Forensic Psychiatry is a psychiatric specialty that provides assessment and treatment to people with mental disorders who pose a significant risk to the safety of others as a result of these disorders, or where the disorder appears to be associated with offending behaviour.
The Orchard Clinic is a Medium Secure Unit based at the Royal Edinburgh Hospital. It provides specialist forensic assessment and treatment for patients in Lothian, Borders, Forth Valley and Fife, as well as some national patients.
The Orchard Clinic was opened in 2000 and contains three wards, for a total of 40 inpatient beds: Redwood, a 15-bedded mixed-sex acute admission ward; Cedar, a 14-bedded rehabilitation ward for men; and Hawthorn, a 13-bed mixed-sex rehabilitation ward. There are no outpatient facilities at the Orchard Clinic. Patients are generally transferred from other secure care providers or from the Criminal Justice System via courts or prison.
The Orchard Clinic Community Forensic Mental Health Team caseload largely consists of patients previous discharged from inpatient care within the Orchard Clinic. The team also provides a consultation-liaison service.
Who can refer:
- General Adult Psychiatry services, including Low Secure Settings
- Forensic services
- Forensic and Police Custody Healthcare staff
Who to refer:
- Male or Female adults (>18 years)
- Mental illness as a primary diagnosis (however co-morbid personality disorder is not an exclusion criteria)
- Pose a risk to others which is suspected to be related to their mental illness
- Usually subject to legal proceedings
Referrals can be made to request a review from Forensic services; to request assessment for medium security; to request advice regarding providing a risk assessment; for general management advice; to request attendance at multi-professional discussion. Please discuss with the duty Consultant if there are doubts as to whether a referral is appropriate.
Who not to refer:
- Children and young people (<18 years) – please refer to Child & Adolescent Psychiatry
- Criminal behaviour without suspected mental illness – this is the remit of the Criminal Justice System
- Alcohol or drug misuse without suspected mental illness – please refer to Addiction Services
- Offenders with a primary diagnosis of acquired brain injury or neurological disorders – please refer to Robert Ferguson Unit in first instance
- Offenders with Learning Disability – please refer to Forensic Intellectual Disability Services in first instance
- Patients who require close observation to prevent self-harm or suicide, without associated risk of harm towards others – please refer to General Adult Psychiatry services
How to refer:
The Orchard Clinic consultants are generally happy to offer advice and consultation. Consultant responsibility is defined based on gender of the patient and geographical location.
- For non-urgent enquiries, please contact our administrative staff, who can direct queries to the appropriate consultant.
- For enquiries which require an immediate response there is a duty consultant available.
If formal referral is agreed following consultation, or for any direct referrals:
- Please follow the guidance on this page and complete the referral pack below. Please send the completed pack to our secure admin mailbox for processing.
- All referrals will be discussed at the bed management meeting held every other Monday. Referrals will be allocated to the appropriate clinical team who will liaise with the referring service for further assessment.
Referrals out with this pathway will not be allocated for discussion except in cases where it has been mutually agreed that the situation warrants an emergency response. In these cases, the referral documentation can be completed retrospectively by the referrer.
Administrative queries about patients that have already been referred or being seen by our service can be dealt with by ringing our administrative team.
Referral Resources:
Referral pack (download from this link): Referral Document NHS Lothian Forensic Service2020.doc
Secure e-mail address for referrals: loth.orchardadmingroup@nhslothian.scot.nhs.uk
Address:
The Orchard Clinic
Royal Edinburgh Hospital
Morningside Terrace
Edinburgh
EH10 5HL
Telephone: 0131 537 5860
Secure E-mail: loth.orchardadmingroup@nhslothian.scot.nhs.uk
Orchard clinic intranet website: http://intranet.lothian.scot.nhs.uk/nhslothian/healthcare/a-z/theOrchardClinic/Pages/default.aspx
Scottish forensic network: http://www.forensicnetwork.scot.nhs.uk/
