C02. Adult Secure Services


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

The focus of the CRG over the coming 12 months will be on:

  • supporting the delivery of service procurement
  • providing support and guidance for the secondary commissioning and new models of care agenda
  • having a specific focus on the relationship with the prison health system.


  • Chair: Dr Mayura Deshpande, Consultant Forensic Psychiatrist, Southern Health NHS Foundation Trust
  • Dr Robert Bates
  • Dr Mary Harty
  • Dr Jeremy Kenney-Herbert
  • Dr Ashimesh Rowchowdhury
  • Dr Sandeep Mathews
  • Dr Raman Deo
  • Dr Katina Anagnostakis
  • Susannah Pashley, Patient and Public Voice representative
  • Sheena Foster, Patient and Public Voice representative
  • Emachi Eneje, Patient and Public Voice representative


A key part of the CRG’s work is the delivery of the ‘products’ of commissioning. These are the tools used by the 10 Hub Commissioning Teams to contract services on an annual basis.

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.

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, commissioners, expert patients 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

Carers and families of service users who access adult secure services have a vital contribution to make to the commissioning process as experts by experience. Engaging with carers and enabling them to get involved in adult secure mental health services should be a priority for providers and commissioners. It helps to ensure positive healthcare experiences for everyone involved and can support the recovery of the service user.

NHS England has worked closely with carers and families through the adult medium and low secure mental health services review (MHSR) and other programmes. They told us that they wanted adult secure providers and commissioners to:

  • Be more aware of the value of their contribution.
  • Understand more about carers’ needs.
  • Understand the importance of being involved in the care of their loved ones.

After listening to what carers told us, 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.

NHS England has worked in partnership with the University of Central Lancashire (UCLAN) to develop the toolkit. The content has been co-produced by a steering group, with a range of expertise and experiences, which included carers

The toolkit steering group has been working closely with the Royal College of Psychiatry and its Quality Network for Forensic Mental Health. Carer involvement and engagement is a key focus for their peer review process and they plan to use the toolkit to help embed carer involvement and ensure it becomes part of everyone’s practice in secure mental health services.

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. This document provides 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.