The service has a responsibility to oversee the care of Merseyside and Cheshire service users admitted to specialist low and medium secure beds. There is also a responsibility to oversee long-term care pathway issues for Merseyside and Cheshire service users in high secure personality disorder facilities.
The pathway oversight function makes sure that service users in specialist beds are cared for in the least restrictive setting, for the shortest period of time necessary. As such, from the point of admission, the team seek to anticipate obstacles to pathway progression and take a proactive approach to addressing them. Treating teams are asked to communicate any significant incident or proposed change in the care plan. The SPaRCS continue to monitor service user treatment and progress with an awareness of the original care plan, current clinical issues and treatment/management needs, and also longer-term pathway considerations.
Where appropriate the SPaRCS will encourage discussion about the next step in the service user’s clinical pathway. When the treating team see that a change in placement / level of security is indicated they should make a referral for a review and an assessment will be initiated following the processes outlined in the access assessment protocol. If / when an alternative placement is identified and agreed the referral should be made by the treating team.
The liaison role involves working with criminal justice agencies (prison, probation) and clinical services (NHS and independent sector) that may be considering their service user’s need for specialist inpatient treatment. It involves exploring potential alternatives to admission and offering advice regarding clinical and risk management through attendance at multiagency and multidisciplinary meetings, and by liaising with key stakeholders.
The criminal justice liaison role primarily involves attendance at MAPPP meetings for access assessment referrals accepted. This will serve to assist the assessment and is a venue in which the findings of the assessment can be formally fed back. Attempts will also be made to be available to liaise with professionals involved (e.g. the offender manager) outside the MAPPP meeting. This will allow more detailed discussions about the recommendations and how these can be applied to supervision and management.
As regards clinical liaison, the team is available to attend CPA or other clinical meetings to feed back the assessment.
The senior leadership team may accept an instruction (subject to agreement on funding at a fee set by the Trust’s finance deptartment and capacity in the service) when there is an identified need for independent / specialist consultation and/or assessment falling outside of the above criteria (e.g. assessment requests made on behalf of the Parole Board, Local Authority Social Services, out of area ICBs; or other organisations).