Psychiatric offenders who have committed homicide are being paid by NHS trusts to advise on patient care, a new investigation has found.
The practice stems from NHS England’s “recovery approach”, under which individuals with a history of severe violence are designated as “experts by experience” and work alongside medical professionals as “equal partners” in shaping mental health services. Critics say the scheme can lead to premature discharge, undermine public safety, and cause further distress to victims’ families.
The ‘Recovery Approach’ and Its Risks
The “experts by experience” (EBE) scheme is intended to give patients a direct voice in how services are planned and delivered. NHS England says the individuals involved provide “detailed feedback on their experiences” to help improve care across both physical and mental health settings. They participate in staff recruitment and training, contribute to research, and help design policy.
Participants can earn up to £140 a day for their work. The scheme is rooted in a philosophy that values the insight of people who have used mental health services, with the aim of reducing power imbalances between clinicians and service users.
But medical professionals and campaigners have expressed alarm that the programme may be putting the public at risk. A former NHS psychiatrist warned that involvement in such roles “could be seen as (making) progress”, potentially accelerating a patient’s discharge from a secure facility before they are truly ready.
A retired psychiatrist from Nottinghamshire Healthcare NHS Foundation Trust described cases in which patients who had committed homicide were taken to inspect security arrangements at other secure hospitals, including examining fence heights, testing keys, and reviewing CCTV systems. “In my view, patients who’ve committed serious offences should not be inspecting the adequacies or deficiencies of other secure hospitals,” he said.
The former leader of an NHS mental health trust called the investigation’s findings “very worrying”. He added: “Hearing the user experience is one thing. But getting someone who has killed someone to advise you on how to care for people who are seriously ill is another.”
The Case of Martin Saberi
One prominent case highlighted by the investigation is that of Martin Saberi, a repeat offender diagnosed with bipolar disorder in 2008. He had served 16 years for armed robbery before his release on licence in 2016.
Despite this history, Saberi was engaged by the Royal College of Psychiatry to lead a substance misuse workshop at its annual forum in July 2018. Records show he was also listed as a “Patient Reviewer” for the Quality Network for Forensic Mental Health Services in October 2018, where he presented on “Diagnoses of prisoners in a secure setting”.
In January 2019, Saberi murdered Amy Griffiths, a transgender woman he had met through a dating website. He beat her with a baseball bat before strangling her and cutting her throat. He had attacked another woman shortly before the murder.
An NHS England report noted that Saberi had been working as a “lived experience consultant” the day before the attack, with no concerns raised at the time. The report suggested the role “may have led to some considerable pressure for [him] to maintain a coping façade”.
The investigation also found that staff overseeing Saberi’s care had concentrated on his current risk assessment when easing restrictions, neglecting a proper examination of his violent history. This led to a “rapid” reduction in treatment that left him “vulnerable”.
In March 2021, Saberi was jailed for life with a minimum term of 24 years and 10 months for the murder of Amy Griffiths and the wounding of the other woman. He is now being treated at Broadmoor Hospital.
Broader Concerns and NHS Response
An NHS England report from 2018 indicated that 18 psychiatric patients released from Oxleas NHS Foundation Trust had gone on to kill in the preceding 15 years, pointing to a broader pattern of systemic failures within mental health services, including issues of understaffing, underfunding, and poor leadership.
In some instances, individuals acting as “experts by experience” have withdrawn from NHS schemes due to perceived ineffectiveness. A self-advocacy charity pulled out of NHS England’s Care and Treatment Review programme, citing concerns that the process was not adequately keeping people out of hospital and that abuse and poor care continued.
An NHS spokesman said: “It is important that the NHS listens to patients about their experiences of care. The term ‘expert by experience’ refers to people who give detailed feedback on their experiences to help plan and improve services – this happens across healthcare in both physical and mental health services. It does not refer to people being equated with doctors or nurses in healthcare settings.”