Forensic Governance Advisory Group: terms of reference

Purpose

The role of the Forensic Governance Advisory Group (“the group”) is to advise ministers on operational and practical changes needed to transition from the existing governance arrangements for adult forensic mental health services to a Forensic Mental Health Board for Scotland by exploring the three scenarios below. 

The group will act to advise on how best to improve integration of existing national and local pathways of care providing adult forensic services.

The fundamental role of this group will be to propose a way forward which will effectively address the issues resulting in recommendation one of the independent review into the delivery of forensic mental health services.

The group will align thinking to the NHS Scotland - blueprint for good governance: second edition. 

The Scottish Government emphasises that the group will not replicate or fundamentally change the work of the Forensic Mental Health Services - Planning and Collaboration Short Life Working Group (SLWG) or the work of the independent review.  

The SLWG undertook an options appraisal exercise which produced no clear preference between Barron’s recommendation, that a NHS Forensic Board be established; and the two alternatives which were:

• an extension to Barron’s recommendation one with custody settings included
• establishing a new partnership-based model such as a Strategic Network

Overall, the outcome of the options appraisal process suggests that continuing the status quo (individual health boards and network) for the strategic governance and planning of forensic mental health services in Scotland is not supported.  

Following complex discussions on a number of ways to move forward in the current climate the Minister agreed to explore putting plans in place to establish a board with the aim of delivering a national approach to planning and governance of forensic mental health services.

To do this though there are still a number of factors that need to be considered in order to identify a practical way forward. Given the complexity the group will consider the optimum governance model for the Forensic Mental Health Board, taking into consideration the intelligence and analysis of previous scenarios.

• option one – strategic planning at a national level with delivery/commissioning remaining at a regional/local level. The intention for this option would not be to create a board that would take over responsibility for the provision of forensic mental health services. The responsibility of service provision would remain with local systems however the board would co-ordinate planning and needs assessment and support the development of services at national, regional and local levels. This option would be similar to the partnership approached identified in option seven of the option appraisal process conducted by the SLWG but managed under a Forensic Mental Health Board utilising current legislation
• option two – responsibility for the provision of high and medium secure services are brought under the management of this forensic board with local service provision remaining as is. The board and local services would work together on local planning and needs assessment with the board supporting local services deliver similarly as described in option eight of the SLWG but led by a Forensic Mental Health Board
• option three – all forensic mental health services, including both inpatient and community services, should be brought under the management of this recast forensic board as described in option two of the option appraisal process conducted by the SLWG but led by a Forensic Mental Health Board utilising current legislation

Governance

The group will report to ministers and align to wider NHS Reform and Strategic planning governance structures and report progress through the Scottish Government. Officials will develop and provide regular updates to the Strategic Planning Board and the new National Clinical Framework Advisory Group

The group will also form part of the newly established Mental Health Transformational Programme, Governance workstream led by Scottish Government.

The group will provide regular updates to wider strategic planning and governance groups and update other relevant governance groups, such as the Mental Health Programme Oversight Group, Health and Social Care Management Board or NHS Chief Executives Group as appropriate.

The Chair will be responsible for ensuring updates on the work of the group is communicated through Scottish government officials into key governance structures and are kept informed of risks and issues as they arise. 

Remit 

The group will ensure that it engages as widely as possible with relevant clinical professions, key stakeholders and those with lived experience and that there are opportunities for stakeholders to communicate their views throughout this work. 

The group will report to the Minister within six months from the first meeting with a proposal on how to move forward considering practical and financial implications.

Term

This terms of reference (ToR) is effective from the first meeting of the group and sign off from the Chair and will be ongoing until terminated by agreement with ministers. 

Chair and membership

The group will comprise of:

• Esther Roberton, Advisor in Corporate, Civic and Constitutional Governance (Independent Chair)
• Dr Ian Dewar, Consultant Forensic Psychiatrist (Clinical Experience within Forensic Services)
• Mr Jim Cannon, Director Regional Planning, NHS Scotland (Senior NHS Planning Experience)

Roles and responsibilities

The membership of the group will commit to:

• attending all scheduled group meetings
• sharing communications within scope of the group and information across all group members
• making timely decisions and taking action so as to not hold up projects
• engaging in a collaborative and supportive manner, open to discussion and feedback

Members of the group will expect: 

• that each member will be provided with complete, accurate and meaningful information in a timely manner
• to be given reasonable time to make key decisions
• to be alerted to potential risks and issues as they arise
• open and honest discussions

Meetings

Decisions made by consensus (i.e. members are satisfied with the decision even though it may not be their first choice). If not possible, group chair makes final decision and reflects areas where consensus has not been reached. All decisions will be agreed and made final by the relevant governance groups. 

Meeting agendas and minutes will be provided by the Forensic Mental Health Reform Team who will act as secretariat to the group. This includes:

• setting up meetings
• preparing agenda, Chair's brief and collating supporting papers
• preparing meeting notes and information
• updating the Minister on progress if and when required (out with the wider governance structure)
• publication of documents onto Scottish Government allocated website

The frequency of the meetings will be determined by the Chair, in consultation with group members. If required the views of the group members may be sought virtually in between meetings. The location of the meetings will primarily be virtual but hybrid or in-person meetings will be supported, with the location of each meeting decided at the point of organising. This will ensure all meetings are as inclusive as possible.

Outputs

The group will produce:

• project documentation to initiate and establish the scope of the work setting out a project and engagement plan
• a final report setting out a clear proposal for a Forensic Mental Health Board a proposal for preferred way forward. This will include identifying the prime responsibilities of the board
• a high level implementation plan which will include an interim solution to establish the way forward

Amendment, modification or variation

This ToR may be amended, varied or modified in writing after consultation and agreement by group members.

Document control sheet

Key information

Title: Forensic Governance Advisory Group
Date published/issued: 17/12/2024
Date effective from: 15/11/2024
Document type: Governance
Document status: Final
Author: Forensic Mental Health Reform Team
Owner: Forensic Governance Advisory Group
Approver: Minister for Social Care Mental Wellbeing and Sport 
Approved by and date: Minister for Social Care Mental Wellbeing and Sport
Contact: forensicmentalhealthreformteam@gov.scot