Multi-Agency Risk Management (MARM)

The Multi-Agency Risk Management (MARM) is designed to support people where high levels of risk have been identified and a multi-agency approach would be beneficial. It brings together senior professional representatives from multiple agencies including the emergency services, health and social care to identify what needs to be done to reduce the risk. The professionals meet once a month to discuss up to four people. They will then decide if a review meeting is needed to manage the ongoing concerns.

MARM does not replace statutory adult safeguarding. It is a framework for managing risk where the concerns do not come from a third party and the person is able to protect themselves, but they remain at risk. The referring agency needs to demonstrate that they have exhausted all strategies to reduce the risk before considering referring to MARM.

• vulnerability factors requiring pro-active prevention and protection measures to reduce the risk of escalation to a safeguarding response
• on-going needs or behaviour, placing the person and/or others at significant risk
• self-neglect including hoarding and concerns around fire safety where the person is able to protect themselves
• refusal or disengagement from care and support services where person is at significant risk without support
• noncompliance with medication or not adhering to treatment advice where this leaves the person at significant risk of harm
• complex or diverse needs, which either fall between statutory responsibilities or eligibility criteria, or span a number of agencies. For example, risks from the impact of neurodivergence, mental health, substance misuse or care leavers who are not eligible under the Care Act 2014 but present with vulnerabilities
• risks previously addressed via a section 42 enquiry but for which the need for ongoing risk management and monitoring has been identified 
• repeated concerns around suicide risk and self-harm where this intersects with other risks and cannot be managed by secondary mental health services alone
• where the person is unable to maintain stable accommodation

If you are concerned about a person due to high levels of risk which haven’t been able to be reduced, you can call Care Connect.

• provide evidence that the risk has reached an unmanageable level and that different strategies have been tried (such as care management, multi-disciplinary team meetings etc) to reduce the risk but it remains unmitigated 
• provide evidence that the person has mental capacity in relation to the risk
• determine if the person would like to be involved in MARM
• let other agencies that are involved know a referral to MARM is being made
• provide sufficient information at the initial MARM meeting to allow for consideration of risk and needs

1. person identified to be at high level or risk

2. if not emergency, referrer contacts Care Connect

3. Care Connect record concern and forward to SPA

4. SPA decide concern meets threshold for MARM

5. MARM process is initiated

6. initial MARM meeting discusses up to four cases with all partner agencies. The MARM coordinator will chair this meeting. If a review meeting is required, a lead agency will be identified and will confirm which agencies will need to attend review meetings going forward

7. MARM coordinator convenes review meeting with lead agency. Lead agency will chair the review meeting and any ongoing MARM meetings for that person. The MARM coordinator will liaise with the lead agency for updates throughout the process

8. the review meeting will establish if risks have been reduced. It will also be decided if another review meeting is required, if MARM involvement needs to end or whether legal advice should be sought

9. if no further review meetings are required, the case will be discussed as part of a final review meeting

10. if agreed by all agencies that no further action is possible, this decision will be clearly recorded and authorised by the lead agency (under guidance by MARM partner agencies)