Richard Green

Dear Mr Roberts, Re: Death of Mr Richard Scott Green at HMP Haverigg on 9 May 2014 Thank you for your letter dated 2nd November 2015 regarding this sad case which was passed onto me by the Ministry of Justice. Nationally, it is recognised that identification of mental health problems, particularly depression and anxiety disorders, is poor within prisons1 due to the high incidence of co-morbities and dual mental health problems. It is also recognised that current evidence based tools, such as the PHQ9, are not reliable tools for assessing anxiety or depression within the prison population. NICE are currently developing guidelines on the identification and assessment of mental health of adults in contact with criminal justice system which includes prison. These guidelines will include identifying people at risk of developing and those with a mental health problem (including formal identification tools). A key concern for this guidance will be adapting existing NICE recommendations to the criminal justice system. The draft guidelines will be consulted on in June 2016 with an anticipated date for publication of November 2016. The current NHS England service specification, which healthcare providers are commissioned to deliver, states that all prisoners must undergo an initial health screen on receipt into establishment to identify any immediate health needs or risk, particularly in relation to suicide or self-harm. The Mental Health service specification requires all patients assessed by mental health services should use a suitable screening tool which adheres to national standards, such as National Service Framework for Mental Health (1999). 1 NICE DRAFT Guidelines on Mental Health of adults in contact with the criminal justice system. https //www.nrce.org . uk/guidance/indevelopment/gid-cgwave0726 Health and high quality care for all, now and for future generations

OFFICIAL-SENSITIVE PERSONAL HMP Haverigg mental health provider, Greater Manchester West Mental Health Foundation Trust have commissioned an in-trust review of all of the available assessment tools to ascertain if there is anything better placed for use in the prison setting. The review is expected to be completed by the end of January 2016. In relation the second recommendation NHS England are re-procuring the healthcare electronic healthcare system, SystmOne. This system will include improvements on the current system such as the sharing of risk indicators (e.g. 'increased risk of suicide') between healthcare & NOMS and there is a joint commitment between NHS England and NOMS to implement the interface to show that proactive steps are being taken to address this issue in the longer term. The implementation of the new system will include a full training programme along with regular training updates undertaken. Cumbria Partnership Trust within HMP Haverigg are looking at the use of protocols to be used on SystmOne to pick up some key words within patient records, such as intoxication, intoxicated, illicit, spice, NPS, psychosis, self-harm, suicide that will be highlighted on the system and flag that there is a risk. The work is being carried out in consultation with other providers in the prison and in collaboration with NECs with the intention of putting protocols in place as soon as practicable.