The process was developed in 2005 and adopted as Scottish Government Policy in HDL (2006) 48. The conflict resolution model takes into account that Responsible Medical Officers (RMO) cannot be obliged to accept a patient whom, in their professional judgement:
- does not meet the criteria for compulsory detention under current mental health legislation; or
- would be inappropriately managed at their level of security – either that the level of security is excessive for the risks posed or insufficient to ensure safe care and treatment; or
- would be inappropriate in terms of the treatment available in their facility.
In the case of an upheld tribunal as a result of the Mental Health (Care and Treatment) (Scotland) Act 2003 the responsibility to find a suitable location for a patient’s treatment lies with the Health Board and not any particular RMO.
Conflict Resolution Group
The process is managed by the Conflict Resolution Group (CRG), chaired by the Director and Lead Clinician of the Forensic Network. The CRG comprises independent experts and multidisciplinary practitioners.
The process includes three main stages:
Stage 1: Initial Resolution: A meeting between the referring and receiving boards to reach an agreement or create an Agreed Joint Statement outlining areas of disagreement.
Stage 2: Referral to Conflict Resolution Group: Independent experts review the case, prepare a report and provide recommendations.
Stage 3: Judgement: The CRG reviews the experts’ findings and offers final recommendations.
An expedited process is available for cases in which an urgent decision is required. This involves a single independent Consultant Forensic Psychiatrist reviewing the case and preparing a report with recommendations which are then accepted as the outcome of the process.
Frequently asked questions
Who oversees the Conflict Resolution Process?
The process is managed by the Conflict Resolution Group (CRG), chaired by the Director and Lead Clinician of the Forensic Network. The CRG comprises independent experts and multidisciplinary practitioners.
What happens in each stage of the process?
What happens in Stage 1? Clinicians and managers from the involved boards attempt to resolve the conflict through discussion. If an agreement is reached, the matter is resolved. If not, an Agreed Joint Statement (AJS) outlining points of agreement and disagreement is prepared. This AJS can be provided in bullet point format and will be used as the basis of the discussions by the CRG.
What is the role of the Conflict Resolution Group in Stage 2? The CRG assigns independent experts to review the case. These experts may examine records, assess the patient, and consult with clinicians to produce a comprehensive report.
How are decisions made in Stage 3? The CRG reviews the expert report and formulates recommendations to resolve the conflict. These recommendations guide the next steps for patient care.
How does the expedited process differ from the full process?
The expedited process is a faster alternative for urgent cases. It involves a single independent Consultant Forensic Psychiatrist who reviews the case and prepares a report with recommendations.
This process is suitable for cases requiring urgent decisions but may not be appropriate for complex disputes. All parties must agree to the use of the expedited process at the outset.
Unlike the standard process, the expedited process involves only one expert, reducing the time needed for review and judgement. The final report and recommendation by the single clinician is agreed as the outcome of the process.
Who pays for expert reports?
Responsibility for funding reports is agreed upon before referral to the CRG. Costs include fees for consultants and multidisciplinary practitioners.
How long does the process take?
Timelines vary by case complexity, but full cases take in the region of 4-8 weeks. The expedited process is designed to be faster than the standard process and can often be completed within 7-10 days of a report being commissioned.
Can I provide feedback on the process?
Yes, feedback is encouraged to improve the process. You can share your views via the feedback form below or contact the Forensic Network Office.