Chris Heginbotham, chief executive of East and North Hertfordshire health authority admits that a joint mental health risk team was set up on the suggestion of Hertfordshire social services director Ian White. Both were concerned about patients with a history of mental illness who were living in the community and were potentially at risk, but not ill enough to warrant being sectioned in hospital. The team meets every couple of months to discuss problem cases, rather like a child protection committee.

'It has been going for a year now, and brings together HAs in the area with social services, police, probation and consultant psychiatrists,' says Mr Heginbotham.

Patient confidentiality is an issue, so the team is finalising a protocol, agreed by the General Medical Council and the British Medical Association about passing information on to relevant agencies on a 'need to know' basis.

'The idea is to share information on indivdual cases and inform the ways we work together. What we are not doing is a Big Brother thing. We share information that is relevant to make sure indivduals are properly monitored and provided with appropriate support. Before, it would have relied on individual social workers or consultants. It would have been very ad hoc.

'Now we have got a very much better grasp of what each agency can offer - and what some of the constraints are. We have a much more common concern.'