HM Prison and Probation Service
Central Government
Action Taken
HMPPS implemented a revised version of ACCT in July 2021 that focuses on a person-centred approach, information sharing, improved case reviews and a strengthened post-closure period and shared a learning bulletin about transferring prisoners on an open ACCT which emphasises the importance of good communication and information-sharing. (AI summary)
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Dear Dr Morris
Thank you for your Regulation 28 report of 30 September 2021 following the inquest into the death of Stephen Cope at HMP Belmarsh on 18 November 2019. I am responding on behalf of Her Majesty’s Prison and Probation Service (HMPPS) as the Director General of Prisons.
I know that you will share a copy of this response with the family of Mr Cope and I would like to express my condolences for their loss. Every death in custody is a tragedy and the safety of those in our care is my absolute priority.
Following evidence heard at the inquest you have raised a concern in relation to the transfer and review of prisoners on an open ACCT and have suggested a set review period to allow time for support services to meet with and interview the transferred individual before an ACCT is closed. I thank you for bringing your concern to my attention.
You may be aware that HMPPS has developed a revised version of ACCT, known as ACCT version 6, (ACCT V6) that was implemented across the prison estate in July 2021. The changes introduced in this new version are intended to assist staff to provide high quality multi-disciplinary care and support to individuals at risk, focusing on a person-centred approach which meets the needs of each individual. Some of the key changes include an emphasis on information sharing, improved case reviews and a strengthened post-closure period.
As a key aim of ACCT is to focus on the needs of the individual, we do not believe that it is appropriate to mandate a period during which an ACCT cannot be closed. However, I wish to assure you that the processes in place work to provide the support needed in order to reduce the risk of self-harm and suicide and to ensure that an ACCT is not closed until it is considered safe to do so.
Reviews should be multi-disciplinary, with attendance determined by the identified needs of the individual. Documents should not be closed on the basis only of the answers that a prisoner gives to any specific questions, and staff should not rely solely on an individual’s presentation when making judgements about risk. The ACCT v6 document now prompts for
background information relating to risk to be recorded as part of the assessment process. Support actions are agreed, documented and updated during case reviews and should have clear outcomes and owners. Attendance at case reviews should include those responsible for actions and the support plans should identify all immediate and long-term risks, and the actions taken to mitigate them. The ACCT process should continue to be conducted in this way until all support actions are completed and the ACCT case review team feels that risk has reduced to a level at which the document can be closed.
Once an ACCT has been closed, there is a mandatory seven day period of post-closure monitoring and a post-closure review is held, at which consideration is given to whether there needs to be any further post-closure reviews or whether the ACCT needs to be re- opened. Discussions and decisions are documented on the post-closure review form to ensure that there is a record of the reasons for the decision that has been made. An ACCT can then be re-opened if the level of risk changes and further support is required.
We recognise that transferring to a new prison on an open ACCT is an uncertain time for prisoners, and that this can lead to an increased risk of suicide and self-harm. The updated ACCT v6 guidance that is now in place addresses this and makes clear to staff that when a change of circumstances occurs an urgent case review must take place. Such a review should take place prior to transfer to ensure that an individual’s level of risk has been properly considered and that observations remain set at an appropriate level in order to support the person. A review must also take place at the new establishment as soon as possible, informed by a handover from the transferring establishment. A learning bulletin about transferring prisoners on an open ACCT which emphasises the importance of good communication and information-sharing has been shared with all establishments and is available on the HMPPS intranet.
Therefore, if the process is followed effectively and defensible decisions are made based on effective risk assessment then a mandatory period of monitoring for those who transfer on an open ACCT should not be required. The ACCT document will not be closed until all support actions have been completed and there is multi-disciplinary agreement that the level of risk has reduced.
Thank you again for bringing your concern to my attention. I trust that this response provides assurance that the measures that we have introduced as part of ACCT v6 are sufficient to address the matter of concern that you have raised.
Thank you for your Regulation 28 report of 30 September 2021 following the inquest into the death of Stephen Cope at HMP Belmarsh on 18 November 2019. I am responding on behalf of Her Majesty’s Prison and Probation Service (HMPPS) as the Director General of Prisons.
I know that you will share a copy of this response with the family of Mr Cope and I would like to express my condolences for their loss. Every death in custody is a tragedy and the safety of those in our care is my absolute priority.
Following evidence heard at the inquest you have raised a concern in relation to the transfer and review of prisoners on an open ACCT and have suggested a set review period to allow time for support services to meet with and interview the transferred individual before an ACCT is closed. I thank you for bringing your concern to my attention.
You may be aware that HMPPS has developed a revised version of ACCT, known as ACCT version 6, (ACCT V6) that was implemented across the prison estate in July 2021. The changes introduced in this new version are intended to assist staff to provide high quality multi-disciplinary care and support to individuals at risk, focusing on a person-centred approach which meets the needs of each individual. Some of the key changes include an emphasis on information sharing, improved case reviews and a strengthened post-closure period.
As a key aim of ACCT is to focus on the needs of the individual, we do not believe that it is appropriate to mandate a period during which an ACCT cannot be closed. However, I wish to assure you that the processes in place work to provide the support needed in order to reduce the risk of self-harm and suicide and to ensure that an ACCT is not closed until it is considered safe to do so.
Reviews should be multi-disciplinary, with attendance determined by the identified needs of the individual. Documents should not be closed on the basis only of the answers that a prisoner gives to any specific questions, and staff should not rely solely on an individual’s presentation when making judgements about risk. The ACCT v6 document now prompts for
background information relating to risk to be recorded as part of the assessment process. Support actions are agreed, documented and updated during case reviews and should have clear outcomes and owners. Attendance at case reviews should include those responsible for actions and the support plans should identify all immediate and long-term risks, and the actions taken to mitigate them. The ACCT process should continue to be conducted in this way until all support actions are completed and the ACCT case review team feels that risk has reduced to a level at which the document can be closed.
Once an ACCT has been closed, there is a mandatory seven day period of post-closure monitoring and a post-closure review is held, at which consideration is given to whether there needs to be any further post-closure reviews or whether the ACCT needs to be re- opened. Discussions and decisions are documented on the post-closure review form to ensure that there is a record of the reasons for the decision that has been made. An ACCT can then be re-opened if the level of risk changes and further support is required.
We recognise that transferring to a new prison on an open ACCT is an uncertain time for prisoners, and that this can lead to an increased risk of suicide and self-harm. The updated ACCT v6 guidance that is now in place addresses this and makes clear to staff that when a change of circumstances occurs an urgent case review must take place. Such a review should take place prior to transfer to ensure that an individual’s level of risk has been properly considered and that observations remain set at an appropriate level in order to support the person. A review must also take place at the new establishment as soon as possible, informed by a handover from the transferring establishment. A learning bulletin about transferring prisoners on an open ACCT which emphasises the importance of good communication and information-sharing has been shared with all establishments and is available on the HMPPS intranet.
Therefore, if the process is followed effectively and defensible decisions are made based on effective risk assessment then a mandatory period of monitoring for those who transfer on an open ACCT should not be required. The ACCT document will not be closed until all support actions have been completed and there is multi-disciplinary agreement that the level of risk has reduced.
Thank you again for bringing your concern to my attention. I trust that this response provides assurance that the measures that we have introduced as part of ACCT v6 are sufficient to address the matter of concern that you have raised.