Planning & support · England
The Dynamic Support Register
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A register is a list of people and their support needs.
The Dynamic Support Register helps services plan support together.
The register is for people with a learning disability and autistic people.
It covers children and adults.
It helps identify people who may need a mental health hospital.
The aim is to help you get support outside hospital.
People already in a mental health hospital can also be included.
Services can then plan support for leaving hospital.
Ask your local NHS team about joining the register.
You can ask yourself.
A family member, advocate or worker can help you ask.
Staff will check whether you might need to go into hospital.
They will check whether the register is right for you.
A learning disability or autism does not automatically put you on it.
Staff should explain what joining the register means.
They should explain who will see your information.
They should ask for your agreement.
Ask for help to understand and decide.
If you cannot decide, staff must follow the right legal process.
Being an adult’s parent does not automatically give someone power to decide.
Ask who is arranging your support.
Ask what will happen and when the plan will be checked.
Being on the register does not guarantee a particular service.
Ask whether you need a Care and Treatment Review.
This is a meeting to check your care and support.
Some reviews also look at education.
You should get help to explain what matters to you.
If you have a keyworker
Ask your keyworker to explain the register.
Ask what will happen next and who will help.
What you can do next
Ask for the team responsible for the Dynamic Support Register.
If you need urgent help, ask for it now.
Do not wait for a register referral.
Find your local NHS planning team Web pageThis link opens another website.
It may use harder words.
More useful links
- NHS England: plain-English DSR and C(E)TR guide Web pagePlain English
An introduction to the register and reviews. The full policy explains detailed consent rules.
- NHS England: review resources and toolkit Web pageOfficial guidance
Resources to help people prepare and take part.
- NHS England: keyworking minimum standards and Easy Read version Web pageEasy Read resources
The 2026 standards and a linked Easy Read version. Ask your ICB to explain local eligibility.
These links open other websites.
They may use harder words.
The Dynamic Support Register
Extra planning when there is a risk of mental health hospital admission.
Children, young people and adults with a learning disability and autistic people · England
Who the register is for
The national policy covers people with a learning disability and autistic people of all ages. As a minimum, it includes people at risk of mental health hospital admission, subject to the consent arrangements. Having a diagnosis does not automatically put someone on the register. Local services assess the person's situation and support needs.
How to ask
Find your integrated care board (ICB), the NHS body responsible for the register locally. Ask for its DSR contact, referral process and criteria. You or your family can request a referral; a health worker, social worker, advocate or keyworker can help. Explain any worsening mental health or risk that support at home will break down. The council's SEND Local Offer should also explain the route for children and young people.
What should happen next
Services consider the referral and assess the risk, using red, amber and green ratings. A separate blue rating identifies people already in mental health inpatient services, so their care and plans for leaving hospital can be reviewed. Your views and your family's concerns should be considered. Ask who is coordinating support, what action is agreed, when it will be reviewed and what to do if things worsen. Registration is a route to coordinated planning, not a guarantee of a particular service. Do not wait for a referral if urgent help is needed.
Your agreement and private information
Staff should explain who will see your information, what will be shared and why. They should record your informed agreement and review it. The policy says refusing consent should not remove care or resources you are entitled to, and you can change your mind. Ask for information and communication support that works for you.
When someone needs help to decide
Capacity is considered for this particular decision. From age 16, the Mental Capacity Act applies: support the person to decide, then use the appropriate lawful representative or best-interests process if they cannot. A child under 16 who has sufficient understanding may consent; otherwise someone with parental responsibility is involved. Being an adult's parent or carer does not itself give authority to consent for them.
Ask about a Care (Education) and Treatment Review
A C(E)TR brings an independent perspective to whether care, education and treatment are meeting the person's needs. It considers alternatives to hospital, or safe discharge if the person is already admitted. Ask whether a community C(E)TR is needed and how you can request one. You should be helped to prepare, explain your wishes and follow up agreed actions. The NHS toolkit below includes further information and resources.
I already have a keyworker
Ask your keyworker to explain your DSR rating, the support plan, who must act and the next review date. Ask how to contact the team and what happens if support ends. The separate keyworker guide explains the 2026 standards and questions about local eligibility.
Words you could use
“I am worried that the current support is breaking down. Please explain how to request a Dynamic Support Register referral and whether a community C(E)TR is needed.”
More useful links
- NHS England: plain-English DSR and C(E)TR guide Web pagePlain English
An introduction to the register and reviews. The full policy explains detailed consent rules.
- NHS England: review resources and toolkit Web pageOfficial guidance
Resources to help people prepare and take part.
- NHS England: keyworking minimum standards and Easy Read version Web pageEasy Read resources
The 2026 standards and a linked Easy Read version. Ask your ICB to explain local eligibility.
These links open other websites.
They may use harder words.
Where the information comes from
Links checked 26 October 2026.
These links open other websites.
They may use harder words.
- NHS England: DSR and C(E)TR policy and guidance PDF
National policy. See sections 2.3–2.5 on scope and consent, and sections 3–7 on the register and referral.
- NHS England: DSR and C(E)TR code of practice Web page
Practical guidance on referrals, considering risk and recording support.
- NHS England: DSR and C(E)TR resources Web page
Official policy, guidance and resources to help people prepare and take part.
- Mental Capacity Act Code of Practice Web page
Explains support to decide, decision-specific capacity and best interests.
- NHS England: plain-English DSR and C(E)TR guide Web pagePlain English
An introduction to the processes. For the full rules about children's consent, use the detailed policy above.
- NHS England: keyworking minimum standards and Easy Read version Web pageEasy Read
The 2026 standards and a linked Easy Read version. Ask your ICB to explain local eligibility.