Ratings
A dynamic support risk tool has been developed that includes 12 scored questions. This provides clinicians and the wider team with a starting point to help inform clinical decision-making while considering red, amber, green (RAG) ratings and inclusion to the DSR.
Everyone on the DSR must have a RAG rating assigned to them. The rating will help inform and suggest next steps and the additional support that can be offered.
These ratings are from the NHS England, dynamic support register and care (education) and treatment review: policy and guidance (2023).
The RAG ratings
The ratings are red, amber, green or blue.
Additionally, there are four key questions which if the answer to all is yes would indicate a red rating:
- does the child or young person have an unstable or untreated mental health condition?
- do they present with significant behavioural challenges?
- are they being supported in an unstable environment or by changing staff teams?
- have they presented in crisis at A&E in the last month?
There will be times where an appropriate admission to either a mental health or specialist hospital is required.
At the point of admission, an individual who is on the DSR will move to blue on the RAG rating, or if an individual in not already on the DSR will be added as blue (with appropriate consent), this will indicate that they are an inpatient. The individual will remain on blue until the point of discharge.
During the discharge planning stage, the Enhanced Support and Liaison Service will ensure that the correct community teams are in place ready for discharge if this is needed. Upon discharge, the individual will move to red on the DSR for a minimum 2-week period. Children and young people will be offered enhanced post discharge support from the CAMHS crisis and enhanced treatment team for a minimum of 14 days. The individual will be discussed in the relevant Lincolnshire DSR system wide meeting while they remain red on the DSR.
