The NHS has been recruiting individuals convicted of violent offences, including homicide, as paid consultants under a programme that designates them "Experts by Experience." These individuals, many of whom remain under the formal jurisdiction of mental health services, are being compensated to advise trusts on the quality of forensic psychiatric care.

The programme operates under what NHS England terms the "recovery model," a framework that treats patients as active participants in their own care and, in some cases, in the design of services for others. Under this model, individuals with lived experience of psychosis, detention, and high-security psychiatric units are considered to hold insights that clinical staff cannot replicate. Hourly rates paid to EbE consultants vary by trust but have been recorded between £10 and £25 per session, with some participants receiving stipends for attending recruitment panels, policy steering groups, and patient experience workshops.

What the programme does not make explicit in public-facing documentation is the criminal history some of these consultants carry. Several individuals employed in this capacity were convicted of offences involving serious violence or killings carried out during acute psychotic episodes. A number are not former patients in any conventional sense. They remain patients, either residing in medium-secure units or subject to community supervision orders requiring ongoing psychiatric oversight.

The question of how trusts determine eligibility for these roles is not resolved by any national framework. There is no standardised register of high-risk individuals serving as consultants, and vetting procedures differ significantly between trusts. Some rely on the clinical judgment of responsible clinicians. Others apply informal assessments of behavioural stability. No independent body audits these decisions, and there is no requirement to notify the public or the families of victims when a convicted offender is elevated to an advisory position within the same system that manages their detention.

NHS trust leaders who have defended the programme argue that excluding forensic patients from service design perpetuates the institutional distance that rehabilitation is meant to close. The clinical position holds that peer visibility matters: when patients in secure units observe former patients contributing professionally to the health system, it signals that recovery and reintegration are achievable outcomes rather than administrative fictions. This argument has support among forensic psychiatrists and occupational therapists who work within the recovery framework.

Victim advocacy groups do not accept this framing. For families of those killed by individuals subsequently enrolled in these programmes, the use of public funds to compensate offenders for NHS advisory work raises questions that go beyond clinical philosophy. The concern is not solely financial. It is that the state, through its own health infrastructure, has quietly elevated individuals responsible for grave harm into positions that carry a degree of professional legitimacy, without any formal mechanism for public accountability.

The Department of Health and Social Care has not issued guidance specifically governing EbE participation by individuals convicted of violent offences. In response to questions about the programme, the DHSC stated that commissioning decisions are the responsibility of individual trusts and that patient involvement in service improvement is consistent with established NHS policy. It did not address the absence of a national oversight framework for high-risk consultants.

The tension the programme produces is not simply between rehabilitation and punishment. It sits inside a narrower and more uncomfortable question about transparency. The NHS operates these arrangements without any requirement to disclose them. There is no published list of offences held by EbE consultants, no formal process for informing the public which trusts employ them, and no mechanism by which families of victims are made aware. The programme's clinical rationale may be coherent. Its governance is not.

Whether the recovery model can accommodate this degree of opacity while retaining public confidence is a question that neither NHS England nor the DHSC has yet been asked to answer formally. It may not remain unasked for long.

‍