main purpose of the CTR Code and Toolkit is to provide a solid framework for CTRs in order for them to be delivered to a consistently high standard across England.

Primarily designed for people who attend CTRs in a professional capacity but is of use to anybody who needs to understand the ‘rules’ of a CTR.

CTR Review codes and toolkit

Care and treatment reviews

Patient Booklet

Easy Read Patient Booklet with photosymbols

NHSE information

CTR Planner

Patient Booklet DSR and CTR

DSR and DST Training Presentation


Dynamic Support Tool 

Clinical Decision Support Tool

Complex needs escalation and support tool (CNEST) for children and young people


Tool Guidance

Launch Presentation

Information leaflet