Recommendations & Conclusions
21 items
1
Conclusion
5th Report - Ageing prison population
A clear definition of the older prisoner is necessary for establishing a more strategic approach to the cohort and the ageing prison population. We do not take a view on what that definition should be, but whatever age threshold is used should be based on firm evidence, and we encourage …
Government response. • Each year we publish projections of the prison population as National Statistics reflecting the latest statistics and insight available at the time. Due to uncertainty caused by the COVID-19 pandemic, we were not in a position to publish these …
Ministry of Justice
2
Recommendation
5th Report - Ageing prison population
At the very least, older prisoners will remain a significant proportion of the prison population. It is likely that the size of the cohort will rise further after increases in police numbers and changes to sentencing come into effect. It is important that the size of the older prisoner population …
Government response. • The Prime Minister has previously made clear his focus on tackling crime, and last year announced investment of up to £2.5 billion to provide 10,000 additional places that are decent, safe and secure. Alongside meeting the immediate need of …
Ministry of Justice
3
Recommendation
5th Report - Ageing prison population
It is welcome that the new prison places planned as part of the Government’s expansion of the estate will be designed to better accommodate older prisoners and others with disabilities or limited mobility. However, the number of new places delivered under existing expansion projects has been limited. In addition, much …
Government response. • We are considering models for accommodating older offenders as part of the older offenders strategy, and we will update further once this is published. Linked to this work, and as set out above, we are exploring how the prison …
Ministry of Justice
4
Recommendation
5th Report - Ageing prison population
We are concerned that HMPPS is not consistently fulfilling its duties towards older and disabled prisoners, as required by the Equality Act 2010. These prisoners should not be housed in establishments where the physical design prevents them receiving equitable treatment. In its response to this report, the Government should set …
Government response. • We are considering models for accommodating older offenders as part of the older offenders strategy, and we will update further once this is published. Regimes and activity for older prisoners
Ministry of Justice
5
Recommendation
5th Report - Ageing prison population
It can be very difficult to accommodate some older individuals on the prison estate. Steps taken by some prisons to develop specific wings or units for older prisoners are welcome, though the variability of individual needs should be considered. Good practice around the accommodation of older prisoners should be shared …
Government response. • We have produced a model of operational delivery for older prisoners, which collates evidence on best practice for older offenders, sets out the nature of the services and activities a prison should deliver and includes case study examples from …
Ministry of Justice
6
Recommendation
5th Report - Ageing prison population
There needs to be greater recognition across the prison estate that some older prisoners will be unable to engage with the normal regime. Suitable activities and forums should be available to older prisoners to support their welfare and rehabilitation. We commend the excellent work done by some establishments, but provision …
Government response. • NHS England and NHS Improvement continue working in partnership with HMPPS colleagues to ensure that all vulnerable patient populations are managed and supported through healthcare and supported through an appropriate enablement process to engage in the healthcare interventions they …
Ministry of Justice
7
Conclusion
5th Report - Ageing prison population
We praise prison staff, HMPPS and MoJ officials for their work in responding to the Covid-19 pandemic. The virus has brought into sharp relief many of the issues affecting the prison system, including the particular health vulnerabilities of older cohorts. Amid the focus on protecting prisons from Coronavirus, HMPPS must …
Government response. • We are developing proposals on the models of staffing and training required to support older prisoners as part of the older offenders strategy, and will update further once the strategy is published.
Ministry of Justice
8
Recommendation
5th Report - Ageing prison population
An ageing prison population will increase pressure on prison healthcare. To ensure an equivalent standard of care as in the community, it is important that prison healthcare services are appropriately resourced, and staff have awareness of age- related health conditions. We recommend that all prison healthcare teams have a designated …
Government response. • In response to the pandemic, and to ensure continued access to health services during the increased restrictions in place, NHS England and NHS Improvement have worked with HMPPS digital teams to assure a telemedicine model for use in the …
Ministry of Justice
9
Conclusion
5th Report - Ageing prison population
Older prisoners are disproportionately affected by cancellations to external medical appointments, and their health can be seriously impacted by non-attendance. While increasing the number and availability of prison staff to escort prisoners to appointments is important, we also recommend that the Government review increasing the use of telemedicine and other …
Government response. • Healthcare providers who are working with vulnerable older prisoner populations will be having targeted conversations with these patient groups to ensure they know what to look out for in relation to symptoms, and where these arise, what they need …
Ministry of Justice
10
Conclusion
5th Report - Ageing prison population
The prevalence of dementia in prisons is poorly understood and prison staff can lack awareness of the condition. All older prisoners should have access to screening services for dementia, and prison officers who work with older prisoners should receive training on recognising and managing its symptoms.
Government response. • We are considering models for accommodating older offenders as part of the older offenders strategy, and we will update further once this is published.
Ministry of Justice
11
Recommendation
5th Report - Ageing prison population
Continuing to incarcerate prisoners with severe dementia, who may no longer remember or understand why they are imprisoned, raises practical and ethical 46 Ageing prison population considerations, especially as their condition is very difficult to manage on the prison estate. Equally, the Committee recognises that a significant element of this …
Government response. • In response to the HMIP and the CQC’s joint thematic report, HMPPS continues to build on the findings of the report by developing social care in custody. • This includes the introduction of the National Social Care Partnership Board, …
Ministry of Justice
12
Recommendation
5th Report - Ageing prison population
An ageing prison population will increase demand for social care services in prisons. While the Care Act 2014 has brought some improvements, standards of provision are highly variable across the estate. A more strategic and coordinated approach is needed to improve consistency and ensure effective collaboration between prisons, local authorities …
Government response. • In May 2018, MOJ and HMPPS launched guidance for peer-to-peer schemes with supporting operational tools for all prisons. In areas where local authorities and prisons work together to train, manage and support “buddies”, peer-to-peer schemes are being developed to …
Ministry of Justice
13
Conclusion
5th Report - Ageing prison population
Peer support or ‘buddy’ schemes can be an effective way to help meet the care needs of older prisoners. We commend the good work done by some prisons in partnership with third sector organisations to develop such initiatives. Prisons must ensure that prisoners providing care to other inmates are suitably …
Government response. End-of-life and palliative care • HMPPS work with NHS England to identity men and women in our care who are at or near the end of their life, to ensure that services are in place prior to need and that, …
Ministry of Justice
14
Conclusion
5th Report - Ageing prison population
The ageing prison population has and will continue to increase the need for end-of- life and palliative care in prisons. We welcome the publication of the Dying Well in Custody Charter and the good practice at some establishments. But standards are not consistent across the estate. In addition, as mentioned …
Government response. • Under the new resettlement model, pre-release planning with a service user will now include face to face interaction with a National Probation Service responsible community offender manager. These offender managers will be in a position to provide information and …
Ministry of Justice
15
Recommendation
5th Report - Ageing prison population
Prisoners applying for early release on compassionate grounds should have their applications processed in an efficient and timely manner. This is especially important for terminally ill prisoners near the end of their lives. We recommend prisons identify a single member of staff to have overall responsibility for progressing an application …
Government response. • HMPPS established the Residential Accommodation and Support Service in April 2019 (RASS). This was primarily to raise the profile of offender accommodation on a national platform; previously, offender accommodation was managed along regional lines. RASS does not provide sustainable …
Ministry of Justice
16
Conclusion
5th Report - Ageing prison population
Older prisoners can experience greater levels of institutionalisation and be less able to live independently following their release compared to younger cohorts. Many will require additional support to prepare them to re-join society. Release programmes and guidance that are age relevant, focusing on issues such as using technology, finding accommodation, …
Government response. • We welcome NHS England’s commitment to develop their care after custody service, RECONNECT, to engage and support more people after custody. The NHS Long Term Plan, published in 2019, made a commitment to fund the RECONNECT service, which has …
Ministry of Justice
17
Recommendation
5th Report - Ageing prison population
There is a shortage of suitable accommodation for older prisoners following their release, which can undermine their rehabilitation and prevent them from successfully re-integrating into society. We are particularly concerned about reports of older individuals being released to no-fixed abode. With the older prison population likely to rise further, and …
Government response. • Work is underway with healthcare teams across prisons to ensure that, as part of each site’s discharge/release planning process, patients who do not currently have a registered GP are pre-registered with a GP in the area that they are …
Ministry of Justice
18
Recommendation
5th Report - Ageing prison population
Prisons, local authorities, and health and care providers do not always work together effectively to ensure continuity of older prisoners’ health and social care. This can have a detrimental impact on an individual’s health and their efforts to re-integrate into society. The development of the new RECONNECT service is welcome, …
Government response. • We agree that now is the time to produce a national strategy for older offenders, to ensure the prison system is best-placed to meet the needs of these offenders, and that they are treated consistently across the estate. We …
Ministry of Justice
19
Recommendation
5th Report - Ageing prison population
We are concerned about reports of older prisoners being released without prescription medication or without being registered with a GP. We recommend all older prisoners are supported to register with a GP prior to release; where a prisoner is unable to do so, they should be provided with guidance and …
Government response. • Work is underway with healthcare teams across prisons to ensure that, as part of each site’s discharge/release planning process, patients who do not currently have a registered GP are pre-registered with a GP in the area that they are …
Ministry of Justice
20
Conclusion
5th Report - Ageing prison population
We disagree with the argument that older prisoners’ needs are too wide-ranging to generalise. Though it is important to treat each prisoner as an individual, there is a commonality among older prisoners which warrants a specific approach to their management. The MOD: Older Prisoners shows that the MoJ recognises this; …
Government response. • We are considering models for accommodating older offenders as part of the older offenders strategy, and we will update further once this is published.
Ministry of Justice
21
Conclusion
5th Report - Ageing prison population
An ageing prison population creates specific pressures on the prison system. Currently, the response to these and the treatment of older prisoners is highly inconsistent across the prison estate. Though the Model for Operational Delivery: Older Prisoners contains useful operational guidance, it is not enough to address this inconsistency and …
Government response. We agree that now is the time to produce a national strategy for older offenders, to ensure the prison system is best-placed to meet the needs of these offenders, and that they are treated consistently across the estate. We have …
Ministry of Justice