Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the written evidence submitted by NHS England to the Public Accounts Committee on 23 October 2017, NHS England MHP0008, what steps are being taken to prevent Regulation 28 failures from contributing to prisoners taking their own life.

NHS England is working with partners across the criminal justice system to improve services for offenders with mental health difficulties, which includes a service review across all adult medium and low secure services.

The service review is considering a number of issues including the future demand and capacity required against a number of criteria, levels of security, gender, service type and geographical location. A detailed understanding of difficulties in the system in relation to remissions from hospital to prison is being considered so that access, egress and throughput are all improved. This is vital to ensuring that the appropriate capacity is planned for the future.

The current Prison Transfer and Remission Guidance, published by the Department in 2011, is being reviewed, and two separate documents being developed to replace it, one for Immigration Removal Centres and another for Prisons. A particular focus of this work is about ensuring that the timescales within the guidance take into account clinical urgency and need. NHS England anticipates publication of the new guidance documents in April 2018.

Regulation 28 letters are sent to local commissioning leads, in addition to NHS England’s National Medical Director. Local commissioners produce reports in response to the challenges raised in each Regulation 28 letter.

The dedicated NHS England national lead picks up any recurring themes and reflects these in the responses made on behalf of NHS England. Action plans are initiated at a local level to support changes in how organisations and professionals work locally, where these are viewed as potentially being contributory to deaths.

The national lead works very closely with the local commissioner to ensure activities described in the local response, and reiterated in the national report, are adhered to.