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Prison Transfer Service

Cygnet Health Care is a recognised supplier of secure services by NHS England. All prison referrals would ordinarily be gate kept by an NHS England case manager prior to admission to Cygnet facilities. Our Prison Transfer services provide a rapid assessment and turnaround programme for sub-MSU prison and court transfers.

These include the following

  • Section 48/49 transfers of unsentenced prisoners requiring assessment and recommendations for court.
  • Section 47/49 transfers of sentenced prisoners requiring assessment, treatment and stabilisation for return to prison.
  • Section 38 directions from court for pre-sentencing assessment.
  • Section 35 directions from court for assessment and recommendations to the court prior to trial (28 days initially but may be renewed for up to 12 weeks).


Referrals are accepted 24 hours a day. For prison referrals, assessment will take place at the prison by members of the multi-disciplinary team within 48 hours. The purpose of the assessment is to initially assess clinical risk for suitability for transfer to levels of low security. The results of the assessment will enable the team to make recommendations regarding placement and future treatment options within a timely manner, in line with the Bradley Report 2009.

Our speciality doctor will always attend the assessment and will provide a short assessment report making recommendations to the Ministry of Justice, who will balance the clinical presentation against security and political risks associated with the transfer along with a medical report from a section 12 approved prison psychiatrist. An alternative transfer request from a court under section 35 or 38 will be decided upon by the judge rather than the Ministry of Justice.

Commissioning for the healthcare of prisoners is the responsibility of the local authority where the prisoner is resident. If this information is unavailable or the prisoner is NFA, it resorts to the local authority where the alleged offence took place. Once the transfer of the prisoner has been agreed by the responsible mental health commissioner and IPPA forms received, a bed on the ward will be booked for receipt of the prison transfer service user.

During the period between assessment and admission, our clinical team will work with the prison in-reach team and responsible CMHT (if applicable) to source as much clinical and offence history as possible within the confines of data protection legislation. This will be important in formulating an accurate assessment of risk and presentation within the shortest period possible.

Protocol for assessment

  • Full assessment on admission
  • Basic outcomes completed within the first 7 days
  • CPA organised with CMHT, prison in-reach team at 6 weeks
  • Full HCR-20 completed for 6 week CPA
  • Basic psychology assessments to be completed for 6 week CPA
  • CPA to take place at 6 weeks to review current diagnosis and risk profile with local teams / prison in-reach and decide upon an interim decision for the court recommendations
  • Within 8-10 weeks complete final recommendations for court in the form of a court report

Disposal following court hearing

Possible disposal routes for service users following court may be:

Section 48/49

  • Convicted of the alleged offences, Section 37 hospital order with or without section 41 restriction
  • Convicted of the alleged offences but judge dismisses recommendations and the service user returns to prison
  • Convicted of alleged offences but deemed to have served their sentence on remand and returned to hospital under Part 2 of the MHA e.g.section 3
  • Prosecution decide it is not in the public interest to proceed and prisoner is detained under Part 2 of MHA e.g. section 3

Section 47/49

  • If treatment is completed to the satisfaction of the prison and hospital teams, the service user will be returned to prison with recommendations to the in-reach team for continued treatment
  • If the tariff has been completed but the mental health team deem there is need to continue hospitalisation, the service user may be transferred to notional section 37

Section 35

  • Recommendation made to the court as to whether the service user is fit to plead. The service user may be released by the court if no case to answer, remanded in prison or transferred to hospital under section 48/49

Section 38

  • Recommendation made to the court regarding sentencing decision. The service user may then be placed on a section 37 or 37/41 or sent to prison

Why Refer to our Prison Transfer Service?
  • Comprehensive offender health team.
  • Time limited outcome.
  • Suitable for all presenting mental disorders including mental illness, learning disability, personality disorder and dual diagnosis.
  • Resources available to accept both remanded and convicted prisoners.

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