July 2024 Plans for dedicated forensic health board for Scotland

A health board dedicated to the care of some of Scotland’s most dangerous patients is being planned by government ministers.

The new forensic board for Scotland will bring together all high, medium and low security services under one roof.

Under current arrangements, the high security hospital at Carstairs has its own board – The State Hospitals Board for Scotland – while other units fall under the management of geographical health boards.

But in a letter to NHS chief executives and NHS board chairs, Maree Todd, Minister for Social Care, Mental Wellbeing and Sport, has said that operating under the status quo was not supported by the working group set up to agree a new approach to managing those deemed criminally insane and mentally ill.

Todd said she has asked her officials to begin putting in place plans to establish a forensic mental health board for Scotland “with the aim of delivering a national approach to planning and governance of forensic mental health services”.

However, whistleblowers at Carstairs said they were disappointed there has been no announcement to force the state hospital board to accept female patients for treatment.

Women who need to access specialist mental health care are currently sent hundreds of miles away to England for treatment despite a review saying this practice was “indefensible”.

In the letter, dated May 2024, Todd wrote: “This board will be created by utilising existing legislation and functions of The State Hospital Board for Scotland.

“Given the complexity of developing a more coherent governance model, there are still a number of options and details that will need to be considered as a priority to identify a practical and legal way to move forward.

“Therefore the Scottish Government will establish a ‘forensic governance advisory group’ to engage with stakeholders across the system to support the development of this new board.

“This group will advise on the operational, legal and practical changes needed to transition from existing governance arrangements to a board with responsibilities for forensic mental health services beyond The State Hospital.

“The group will set out an implementation plan for the transition to the new board.”

Todd was keen to stress that this does not mean The State Hospital will take over forensic services in Scotland.

She said the role of the new board, which will not be based at Carstairs, will be to ensure that patients are receiving appropriate care and treatment.

“The Scottish Government will establish a forensic governance advisory group to engage with stakeholders across the system to support the development of this new board”

Todd said that delivering on the Barron report will still be a priority, despite no new mental health funding.

The report, commissioned by the Scottish Government and published by Forensic Mental Health Services in 2021, was carried out by Derek Barron who made a series of recommendations to overhaul forensic health services in Scotland.

Todd also revealed that trade unions may have to be consulted if the new board impacts on the current workforces of health boards.

She said: “In considering the functions of a forensic mental health services board, the advisory group will have to consider how its functions align with territorial health board accountabilities for the planning and provision of services.

“Depending on the functions of the new board, it may also be necessary to amend the functions of territorial health boards.”

It is not yet known if the new health board will oversee forensic services to the Scottish Prison Service which currently deals with individual health boards.

A whistleblower told 1919 that staff were disappointed there were still empty beds at the state hospital which could be used for treating women.

They said: “Hopefully an announcement on women will be next.

“A new standalone board is a good idea as that means a more structured approach to delivering the mental health care our patients need, but sadly for women prisoners they will still be transferred to England.”

During the general election campaign, Scottish Labour outlined plans to dramatically reduce the number of health boards in Scotland.

In a keynote speech on the NHS, leader Anas Sarwar said: “Today, we have 14 health boards, 31 integrated joint boards, and eight specialist health boards.

“This creates a top-down, bloated, manager-heavy health service.

“We need fewer chief executives and more doctors, fewer managers and more nurses.

“Alongside these measures to boost our workforce, and tackle bureaucracy, we must also bring back the focus on preventative measures that has always been at the heart of Labour’s approach to healthcare.”