RCPsych comments on Nottingham Inquiry

The Nottingham Inquiry, which was established to build a clear understanding of the events that led up to the tragic homicides in Nottingham in June 2023, concluded its evidence hearings on 5 June 2026.

Following the submission of written and oral evidence, the College has published a broad comment on the Inquiry.

Dr Lade Smith CBE, President of the Royal College of Psychiatrists, said:  

“The Nottingham Inquiry must be a turning point. We have warned that mental health services are at breaking point. People are required to be in acute mental health crisis to access services, instead of being supported to recover and stay well and it is at this point that they are most likely to pose a risk to themselves or others. Commissioning is disproportionately focused on crisis care rather than early intervention and ongoing community-based support.  

“We know that severe mental illness can be effectively treated, but it takes people up to nine years to receive a diagnosis and less than one-third of those in need of care are in contact with services. When people do receive treatment, it is all too often focused only on the acute symptoms of their mental health crisis. Effective, evidence-based treatment is the best way to help people recover and stay well, and also the best way to manage any risks they might pose to themselves and others. The Royal College of Psychiatrists have repeatedly highlighted these concerns. 

“In the past, there was debate about the causes of higher rates of mental illness among Black communities in the UK, but there is now compelling evidence that these disparities are driven by social inequality including deprivation, discrimination, early childhood trauma and other forms of socioeconomic disadvantage all of which contribute to increased rates of all mental illness.  

“People with severe mental illness who are at the greatest risk of violence, are those who have used substances, have an existing history of violence and are acutely unwell. Risks to patient and public safety can be consistently recognised, and managed more effectively, in a well-resourced system with well-trained staff.  

“Continuity of care must be at the heart of the solution through an empowered workforce with the time and capacity to build trusted relationships with their patients. Instead, workforce shortages, poor retention and constrained funding dating back decades have left services overstretched and overwhelmed. Mental health accounts for 20% of the country’s disease burden but only receives around 8% of national funding. This erodes service benchmarks over time and regardless of how good their training might have been, as fewer clinicians are exposed to best practice, definitions of “good standards of care” become shaped by service capacity rather than patient outcomes. 

“The College holds an advisory role in setting evidence-based standards. We develop guidance and provide training to support clinicians and services; however, as with other medical Royal Colleges, we do not have the authority to ensure these standards are implemented. 

“We must refocus the system on keeping people well in their communities and preventing relapse. That means shifting the commissioning focus away from reducing beds and bed occupancy to building community capacity, including restoring core functions and teams like assertive outreach and rehabilitation services. Keeping people well in the community is not only better for them, but also important for public safety. 

“The solutions are clear. We must close the treatment gap, particularly for people with severe mental illness; fully and properly implement the Community Mental Health Framework including 24/7 support and ensure commissioning is local population needs-based, evidence-led and clinically driven. Mental health leaders must be embedded within ICB decision-making.  

“These terrible attacks must lead to real and lasting change, otherwise we risk a similar tragedy happening again. These families have fought hard to bring this Inquiry forward. It must now result in decisive action, because the cost of inaction is simply too high. 

“For years the College has consistently advocated for improvements in mental health services and must be given an active role to ensure steps are taken to deliver better outcomes for patients and the public.”

The Nottingham Inquiry is expected to publish a final report with its findings by May 2027.