High Risk Adults Panel (HRAP)

The High Risk Adults Panel (HRAP) is a multi-agency high risk panel which was developed in response to the need to establish a multi-agency way of supporting work on complex and/or high-risk cases. The cases heard at HRAP may involve issues like:

• homelessness
• sexual abuse / exploitation
• self-neglect
• hoarding
• alcohol and drug use

The purpose is to facilitate, develop, monitor, and evaluate risk management plans. The panel will support agencies in their work to lower and manage risk.

HRAP meetings are held to:

• share information to identify, clarify, and agree on risk
• promote the safety and wellbeing of high risk adults in Middlesbrough
• improve multi-agency communication pathways
• utilise resources more efficiently
• develop risk management plans
• (for those who are not engaging) co-ordinate a risk management plan to seize opportunities to enable engagement and/or monitor the wellbeing of the person
• improve agency accountability
• share risk across agencies
• identify a lead/key worker

HRAP takes place every four weeks.

It is coordinated by the Access Safeguarding Team in Middlesbrough Council Adult Social Care, and is chaired by the Head of Access and Safeguarding.

The core membership is made up of senior representatives from statutory and non-statutory organisations.

A single referral document, including a case summary, with relevant details and presenting issues, will be sent to attendees prior to the meeting.

At the beginning of each panel, a short update of the previous meeting's referrals will be made, in order to monitor agreed actions/outcomes.

The agency making the referral will present the case to the panel, followed by focused consideration of risk, options, and solutions, before agreeing actions.

The panel representatives/agencies agree to take responsibility for delegated actions and principally support the referring agency with managing risk.

The panel also includes time to debate how cases previously presented have been resolved or review progress. This is to capture best practice and organisational learning.

Where cases have been carried forward from the previous month, a short update of the previous meeting's referrals will be made, in order to monitor agreed actions/outcomes.

Professionals who identify a case for HRAP should follow the TSAB guidance, and primarily use professional judgement, with detailed reasons, of current, unmanaged risk, as the basis for making a referral.

Anyone can present a case to the High Risk Panel where there is a complex or challenging risk issue, and where the criteria for acceptance is met and guidance and decision making are needed.

Professionals currently working with an adult must show clear evidence that all attempts to engage, and multi-agency management of the case prior to referring to HRAP (except in cases of immediate high risk where professional judgement is required), have failed.

The case has either been managed through adult safeguarding processes but these have been unable to minimise risk, or the professional considers the adult may be at risk of significant harm but the adult safeguarding criteria has not been met.

To be eligible, the individual concerned must:

• be at risk due to severe self-neglect/self-harm
• exhibit risk-taking behaviours
• be resistant to change
• refuse to engage with services
• be suffering abuse by a third party but not be willing to engage in safeguarding or services
• be 'frequent caller' to services
• be causing the agency to struggle to maintain the high risk situation as a single agency

You can make a HRAP referral by completing the 'High Risk Adults Panel (HRAP) Tees-wide referral form' on the TSAB website.

Email your referral to adultaccessteam@middlesbrough.gov.uk.