The future of secure care and the single point of contact (SPOC) for victims in the Children's Hearings System

Secure care in Scotland is a locally commissioned service, supporting a very small number of children with complex needs. The interaction between demand and supply of secure care has consistently been recognised as a complex and shifting landscape. A spot purchase model currently operates, whereby local authorities and the Scottish Government directly approach the approved and registered secure providers in order to access secure care placements. The four secure providers subscribe to a national framework contract managed by Scotland Excel.

The Scotland Excel contract does not prohibit, provide for, or offer clarity on cross-border placements – which remain bilateral private commercial arrangements between individual providers and the placing authorities from elsewhere in the UK.

Since 2011, the current contract has played a supportive role in standardising expectations and placement processes across Scotland’s independent secure care centres, as well as bringing transparency and consistency to placement costs. However, successive strategic reviews, the experience of providers and purchasers, the observations of parliamentary inquiries and The Promise, all raise fundamental questions about whether the existing contractual frameworks continue to meet Scotland’s needs.

Challenges identified include:

• Financial instability due to variable occupancy levels posing challenges to the sustainability of the charities operating the centres;
• Spot purchase arrangements mean costs vary from year to year, depending on the number and complexity of placements. Demand-driven arrangements make it difficult to plan capacity;
• Inconsistent access and affordability for placing authorities;
• Difficulties in workforce recruitment, development, retention and investment;
• Complex commissioning arrangements;
• Limited flexibility for innovation by individual providers or to explore and adopt new models of care.

Nationalisation

The Scottish Government has committed to ensuring that secure care is sustainable and equitable. There is growing interest in whether alternative funding approaches – including nationalisation of funding – could better reflect secure care’s role as a national resource.

The 2026 COSLA manifesto calls for the nationalisation of the provision of secure care:

“Nationalising the provision of high-quality secure care for children. The current model relying on four independent providers is precarious, and availability of places is unreliable. Creating a national approach should also incorporate the Child and Adolescent Mental Health Services (CAMHS) inpatient and secure mental health provision.”

Nationalising secure care could involve creating a single national service, taking over existing services and staff and buying out current providers. This would shift a lot of responsibility to the national level and would require major public investment. It would also represent fundamental change in identity for the future provision of secure care.

Nationalisation could potentially:

• Provide greater financial stability for secure care providers.
• Support consistent availability of secure care beds across Scotland.
• Enable more strategic planning of capacity, workforce and specialist services.
• Better align funding with the Secure Care Pathway and Standards, including expectations around transitions.
• Improve coordination across health, education, and social work support.

It is important to note that the National Child Inpatient Unit (IPU) and the National Secure Adolescent Inpatient Service, Foxgrove, are both already national services, provided in the NHS and commissioned by National Services Scotland (NSS). The Adolescent IPUs are regionally provided, with flexibility to admit young people from other areas in Scotland. These are provided under the terms of the Mental Health Act and their principles require care to be provided in the least restrictive environment and where the care required cannot be provided in any other way than an IPU. 

At the same time, any move towards nationalisation would require careful consideration of governance, accountability, funding, resources – including how funding models interact with efforts to strengthen alternatives to secure care to ensure it remains a last resort.

This consultation therefore seeks views on how secure care should be funded in the future, including whether changes to the current funding model – up to and including national funding – could better support children and ensure sustainability of the provision of secure care.