Clinical Reference Group

Scope and service

The services encompassed by this group include:

  • Representing the Health and Justice clinical body across the sector and in doing so establish strong communication links across the broad range of the clinical body including all professions involved in service delivery.
  • Make relevant links with service users, families and communities impacted upon by health and justice clinical care pathways and ensure a voice of the service user and carer is considered at the heart of every decision made.
  • Actively participate in the development and completion of identified objective area programmes, guidance documents, analyses, and products for specialised populations in all areas of health and justice.
  • Work with the Health and Justice national team and the local area team leads in horizon scanning, identifying and shortlisting potential innovations for the relevant population. Working to support continuous service improvement initiatives and the learning of lessons from identified good practice.
  • Champion best practice and evidence based approaches to clinical service delivery acknowledging the unique position of justice health and wellbeing in relation to custodial care.
  • Collate, assess and analyse local intelligence as to the impact, clinical and provider interdependences as well as opportunities relevant programmers and strategy will have at an area and local level. They will provide a rich source of information to highlight convergence issues, risks and benchmarking to inform the development of products.
  • Ensure relevant information governance, investment and appraisal is conducted as part of all programmers initiated, developed or reviewed through the CRG.


To operate as a catalyst to support ‘what good looks like’ across the health and justice clinical care sector and promote consistent and sustained implementation of quality standards across England focussing on outputs and outcomes. This must be a two-way resource linking into regional and area teams.

Our mission

  • To promote the highest quality and consistent standards of treatment and care for offenders and those in detention.
  • To deliver a strong and consistent clinical voice championing the needs of individuals suffering significant health inequity in order to successfully close the health inequalities gap for this specific population.
  • Advocating for ‘joined up’ services in health and justice where agencies work toward eradicating the risk of people ‘falling through the gaps’ in services  and where care is truly seamless including information and data flows.
  • Promotion of equivalence of care based on the delivery of evidence based and clinically effective interventions and pathways.


The group will support the agreed commissioning priorities for Health and Justice working closely together and gaining consensus of agreement in quality standards.

Chair and membership

A Chair is appointed for a three-year term. Clinical members are drawn from the 12 Senate areas in England and are voluntary appointments.

Up to four patient and carer members and up to four professional/training organisations are eligible to become a member of the CRG.

The accountable commissioner holds the managerial accountability for the work of the CRG; collaborating commissioners hold an interest in the work of the CRG.

Please see the Clinical Guide for CRGs  for further information.

Documents the group have been involved in producing:

Prison Pain Formulary

The Prison Healthcare Board approved a programme of work, hosted by the NHS England Health and Justice Clinical Reference Group, to deliver a recommended national pain management formulary for use in HM Prisons. The formulary supports clinicians in the management of acute or persistent pain and neuropathic pain for people taking account of the specific challenges of prescribing pain medicines in prisons.

The formulary is published as two documents which should be used together to embed the formulary into practice:

  • The Formulary – shows the recommended medicines along with advice and clinical guidance links to support these choices. Updated October 2017, the medicine choices remain the same but clinical evidence and guidance information have been updated
  • The Implementation Guide – this guide provides information about:
    • The scope and development of the formulary and who should use it.
    • How medicines fit into the pain care pathway versus alternative treatment.
    • The patient perspective on their experiences of current pain care in prisons.
    • Prescribing, reviewing and continuing pain care for people coming into prison, during their stay and on release or transfer to another prison.
    • Self-care and supporting self-management of pain by prisoners.
    • How to optimise safety when prescribing and using pain medicines for people in prison.

Safer use of mental health medicines (2017)

This document provides clarification on the prescribing responsibility for initiating, continuing, reviewing or repeat prescribing of mental health medicines by specialist mental health prescribers.

Handling of gabapentin and pregabalin as Schedule 3 Controlled Drugs in health and justice commissioned services

This letter is to inform NHS England commissioned health and justice services and key stakeholders about the expectations for the handling of gabapentin and pregabalin as Schedule 3 Controlled Drugs from 1 April 2019.