Multi-Agency Public Protection Arrangements (MAPPA): overview report 2020 to 2021

7. Health

The Health contribution to the MAPPA process has continued throughout the COVID-19 pandemic albeit in an adapted way with remotely attended meetings having become the norm. NHS Boards have a dual role under MAPPA and are both a Responsible Authority and a Duty to Co-operate Agency under Section 10(3) of the 2005 Act. As a Responsible Authority, Health Boards are the lead agency for the management of restricted patients. This means they are responsible for both clinical care and risk management of restricted patients in accordance with the MAPPA National Guidance. This also extends to providing data to the MAPPA co-coordinators for publication in the local annual report about the number of restricted patients in each Health Board Area.

NHS Boards also have a responsibility to contribute to MAPPA strategic planning. Each Board has a nominated senior manager who will represent the Board at the strategic and also Level 3 MAPPA meetings. As a Duty to Co-operate Agency, NHS Boards also have a responsibility to share risk relevant information about individuals subject to MAPPA. Each Board has a MAPPA health liaison officer who has responsibility for this. The MAPPA health liaison officer will also represent the Health Board at MAPPA meetings and as well as sharing health information that is relevant to risk, will also manage risk relevant information that is provided to them by other MAPPA partners. This information is then used to ensure that risk is considered and, when appropriate, managed within a healthcare setting.

In addition, the Scottish Government continues to provide funding to the Forensic Mental Health Services Managed Care Network (the Forensic Network) to support engagement by the NHS with MAPPA. The Forensic Network, through the Lead for Serious and Violent Offenders, supports the NHS MAPPA work in a number of ways. These include attendance at National Strategic meetings on behalf of Health and chairing regular meetings with MAPPA Health liaison colleagues to share good practice and undertake specific MAPPA related pieces of work which has this year included contributing to the revision of the MAPPA guidance. All of this work has been able to continue in an adapted way throughout the COVID-19 pandemic.

The Forensic Network Lead also advises on a range of MAPPA related projects, for example the development of training packages for those working with Internet Offenders and the revision of treatment packages for those who have committed sexual offences.

The Forensic Network also supports the MAPPA Clinical Forum, an annual practitioner forum which has the objectives of "Networking, Education, Operations and Policy". The forum provides a vehicle for services to consider areas within MAPPA practice that might require guidance and a shared approach, as well as providing the opportunity to network and share good practice. This year due to the COVID-19 pandemic, the fora have been delivered remotely and have involved one on the theme of risk formulation and one on managing Terrorist Risk offenders under MAPPA which welcomed Jonathan Hall QC, the UK's Independent Reviewer of Terrorism Legislation, as its key speaker. The Forensic Network Lead, along with other health colleagues, also support MAPPA partners through research which has this year included a study into the applicability of a new risk assessment tool for use in Scotland.

The Independent Review into the Delivery of Forensic Mental Health Services

The Independent Review into the Delivery of Forensic Mental Health Services chaired by Derek Barron, published its final report in February 2021. The Review made a number of recommendations which, if taken forward will have implications for MAPPA partners. One MAPPA specific recommendation is for the Scottish Government to consider the development of a more consistent way of sharing forensic mental health expertise with MAPPA partners and other external individuals or organisations (including other NHS services) across the country, citing the NHS Lothian SOLS and NHS Greater Glasgow and Clyde STARR services as potential models for this.

The Scottish Government are currently considering all recommendations made in the final report and will publish a formal response in due course.