The optimal system for delivering forensic psychiatric care has yet to be established. At an early stage, Gunn (1977) drew attention to the differing models of a ‘parallel’ service and an ‘integrated’ approach. Only with the integrated system do forensic patients pass to ordinary NHS facilities when they no longer require security or other specialist expertise. The debate can be extended into whether forensic services should be provided by regional units, by district services, or by a mixture of both. Indeed, the Royal College of Psychiatrists (1988) recognised that in addition to a regional service led by a fully trained forensic psychiatrist, secure care can be provided at a district level by consultants who have sufficient training to hold posts with a special responsibility. Furthermore, managers are understandably keen for as much as possible to be provided by their own district services.