Multi-Agency Public Protection Arrangements (MAPPA) in Scotland: National Overview Report 2024-2025

8. Health

The roles and responsibilities of the NHS within the MAPPA framework are set out in the Management of Offenders etc. (Scotland) Act 2005. The legislation also provides the 14 territorial Health boards and the State Hospital Board for Scotland with statutory functions as Responsible Authorities to establish joint arrangements for the assessment and management of risk posed by restricted patients.

On 31 March 2025 there were 317 restricted patients recorded on ViSOR as being managed under the MAPPA process in Scotland. The collation of restricted patients’ data nationally for annual reporting purposes is a complex issue, and consideration continues to be given to how this data is collected, with a view to ensuring that what is provided is meaningful and robust.

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, for example, those related to MAPPS and information sharing processes; chairing regular meetings with MAPPA Health liaison colleagues to share good practice; and undertaking specific MAPPA related pieces of work, for example most recently responding to proposed changes to the SCR guidance and how this will impact the NHS.

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 has helped develop relationships of those working across the Health Boards and has provided the opportunity to work jointly on initiatives aimed at improving consistency of practice. The group are currently working on improving consistency in relation to information sharing in Level 1 cases.

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 contained one MAPPA specific recommendation 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 Serious Offender Liaison Services (SOLS) and NHS Greater Glasgow and Clyde STAR services as potential models for this.

Work is ongoing to consider this and a proposed model of service designed to provide consistent advice, support, and signposting to forensic mental health services which will be accessible to both justice and health partners across the country. There is a particular focus on addressing gaps and inconsistencies in service provision, especially in relation to Prevent cases, which have been identified as a priority. A key part of this work includes ensuring that existing local arrangements across Health Boards are taken into account, to inform a nationally consistent and effective approach to service delivery. NHS Lothian is leading on taking this work forward, working closely with the Forensic Network and the Health Board Prevent single points of contact (SPOCs) network. As the work progresses, focus will continue to be given to reaching a consensus on the priority elements and next steps to delivery.

The Forensic Mental Health (FMH) Reform Team, Mental Health Directorate is leading on work to coordinate and deliver the recommendations from the Barron Review. The Scottish Government published a Progress Update to this review in January 2025 which highlights positive developments and illustrates the commitment of the Scottish Government to addressing the issues raised by the Review.

The previous Minister for Social Care, Mental Wellbeing and Sport, Maree Todd, requested that plans to establish a “Forensic Mental Health Board for Scotland” should be explored with the aim of delivering a national approach to planning and governance of FMH services. Given the complexity of developing a single system, there are still a number of options that will need to be considered to identify a practical and legal way to move forward. To support this, a Forensic Governance Advisory Group was formed in October 2024 to explore the way forward. The group submitted its final report on 4 June 2025.

The new Minister for Social Care and Mental Wellbeing, Mr Tom Arthur will now take time to carefully consider the report, guided by official advice, and will issue a formal Scottish Government response in due course.