MAPPA: A Guide for Health and Mental Health Staff

Multi-Agency Public Protection Arrangements, known as MAPPA, bring agencies together to manage the risk posed by some of the most serious offenders living in the community. Health and mental health staff are often part of the picture, whether they are treating a patient who is subject to MAPPA, receiving a request for information, or attending a meeting. This guide explains what MAPPA is, who it covers, how the levels work and what staff should remember about information sharing. It is general information, not legal advice, and arrangements differ between the nations of the UK.

What MAPPA is

The Ministry of Justice describes MAPPA as a process through which the police, probation and prison services work together with other agencies to assess and manage the risks posed by individuals convicted of serious violent, sexual and terrorism offences who live in the community, in order to protect the public. The arrangements were established by the Criminal Justice Act 2003 and are delivered locally through Strategic Management Boards across England and Wales; the Ministry of Justice page counts 42 of them.

The Responsible Authority and the duty to cooperate

The police, probation and prison services together form the Responsible Authority in each area. Other agencies are under a duty to cooperate with it. According to the Ministry of Justice, these include children's services, adult social services, health trusts and authorities, youth offending teams, local housing authorities, Jobcentre Plus and certain registered social landlords and electronic monitoring providers. The duty to cooperate is not a duty to disclose everything: it means taking part in arrangements and sharing relevant information lawfully. For NHS and independent health providers it often means attending meetings, giving risk-relevant information and carrying out agreed actions.

Categories and levels

People managed under MAPPA fall into categories. As described by the Ministry of Justice, Category 1 covers people subject to sex offender registration, Category 2 covers those convicted of violent offences who were sentenced to 12 months or more in custody, Category 3 covers other dangerous individuals who have committed an offence and are considered to pose a risk of serious harm to the public, and Category 4 covers terrorism-related offenders and those at risk of involvement in terrorism.

Management is organised at three levels. Level 1 is management by the lead agency with cooperation from others and no requirement for formal meetings. Level 2 involves active multi-agency management with regular multi-agency meetings. Level 3 is enhanced multi-agency management that needs senior agency involvement and additional resources. Cases move between levels as risk changes.

MAPPA in Scotland

In Scotland, the arrangements cover registered sex offenders during their registration period and restricted patients, who are people with a mental disorder detained in hospital under a restriction order. The four responsible authorities are the police, the local authority, health and the Scottish Prison Service. Health acts as the lead agency for restricted patients, both in hospital and in the community. Scotland's levels are routine risk management, multi-agency risk management and a multi-agency public protection panel for the small number of highest-risk cases.

Where mental health services come in

Many people on the MAPPA register have mental health needs, and some are detained patients whose leave, discharge and community follow-up involve risk planning. Practical points for clinicians and care staff include:

• Know whether a patient is subject to MAPPA and who the lead agency and coordinator are.
• Make sure risk assessments, care plans and discharge arrangements reflect any agreed MAPPA risk management plan. Our guide to section 17 leave under the Mental Health Act covers how leave decisions interact with risk.
• Understand the person's legal rights, including their right to review; see our guide to mental health tribunal rights.
• Tell the MAPPA coordinator promptly about significant changes in risk, such as non-engagement, a deterioration in mental state or a change of address.
• Keep accurate, dated records of what was shared, with whom and why.

Information sharing: reasonable, necessary, lawful, proportionate

The Ministry of Justice stresses that agencies share information to reduce risk, but that disclosure must be reasonable, necessary, lawful and proportionate in order to protect victims and the wider community. Health staff should work within their organisation's information governance policy and data protection law, seek advice from their Caldicott Guardian or data protection officer when unsure, and share only what is relevant to risk. Information that is sensitive but not relevant to risk should not be disclosed. Where staff are concerned about harm to adults, the processes in our guide to safeguarding adults reviews may also apply.

Frequently asked questions

Is every patient with an offence history managed under MAPPA?

No. MAPPA applies to specific categories of offender who meet defined criteria. Staff should check with the MAPPA coordinator rather than assuming.

Can a patient refuse to have information shared with MAPPA?

Consent is not always required where disclosure is lawful, necessary and proportionate for public protection, but you should take advice and document your reasoning.

What training is relevant?

Risk assessment, information governance and Mental Health Act training all support this work. Browse the Learnsignal CPD hub for healthcare compliance courses.

Sources: Ministry of Justice, MAPPA overview pages; Inverclyde Council guidance on MAPPA in Scotland. This article is general information, not legal advice.