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The Royal College of Psychiatrists Improving the lives of people with mental illness

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Quality Network for Forensic Mental Health Services

The Medium Secure Quality Network


The Network was launched in 2006, reviewing eight units during this initial pilot period. The Network has continued to grow with all medium secure units across England, Wales, Northern Ireland and the Republic of Ireland becoming members by Cycle 6 (2011-2012). We also have one member service from Scotland who have been with us since the start of Cycle 7 (2012-2013).



Here you can find out more about the Medium Secure Quality Network, including a break-down of the review process and you can view the full set of Medium Secure Standards used to measure the quality of services.



The Cyclical Review Process

The work of the Quality Network is based around a cyclical review model.

By clicking on the links below you can explore each stage of the review process, from agreeing the standards to producing the Annual Report.


Stage 1: Agree Standards

Stage 2: Self Review

Stage 3: Peer Review

Stage 4: Local Reports Compiled

Stage 5: Action Planning

Stage 6: Annual Forum and Report

Stage 1: Agree Standards

The Quality Network has developed the Standards for Medium Secure Services over the last year following extensive consultation with a variety of stakeholders. They are supported with a foreword by Patrick Neville Portfolio Director (Mental Health), NHS England.  These refreshed and updated standards will form the basis of self and peer-reviews for medium secure services in 2014-2015.

The following outline the areas each of the services are measured against during the self and peer-review process:

Patient Safety
Physical Security
Procedural Security
Relational Security
Safeguarding Children & Vulnerable Adults

Patient Experience
Patient Focus
Family and Friends
Environment and Facilities

Clinical Effectiveness
Patient Pathways and Outcomes
Physical Healthcare


Stage 2: Self Review
July - january

The self-review process commences and services are expected to provide commentary and score themselves as to whether they have met, partially met or unmet each of the Medium Secure Standards. We request that the service consults a range of people to ensure the information provided is representative. This should include:

  • Senior Managers
  • Members of the multi-disciplinary team
  • A range of ward based staff
  • Patients

Telephone Conferences

Each service provides contact details of patients, family and friends to be contacted for a telephone conference prior to the peer-review visit. These conferences take place with one of the Quality Network's Patient Reviewers or Family and Friends Representatives. More information about these roles can be found on the Patient and Carer Involvement section of the website.

Policy Check

The Quality Network requests a series of policies from each service. This Cycle we have themed the peer-review visits 'Patient and Family and Friends Involvement' and a few policies relating to this theme will be chosen for further discussion on the review day.


Stage 3: Peer Review
september- march

The peer-review is a supportive process, encouraging services to identify areas of both achievement and challenge, whilst also considering improvements for the future.

Peer-review Team

The peer-review team is usually made up of four staff members from two different services, a Patient Reviewer and a Project Worker from the Quality Network. Two of the staff members assume the roles of Lead Reviewer and Deputy Lead Reviewer. Lead Reviewers have training to support them in this role.


The visit is broken up into various meetings and can last between one and three days, depending on the size of the service. The day is broken down into the following areas:

  • Tour of the Unit
  • Perimeter Check
  • Meeting with Senior Managers
  • Meeting with Frontline Staff
  • Meeting with Patients
  • Meeting with Senior Clinicians

Stage 4: Local Reports Compiled
october - may

Draft Report- Sent to the host service and peer-review team within four weeks of the peer-review date for their comments.

Final Report - Issued only to the host service within eight weeks of the peer-review date.


Stage 5: Action Planning
december - July

The report will outline the key areas of achievement and challenge and suggest a number of action points for improvement for the following Cycle.

Two months after receiving the final report we will expect to receive a copy of the action plan from the service and this will be used in the following Cycle to identify any areas of change or improvement.

Stage 6: Annual report & Forum
5 may 2015

 At the end of each Cycle an Annual Forum is held for forensic mental health staff, commissioners, patients, family and friends and all interested in the Quality Network. It outlines the key trends from the past Cycle and focusses on particular areas for further exploration.

The Annual Report explores each section of the Standards for Medium Secure Services, drawing on the achievements, areas for improvement and solutions to common problems. Members can use the report to benchmark themselves against other services, identify key areas of variance within the Quality Network and gain ideas for service development from the good practice section.