Where they exist, liaison and diversion services should provide the court with relevant information about the offender to help inform sentencing decisions. The same information will be used to inform the pre-sentence report. Where liaison and diversion services do not yet exist, similar information may be provded by other health professionals in court. See section 10c: How you can obtain further information about a defendant's support needs.

Section 157 of the Criminal Justice Act 2003 requires the court to obtain and consider a medical report before passing a custodial sentence on any person who is or appears to be mentally disordered, unless the court finds that it is unnecessary to do so. The court must address the need for a medical report and it is a seperate consideration to the determination of whether to proceed with a pre-sentence report. 

 There are a limited set of situations in which consideration of a report will not be necessary.

These are:

• Magistrates or district judges might have received adequate up to date information about the offender from current mental health professional(s) during proceedings, and therefore do not require another medical report prior to sentencing. 
• The offender may have already spent as much time in custody on remand as would be served under sentence, and so will be released immediately. 
• The sentence is fixed by law, namely mandatory life imprisonment for murder. However, when considering the circumstances of mentally disordered offenders, a medical report might still be necessary prior to administering a life sentence as the court may wish to consider a hospital order. 

Any failure to obtain a medical report does not invalidate a sentence. However, if the case is taken to appeal, the court must obtain a report. 

Alongside the medical report, you should also consider other relevant information, such as that contained in pre-sentence reports and from liaison and diversion services. You should consider the likely effect of a custodial sentence on the particular condition of the offender, and on any treatment that may be available. 

In some cases the offender may think they are well and do not need to see a healthcare professional. If you think that the offender's health warrants an assessment, and it would be in their best interests to see a healthcare professional, a request for a medical report can still be made. 

The legal advisor can assist with requesting a medical report but the decision rests with the magistrates or district judge. 

A medical report should be:

• clear, succint and directly address any questions asked in the letter of instruction
• an appropriate length (for example, a summary report could be two to four pages long, and a full report up to eight pages long)
• easy to understand with any medico-legal terminology explained.