A review of the factors that influence high, medium and low secure care pathways

Abstract

The forensic care pathway that is the focus of this UK regional review has itself seen a considerable amount of change over the last decade, focusing on implementing wide reaching reform within both prison and health care. Reforms have seen a reduction in the number of people in some parts of the care pathway and new interventions and growth in other areas. At the end of 2009, the region that was subject to this review there had seen over 450 people cared for in high, medium or low secure services in that year and had a prison population approaching 10,000. The aim of the review was to understand the impact of these changes with a view to sustaining effective pathways and systems, and to increase impact and ensure value for money in order to improve the efficiency and quality of services. A primary objective was to consider the influence of statutory mental health provision upon the use of high, medium and low secure psychiatric services. It was proposed that from a regional perspective more needed to be understood about the influence of wider services upon the care pathways for people using secure services. This paper considers what is available from primary care locality and its features, alongside the rates of secure service use. It also acknowledges the wider influences upon the use of those services.