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

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annual cycleIntroduction to the Quality Network for Medium Secure Forensic  Services

The Quality Network for Forensic Mental Health Services was launched in 2006 for its first cycle; during this initial pilot period eight units were involved in self and peer-reviews.

The second Cycle began in 2007, and the network continued to grow until all Medium Secure Units in England, Wales, Northern Ireland and the Republic of Ireland were signed up for the start of Cycle 6 (2011-2012). One service in Scotland has signed up for the start of Cycle 7.

Diagram 1 - The Cyclical Review Process

The cyclical review process

The process used by the Quality Network for Forensic Mental Health Services combines the clinical audit cycle with peer-reviews.

The process begins with a set of standards being developed in consultation with member units. Members then engage in a detailed team/service evaluation during the self-review phase.

This is followed by a period of peer-review visits to validate the data provided during the self-review.

After the peer-review stage, units are provided with a local report that compiles the data collected during the self- and peer-review.

When all member units have completed the peer-review phase an annual report of the aggregated findings from all services is written, highlighting national themes and to enable services to benchmark themselves against other services.

The final stage of the process involves action planning and attendance at the Annual Forum.

See Diagram 1 above.


Implementation Criteria for Recommended Specification: Adult Medium Secure Units

The network uses an iterative cycle of self- and peer-reviews using a set of implementation criteria based on Department of Health recommended specifications (2007). A second edition of the implementation criteria was published in 2011, to include additional mapping of the criteria onto the CQC Essential Standards of Quality and Safety.


MSU Standards 2nd edition

A: Safety and Security

       1. Physical Security

       2. Procedural Security

       3. Relational Security

       4. Serious and Untoward Incidents

       5. Safeguarding Children and Child Visiting Policies


B: Clinical and Cost Effectiveness


C: Governance


D: Patient Focus


E: Accessible and Responsive Care


F: Environment and Amenities


G: Public Health