Adult secure services


This Clinical Reference Group (CRG) covers all high, medium and low secure adult services (male and female).

The CRG has a robust workplan for 2019-22. This has been impacted by COVID but the CRG continues provide expert leadership and advice to enable and support:

  • The effective commissioning of high, medium and low secure services nationally, regionally and through NHS-led Provider Collaboratives, including community forensic services incorporating the learning from the Specialist Community Forensic Team (SCFT) and Women’s Secure Blended Service (WSBS) pilots, and ensuring inequalities are identified and addressed. Plus learning from the impact of COVID-19.
  • The effective integration of care pathways with physical health services, non-specialised adult mental health services, CAMHS secure services, and non-specialised LD/ASD services, including where these are delivered in Criminal Justice System (CJS).

People who use adult secure services, as well as their carers and families, have a vital contribution to make to the commissioning process as experts by experience.  Meaningful and effective engagement with experts by experience, enabling them to get involved in adult secure mental health services, should be a priority for providers and commissioners, and is pivotal to informing and shaping the transformation of pathways and the quality of services provided. It also helps to ensure positive healthcare experiences for everyone involved and can support the recovery of the service user.


  • NSA: Dr Mayura Deshpande, Consultant Forensic Psychiatrist, Southern Health NHS Foundation Trust
  • Lead Commissioner: Rebecca Daddow
  • Clinical Members: TBC
  • Patient and Public Voice Members
    • Emachi Eneje
    • Sheena Foster
    • Susannah Pashley


A key part of the CRG’s work is to develop a range of commissioning products, including service specifications, quality dashboards and commissioning policies and guidance. These are tools that will be used by Regional Specialised Commissioning Teams and Lead Providers for NHS-led Provider Collaboratives.

Service Specifications

Service specifications are important in clearly defining the standards of care expected from organisations funded by NHS England to provide specialised care. The specifications have been developed by specialised clinicians, professionals, commissioners, experts by experience (patients and carers), and public health representatives to describe both core and developmental service standards. Core standards are those that all funded providers should be able to demonstrate, with developmental standards being those which may require further changes in practice over time to provide excellence in the field.

The following service specifications fall within the scope of this CRG:


Other important publications that relate to this CRG include:

Supporting carer involvement in secure mental health services

Through the CRG, NHS England commissioned the development of a ‘secure carers’ toolkit’. The toolkit gives clear information for carers, service users, adult secure providers and commissioners about how carers of service users who use adult secure services should be engaged with, supported, involved and empowered.

Transitions from adolescent secure to adult secure inpatient services

This guidance relates to patients who need to transition to the adult secure pathway when leaving CAMHS secure services. It aims to outline good practice standards and give clear guidance for the positive transition of young people. A National Adult Secure and CAMHS Secure Transitions Task and Finish Group, reporting to the CAMHS and Adult Secure Clinical Reference Groups, was established to consider and improve this transition, the guidance and supporting documents should be helpful to all those involved in the process.

Managing a healthy weight in adult secure services – practice guidance

This practice guidance is for commissioners and providers of adult secure services, those who use these services and their families and carers. The aim of this document is to provide helpful and informative guidance to support all stakeholders to ensure that issues related to managing a healthy weight are addressed effectively with positive outcomes for all those involved.

Get involved

If you are interested in the work of the xx CRG or its NPOC, you can register as stakeholder.

For details on our latest consultations please visit the NHS England consultation hub.

Get in contact

For any questions or queries relating to the work of the xx CRG or its NPOC, please contact: