Source · Select Committees · Justice Committee
Recommendation 200
200
Accepted in Part
Mandate overhauling prison substance misuse commissioning, separating services from general healthcare contracts.
Recommendation
The MoJ and Department of Health and Social Care (DHSC) must mandate an overhaul of the current commissioning model for prison-based substance misuse treatment services. We agree with Dame Carol Black that these services must be commissioned directly and separately from general healthcare contracts to ensure specialist focus and dedicated resources. The new model must require direct and active involvement from prison governors and relevant local authorities in the design, delivery and oversight of substance misuse services, ensuring they are user-centred, recovery-focused and align with community provision to ensure equivalence of care. (Recommendation, Paragraph 127)
Government Response Summary
The government partially accepts, stating NHS England is developing a new commissioning structure for Health and Justice services and revising the National Substance Misuse Service Specification. This revision, involving prison governors and stakeholders, will be published by the end of Summer 2026 to improve consistency and integrated working.
Government Response
Accepted in Part
HM Government
Accepted in Part
Partially accept NHS England is responsible for the delivery of healthcare services in prisons under the Health and Care Act 2012. This includes substance misuse services, ensuring health services in prison are integrated to build recovery outcomes and improve overall health. NHS England has a National Substance Misuse Service Specification which is used to commission all substance misuse services into every prison in England and is incorporated into Standard NHS Contracts between NHSE regional teams and providers. This is a well-established and robust approach to commissioning. All seven NHSE regional teams have robust partnership meetings and Boards in place with individual providers, and prisons, aligned to and replicative of the national partnership agreement across NHSE, HMPPS, MoJ, UK Health Security Agency (UKHSA) and DHSC. NHSE partially accepts this recommendation and is in the process, alongside DHSC, of developing a new commissioning structure for Health and Justice services as required by the Prime Minister’s announcement to abolish NHSE. It is expected when the integration of NHS England into DHSC completes by April 2027, subject to legislation passage through parliament, commissioning for healthcare in prisons will be done by integrated care systems (ICBs). This will likely be through offices for Pan-ICB commissioning in regional footprints, and will include full consideration of how we strengthen existing local partnership working, including with His Majesty’s Prison and Probation Service, and Prison Governors in particular. To improve integrated working arrangements between commissioners, providers and governors, and assure availability of specialised and focused resource, NHSE is revising the National Substance Misuse Service Specification to ensure that there is consistency in the design, delivery and oversight of substance misuse services. This is being revised in partnership with system stakeholders from Prison Governors, operational and national policy leads, providers, Collective Voice and colleagues with lived experience. The revised service specification will be published by the end of Summer 2026. To improve integrated working arrangements with Governors, we will strengthen the Local and National Partnership Agreements to ensure a whole system approach to improve health outcomes, as recommended in the recently published Chief Medical Officer for England report, ensuring there are clear lines of responsibility.