Independent Review into the Delivery of Forensic Mental Health Services: progress update report 2024

3 Theme Two: Women’s Pathways

Recommendation 3. A high secure service for women should be opened in the State Hospital within nine months of the publication of this Review.

Recommendation 4. The Short Life Working Group set up in response to the Forensic Network’s report on the Women’s Service and Pathways should reform to complete its work related to women’s pathways across medium secure, low secure and community forensic settings.

A Forensic Network short-life working group reported in 2019 and considered a number of options for the long-term solution of high secure care and treatment for women in Scotland. The report short-listed 4 options:

• The status quo (high secure care and treatment provided in Rampton)
• Enhanced medium secure provision
• A new high-secure unit for women co-located next to a medium-secure unit
• High secure provision for women at the State Hospital

Following the report, NHS Chief Executives endorsed the recommendation for a co-located, high secure unit, but work was paused in light of the newly established Barron Review and the subsequent COVID-19 Pandemic.

The Forensic Network established the Women's Forensic Services Planning Group following the Barron Review and renewed consideration of the above options. This group's remit is to consider the national, regional, and local planning of services for women and the implementation of the recommendations from the 2019 review, encompassing high, medium, and low security. Due to timing, cost and the complexity of recreating the special conditions of security, it was agreed that high secure provision for women at the State Hospital, Carstairs should be progressed.

The Scottish Government recognises that these are some of the most vulnerable women in Scotland and is, therefore, prioritising work on female pathways within forensic mental health settings. This includes consideration of access to hospital for female remand patients who require high security and ensuring equity with provision for male patients who can access high secure care and treatment in Scotland.

Over the last year, several meetings with stakeholders have been held to consider the challenges being experienced with prison-to-hospital transfers and how a high secure service for females could be provided in Scotland. These discussions have examined what is possible both now and in the longer term.

Scottish Government are now planning for High Secure provision for women in the State Hospital, Carstairs. In April, the Minister for Social Care, Mental Wellbeing and Sport met with relevant Health Board Chief Executives to discuss the proposals.

While work is at a very early stage, Scottish Government are committed to working with Health Boards to improve access for women to forensic services, and will continue to do this as the longer-term proposition at the State Hospital is developed.