Warwick Research Highlights Major Ethical Concerns as Birmingham NHS Trust Withdraws from Counter‑Terror Policing Scheme

Professor Charlotte Heath‑Kelly, an international security scholar in PAIS at the University of Warwick, has played a central role in bringing national attention to the controversial Counter Terrorism Clinical Consultancy Service (CTCCS) — a policing–healthcare partnership that embedded counter‑terrorism practices within NHS mental health services. Her research has gained renewed significance following Birmingham and Solihull Mental Health NHS Foundation Trust’s decision to withdraw from the programme, the first publicly confirmed exit by an NHS organisation since the scheme began in 2016.

The Birmingham trust, which oversaw referrals across the Midlands and Wales, ended its participation in April 2025 after concluding that the programme no longer aligned with its strategic priorities. The CTCCS enabled counter‑terrorism police to consult directly with vetted NHS clinicians to assess individuals — including children — deemed vulnerable to extremism. In practice, this created new pathways for police access to sensitive medical information without patient consent.

Professor Heath‑Kelly’s research has long raised concerns about the ethical implications of integrating security practices into clinical settings. Her work documents how the CTCCS blurred the line between therapeutic care and intelligence gathering, enabling clinicians to share information about psychiatric diagnoses, neurodiversity, or treatment compliance with counter‑terrorism officers. Crucially, patients were not informed that their data could be repurposed in this way.

In highlighting these issues, she argues that such arrangements undermine core NHS confidentiality norms:
“The significance of the CTCCS is that the service can share medical information with counter‑terrorism case officers without the consent of the service user. This information — about autism, psychosis, or schizophrenia — is then used to profile terrorism risk in the community.”

Her research has also drawn attention to disproportionate impacts on racialised and Muslim communities. Using census data to compare referral patterns, scholars found that individuals identified as Muslim were assessed at a ratio of 28 to one compared with white British individuals — a disparity that raises serious questions about profiling and racialised surveillance. These findings, made public through academic studies and collaborative work with civil society organisations, were among the concerns brought directly to participating NHS trusts.

Following publication of these concerns, formal complaints were submitted regarding breaches of confidentiality norms. Professor Heath‑Kelly notes that Birmingham’s withdrawal from the programme represents a major shift:
“Their exit speaks to a 180-degree turnaround in the trust’s approach to sharing medical information and participating in the controversial profiling of mental health and neurodiversity in terms of extremism risk.”

Campaign groups such as Medact have similarly welcomed the decision, arguing that counter‑terror policing has become overly embedded within public services through the Prevent duty. They maintain that NHS clinicians should prioritise patient care and autonomy, not intelligence‑led risk assessments.

The Birmingham trust’s withdrawal raises questions about the future of the CTCCS, which has operated quietly across England and Wales since its inception. While two other NHS trusts are reported to still be participating, neither NHS England nor the Home Office has publicly responded to the development.

For Professor Heath‑Kelly, the decision underscores the importance of transparent scrutiny of how security policies intersect with everyday public services. Her work continues to inform national debates on the ethics, effectiveness, and societal impact of counter‑terrorism measures embedded within healthcare.