Dynamic Support Registers (DSRs) and Care (Education) and Treatment Reviews (C(E)TRs) are essential elements of the pathway providing people with a learning disability and autistic people with appropriate support and care at the right time – so that they can lead the lives they want to and meet their ambitions and aspirations; and can stay safely and healthily in the community or return to this as soon as possible. 

The goal is to ensure people with learning disabilities and/or autism and their carers receive the right support, at the right time, to avoid inappropriate hospital admissions.

A Dynamic Support Register is a list of people with a learning disability and autistic people who need support.

The Dynamic Support Register helps identify those who need support the most and quickly, so they do not need to go to a mental health or specialist learning disabilities hospital if it is not appropriate for them.

The list tells health and care staff about the types of support a person with a learning disability or person with autism needs to stay well at home.

The Dynamic Support Register uses a colour system to show different levels of risk of person needing to go into hospital.

The Dynamic Support Register is used to make sure the right actions are carried out by health, education (where apppropriate) and social care teams.

Part of these checks may mean that a Care and Treatment Review or Care (Education) and Treatment Review might take place.

It is also a place where agencies involved in a person’s care can talk about the support they need.

People on the DSR will be reviewed regularly to see if they need extra help. This helps the team find out early if someone needs more support.

A Care and Treatment Review makes sure adults get the right care and treatment. It also looks at how to make care and treatment better for adults.

You might see it called a CTR.

A CTR is for people who are at risk of going into hospital, or are already in hospital. 

A Care (Education) and Treatment Review is different to a CTR because it is for children and young people and includes their educational needs.

You might see it called a C(E)TR.

Citizens can self-refer themselves or their child to be added to the Dynamic Support Register. After being assessed, the individual would go on the Dynamic Support Register if their needs show they are at risk of going into hospital.

Professionals can also refer an individual to the Dynamic Support Register.

In the first instance we recommend  contacting your Health and Social Care Teams to support your referral and to see if the Dynamic Support Register will support your needs.

Professionals can make a referral by emailing the LDA Commissioning Team via their duty inbox at with details of the referral, consent form and evidence or diagnosis. The team will then share the referral form to start the process.

You do not have to go on the DSR or have a C(E)TR.

You will be asked if you agree to go on the DSR and have a C(E)TR.

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

If you do not give consent, health and care services must make sure it will not affect the care and treatment you receive. You can also change your mind at any time.

If someone is under 16 years old, their parents would need to give their consent for them to be added to the DSR and 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.