ELFOS offers two distinct services:
time-limited forensic aftercare for appropriate service users from the areas covers by the service who are being discharged from forensic services.
In line with NHS England standards contract for Medium and low secure services, the service aims to offer:
To provide high quality comprehensive mental health care for patients being discharged from secure services.
To prevent the need for re-admission.
To provide on-going support for high risk individuals in managing any identified risks.
To support people transitioning from secure services with regards their psychological and social care needs.
To contribute to public safety by the provision of specialist forensic mental health care by reducing risk of reoffending during the transition to the community.
To liaise as necessary with the Ministry of Justice, MAPPA and other involved agencies.
To provide a package of care which is developed with the individual and which is sensitive to their personal needs; clearly defines responsibilities for services and individuals who use services; is outcome focused
To aid in the transition back to generic community services, lowering stigma associated with patients who have been in secure care.
To support service users to develop positive lives after serious mental illness and contact with forensic services. Staff will adopt a recovery focused approach to promote positive therapeutic relationships, focussing on relevant issues
B. Offers a consultation/liaison service to other secondary care mental health teams and professionals for service users from the service’s catchment area. This service would offer specific expertise and opinion on service users thought to pose a significant risk to others by reason of their mental disorder.
ELFOS will work collaboratively with local agencies, including community recovery teams, to provide advice, consultation and specialist risk assessment or knowledge sharing.
Advice will be offered in different ways, including through liaison clinics/risk forum, telephone discussion, and when necessary through patient assessments. Assessments will be collaborative and seek to involve carers and professionals who know the service user when possible.
A. Referrals for Community Follow-Up:
• Referrals should be sent in writing by the Consultant Forensic Psychiatrist (or suitable deputy, e.g. ST4-6 doctor) currently caring for the patient. Details should include relevant clinical information and anticipated care pathway, along with key information about risk.
• Referrals should be sent when discharge is being actively planned, or when discharge may result against the team’s advice from an MHRT/Managers’ Hearing.
• Referrals should be sent to the relevant Consultant Forensic Psychiatrist for the catchment area that the service user comes from.
B. Referrals for consultation/liaison/risk assessment:
• Referrals can be made directly to the Consultant Forensic Psychiatrist within ELFOS who is responsible for the patient’s catchment area.
• For perinatal and MBU referrals, these should be sent to the Forensic Psychiatrist within the women’s service at the John Howard Centre.
• Referrals should be completed using the risk forum template (see appendix 1), attaching relevant documents, e.g. recent risk assessment and care plans. Where, exceptionally or by agreement with the local ELFOS consultant, the form is for any reason not used, full clinical details must be separately provided as well as the reason for referral made clear.
• Referrals should be copied to the ELFOS administration email address(ELFOS.email@example.com). Where the referrer has not done so, the ELFOS clinician should forward this on for activity data to be collected.
• A mental disorder (including learning disability and personality disorder), which relates to offending behaviour
The service provides follow up and interventions to service users discharged from low and medium secure services. The service also provides liaison and consultation services to local psychiatric services in ELFT and NELFT localities.
A. Patients requiring forensic follow-up after discharge:
• Patients being discharged from low or medium secure forensic mental health units
• A mental disorder (including learning disability and personality disorder), which relates to offending behaviour.
• The patient can be adequately/safely managed in the community, or for whom continued inpatient treatment cannot be provided.
B. Referrals for risk assessment/advice/liaison
• Patients who are under secondary care mental health services, and
• who are thought to present a significant risk to others, and
• who are over the age of 18, and
• who have a recognised mental disorder.
ELFOS will not accept referrals where:
• substance misuse is the primary/sole problem, or
• antisocial/offending behaviour is not related to an identified mental disorder, or
• Risk of harm to self is the primary concern, or
• where the person is identified as being an imminent high risk to others (where police involvement/immediate hospital admission are needed), or
• for second opinions solely regarding diagnosis, or
• where the reason for the referral being made is unclear.
ELFOS is not responsible for managing referrals for admission to inpatient forensic services (either MSU or LSU), which should instead be sent to firstname.lastname@example.org