Alan Whelan

Dear Mr Longstaff,

Thank you for your Regulation 28 report of 7 May 2026 following the inquest into the death of Alan Whelan at HMP Leeds. I am responding as Interim Director General of Prisons on behalf of the Ministry of Justice.

I know that you will share a copy of this response with Mr Whelan’s family, and I would first 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 raised a concern regarding the requirements for mental health assessments for prisoners held in segregation unit whilst being managed under ACCT procedures. I understand that Practice Plus Group will be responding to this matter separately.

HMPPS remains fully committed to ensuring the safety and wellbeing of all individuals in its care. Where a prisoner is being managed through the ACCT process, placement in segregation will only occur in exceptional circumstances and with appropriate safeguards in place. The current segregation policy (PSO 1700) sets out the requirements for managing those subject to ACCT.

NHS England service specifications require healthcare providers to meet all obligations, responsibilities and requirements for healthcare input as stated in relevant HMPPS policies, with prison Governors required to ensure delivery of healthcare services is facilitated within the establishment. Governors work collaboratively with providers when new healthcare contracts are commissioned and implemented to ensure staff are informed and equipped to meet their responsibilities within the HMPPS operational environment.

A comprehensive review of the segregation policy is currently underway, with publication of the revised framework scheduled for later this year. As part of this work, the Segregation Policy Framework has been aligned with the Safety Policy Framework to reduce duplication, improve clarity and strengthen consistency across related provisions, including healthcare. Under the Safety Policy Framework an ACCT case review must take place within 24 hours of a prisoner being placed in segregation conditions. Healthcare and/or mental health staff are required to attend the initial case review. In exceptional circumstances, where attendance is

not possible, a verbal or written contribution must be provided to ensure appropriate clinical input informs decision making .

The updated Segregation Policy Framework will be published alongside a comprehensive suite of supporting tools and learning resources designed to support effective implementation within prisons and ensure staff are aware of the expectations. In addition, HMPPS will deliver a structured programme of scheduled briefing sessions, providing staff - including healthcare professionals- with the opportunity to familiarise themselves with the revised policy, and receive guidance on its application in practice.

I hope the measures outlined above provide you with reassurance that learning has been taken from the circumstances of Mr Whelan’s death and that the matters of concern that you identified have been addressed.

OFFICE OF THE ACTING SENIOR CORONER for the County of West Yorkshire (Eastern District)

His Majesty’s Coroner’s Office The Coroner’s Courts Burgage Square Wakefield WF1 2TS

RESPONSE TO A REPORT TO PREVENT FUTURE DEATHS REGULATION 29 OF THE CORONERS (INVESTIGATIONS) REGULATIONS 2013 Please do not include any living persons’ names in this document, in accordance with the Chief Coroner’s PFD Publication Policy (2026). THIS RESPONSE IS BEING SENT TO: HM Acting Senior Coroner, Mr Oliver Longstaff, for the Coroner Area West Yorkshire (Eastern) in response to a ‘REPORT TO PREVENT FUTURE DEATH REGULATION 28’ following an inquest into the death of Alan Joseph WHELAN that concluded on 20/03/2026.
1. RESPONDENT In line with our duty under Regulation 29 of the Coroners (Investigations) Regulations 2013, The Ministry of Justice and The Practice Plus Group provide this response within 56 days (plus any extension granted) of the date of the Report to Prevent Future Deaths.
2. DATE OF RESPONSE 03/07/2026
3. CONFIRMATION OF CORONER’S MATTERS OF CONCERN The MATTERS OF CONCERN were identified in the report are as follows: A mandatory requirement that a prisoner on an open ACCT document should have a mental health assessment within 24 hours of being transferred to the Segregation Unit was not complied with. Alan took steps that caused his death after that 24-hour window had closed. There was scant acknowledgment of this breach of a standing instruction from the witnesses who gave evidence to the inquest. The possibility that not carrying out such an assessment made no difference to the outcome is obvious. But that possibility neither explains nor excuses the failure to comply with the instruction, especially where it is unclear whether that failure was inadvertent or deliberate, and if deliberate, with what justification.
4. DETAILS OF ACTION TAKEN, how has the concern been addressed. [If no action is proposed please explain why here]. Please note that any links to webpages included in the response will not be checked for sensitive information prior to publication, as the information is already online.

Practice Plus Group (“PPG”) would like to clarify that the document PS1700, referred to in the Regulation 28 report dated 7 May 2026, is a HMPPS policy and is not under the control of PPG. Practice Plus Group has both its own national policy and local policies in place to address the issue of providing healthcare in segregation. PPG will therefore respond to the Coroner’s concern to which it relates to healthcare only. In respect of PPG’s staff’s knowledge of the relevant provision within PSO1700, following receipt of the Coroner’s Regulation 28 response, both PPG’s National Mental Health & Psychosocial Lead and its Medical Director for Health in Justice (HiJ) have reviewed PPG’s HiJ mental health policies. PPG acknowledge that its policies do not contain an explicit requirement that matches PSO1700, i.e. that: “a mental health assessment must be undertaken by Healthcare/Mental Health In-Reach staff of all prisoners on an open ACCT (or in the post-closure phase of ACCT) who are placed in a segregation unit or awarded a period of cellular confinement in another part of the establishment. This must take place within 24 hours.” PPG’s national HiJ mental health policy is due to be revised at the end of 2026 and PPG will ensure that this issue is specifically addressed in the revised mental health policy, to ensure alignment with PSO1700. In the meantime, communication has been sent to PPG’s HiJ regional managers and regional mental health leads highlighting the requirement within PSO1700 and requesting that this is consistently implemented across all of our services. The role of PPG’s regional managers and regional mental health leads is to implement, communicate and embed processes and ensure compliance with the same.
5. DETAILS OF FURTHER ACTION PROPOSED Please note that any links to webpages included in the response will not be checked for sensitive information prior to publication, as the information is already online. As detailed above, the issue will be addressed in PPG’s updated mental health policy which is due to be published at the end of 2026. In addition, PPG will be working with HMPPS both at site level and nationally to ensure effective communications are in place between the two organisations to make sure patients who are on ACCTs and then moved to segregation are identified, Further, PPG has a mental health steering group, which meets quarterly, and is attended by all regional mental leads, the National Mental Health & Psychosocial Lead, the Lead Psychiatrist and the Lead Psychologist. On the agenda at the next meeting, due to take place in July 2026, is obtaining confirmation that the aforementioned communication has been actioned at site levels and confirmation that compliance is being monitored at a regional level. PPG already has a process in place, within its audit schedule, to audit ACCTs, which is called Take ACCTion. It is intended that the Take ACCTion audit will be updated to include whether there has been compliance with PSO1700, to check if a mental health assessment

has taken place. This will occur at the end of 2026, to align with the publication of the updated mental health policy.

SIGNATURE

, Medical Director Health in Justice, Practice Plus Group

DATE 23/6/2026