Health Department
St Andrew's House
EDINBURGH EH1 3DG
Dear Colleague
Summary
1. This letter attaches a Care Pathway Document showing what needs to be in place where, when and provided by which agency in terms of organising safe care, support and accommodation for mentally disordered offenders.
Background
2. NHS MEL(1999)5 set out proposals for a co-ordinated range of services and accommodation for mentally disordered offenders designed to meet the needs of the individual and public safety. The guidance proposed that mentally disordered offenders be cared for under conditions of security appropriate to the risk they present and also emphasised the importance of rehabilitation in the care regimes to apply. The guidance further suggested that care be organised, as far as possible, in community rather than institutional settings.
3. In setting out these principles for safe services and accommodation, the guidance acknowledged the separate but linked roles and responsibilities for the health, social work, housing and other agencies. The co-ordination of services required was acknowledged as a special challenge and one that would rely on multi agency approaches to ensure that the right services, in the right locations, were available when required.
4. A review of progress with implementation of the policy was commissioned of the Scottish Development Centre for Mental Health, and has been completed. Each local agency received a digest report on progress in their area. The attached Care Pathway Document adds to the information available to agencies by providing a further means of assessing what action is required locally towards completing a co-ordinated response to safe care and accommodation for this group.
5. Publication of the Care Pathway Document fulfils the commitment made in " Our National Health: a plan for action, a plan for change " to "…publish an audit document that will help all agencies identify their role in the care and custody of this group and identify any gaps in current provision."
6. The "what, where, who" dimensions within the Care Pathway Document are shown at each stage of an offender's move through the care and (where appropriate) custody process and in doing so offers agencies a benchmarked management and audit tool to aid joint discussions on the planning and delivery of services.
7. The outcomes of the MacLean and Millan Committees and the Scottish Executive Discharge Protocol Working Group will all impact on the care and accommodation of this group. Other links are identified within the Annex.
Action
8. Health Boards; NHS Trusts; local social work and housing authorities; the Scottish Prison Service; the Crown Office; the Police and other recipients are asked to ensure that this letter and attachment are distributed to all with an interest in the planning and delivery of services, care and accommodation for this care group.
9. It is clear that no single agency can or is expected to meet all the needs and safety dimensions involved in the care and accommodation of mentally disordered offenders. The diversity and complexity of need requires a collaborative agency approach. Joint working and planning is the preferred route to delivering better quality services and outcomes in this and other areas of care and allows for planned activity and timetables to be agreed that reflect the different starting points for each agency.
10 The joint working, resourcing and management guidance set out in the December 2000, "A Joint Future" report is relevant in this respect, (www.scotland.gov.uk). Though not centred on the organisation of care for mentally disordered offenders, the report does provide a framework of principles and approaches that have application for joint agency action. For example, guidance on shared assessments of need and multi agency care responses are covered and are relevant for planning the service and accommodation responses for the offenders care group.
11. In terms of practical inter agency arrangements, one approach may be for the relevant agencies in each area to combine to form a local Forensic Care Forum. Such Forums could, for example, consider and advise locally on how best to advance implementation for the area from the position set out in the local area report. The Forum could also be charged with agreeing a forward action plan and timetable in consideration of the separate and combined agency responsibilities set out in the Care Pathway Document. However, in the final analysis it is for the agencies to agree what approach best suits local needs and circumstances.
12. An on-going assessment of local and national progress will be conducted by the Scottish Executive and as part of that process we will expect all Health Boards to submit a local progress report in September of each year, (starting 2001). We recognise that in particular cases agreement may be reached locally that the local authority or one of the other agencies may be better placed to take the "lead". The reports should show the combined agency position on progress made and action still required, set against NHS MEL(1999)5, the area report and the Care Pathway Document. Where further action is planned, the report should include an appropriate timetable and show the lead agency responsibility for the services or other provision required.
13. The "area" to apply for these purposes will be the geographic Health Board area, in line with the approach adopted for the review. The progress reports should be submitted to the Scottish Executive, Room 129, St Andrew's House, Regent Road, Edinburgh, EH1 3DG, by end September each year.
14. A copy of this letter and attachment are available on the internet (at www.show.scot.nhs.uk).
Yours sincerely
|
TREVOR JONES |
JIM GALLAGHER |
KENNETH MACKENZIE |
|
Head |
Head |
Head |
Addresses
For action
Chief Executives, Health Boards
General Manager, State Hospitals Board for Scotland
Chief Executives, NHS Trusts
Directors of Social Work/Chief Social Work Officers
Directors of Housing/Chief Housing Officers
Chief Executive, Scottish Prison Service
For information
Chief Executives, Local Authorities
Chief Executive, COSLA
Chief Executive, Common Services Agency
Executive Director, SCPMDE
Mental Welfare Commission for Scotland
Chief Executive, Scottish Health Advisory Service
General Manager, HEBS
Director, Scottish Development Centre for Mental Health
Enquiries to:
Health
Mr P Harley
Tel: 0131 244 2426
Fax: 0131 244 2970
Social Work
Mr J Storey
Tel: 0131 244 3704
Fax: 0131 244 3528
Criminal Justice Social Work
Ms F Hird
Tel: 0131 244 5470
Fax: 0131 244 3548
Crown Office
Ms Emma Knox
Tel: 0131 225 2514
Fax: 0131 226 6910
Scottish Prison Service
Mr J McNeill
Tel: 0131 244 8622
Fax: 0131 244 2666
Police
Mr I Fleming
Tel: 0131 244 2149
Fax: 0131 244 2666