Altcourse

I note that the Board remains concerned for people in prison waiting for a transfer to an appropriate secure healthcare setting and the long-term legacy of the Covid-19 pandemic on prisoners’ mental health. Recognising the distress this issue causes, due to a lack of suitable beds on appropriate admission ward, unprecedented demand across communities and difficulties with admissions caused by the pandemic.
I hope to reassure the Board that NHS England and NHS Improvement (NHSE/I) regional teams are currently restoring and recovering routine levels of service where possible.
NHS Commissioners will monitor performance and continue to support mental health services and staff at HMP Altcourse. Work has resumed on the transfer of commissioning responsibility for health services at HMP Altcourse to NHSE/I and they are establishing within the current North West in-patient bed programme the possibility of a specialist mental health element and whether HMP Altcourse is the right environment for this (as a new unit would require appropriate enabling and environmental infrastructure).
More broadly, the Government is determined to improve the transfer process, ensure delays are reduced and avoid prison being used inappropriately. Mental health is taken very seriously, and it is recognised that providing the right interventions at the right time is vital to improve outcomes for people with mental health needs. The Government is committed to introducing the new statutory time limit of 28 days for transfers to mental health hospitals from custody that was proposed in the White Paper on Reforming the Mental Health Act and this will be commenced once the new NHSE/I good practice guidance is fully embedded in practice. This new guidance published on 10 June 2021 promotes the timely access to appropriate treatment and reduces unnecessary delays - https://www.england.nhs.uk/publication/guidance-for-the-transfer-and-remission-of-adult-prisoners- andimmigration-removal-centre-detainees-under-the-mental-health-act-1983. Dissemination of good practice in this area will involve all prisons in the North West and colleagues in specialist mental health services.
The pandemic has caused many long waits for services in high secure hospitals due to some ward closures as a result of patients testing positive for Covid-19. When HM Prison and Probation Service (HMPPS) introduced regime restrictions in prisons to control the spread of the virus and save lives, it was recognised these measures could exacerbate the mental health needs of those in prison. HMPPS staff guidance has therefore been tailored to support specific groups of people in prison whose wellbeing may have deteriorated. Following the impact on the delivery of key work, staff in the closed prison estate will be supported in resuming regular key work sessions. As the Board is aware, the key worker role allows staff dedicated time to provide support to individual prisoners, utilising the knowledge gained from the revised and improved suicide and self-harm prevention training. In addition to this, HMPPS continues to work closely with the Samaritans and has renewed the Listener scheme grant for 2021-22 to ensure this continues. To address anxiety and boredom, as the Board have appreciated distraction packs, in cell activities and a range of self-help materials have been provided, including a Wellbeing Plan, created with input from mental health charity Mind. Likewise, to help prisoners stay in touch with their loved ones provided additional phone credit (in addition to enabling the Secure Video Calling service). NHSE/I have adopted a range of alternative methods to meet the mental health needs of people in prison which included the development of a Covid-19 mental health screen with the International Committee of the Red Cross.
Locally at HMP Altcourse, staff have improved the recording of prisoners waiting for a hospital bed and are monitoring this area regularly to identify when a bed is likely to become available. A Psychiatrist attends the prison regularly to monitor those in need of specialist care and escalates matters when they notice a deterioration in their mental health. I was pleased to read in your report that five psychological therapists will be working closely with the full-time Counsellor as HMP Altcourse recovers from the pandemic.

The current operational guidance on the use of rigid bar handcuffs (RBH) states that any use of RBH is considered a use of force. Any incidents where RBHs are used at HMP Altcourse this is recorded by staff as use of force and their usage is regularly monitored by the Use of Force committee.

HMPPS fully understands the frustration this issue is causing. Following a pause in the development of the new Prisoners’ Property policy framework due to Covid-19, a meeting with IMB representatives took place in August 2020. HMPPS circulated the draft framework to internal and external stakeholders, including the IMB Secretariat and the IMB representatives previously consulted, and a large number of comments received are being considered. It is recognised that some prisons including HMP Altcourse are experiencing great difficulty obtaining missing property from sending prisons, which is one of the many reasons why HMPPS is undertaking a thorough consultation on the new framework.
The framework is now expected to be published early next year. It will provide greater direction and standardisation on a national basis and has been designed with procedural justice at its core. It strengthens guidance on known problem areas such as volumetric control and seeks to ensure prisoners’ property is managed efficiently, effectively, consistently and with care and respect.
HMP Altcourse will continue to follow up issues with sending establishments and respond to these complaints as timely as possible.

The Commissioned Rehabilitative Service (CRS) contracts which went live on 26 June 2021 are being monitored to ensure they are effectively embedded. Regular meetings are held with the providers to review contracted service delivery and where any issues arise, including any staffing concerns, these are addressed with the provider. It is acknowledged that we remain in the early days of the new contract provision, but HMPPS is committed to ensuring that people in prison receive the support they need to address their offending behaviour via the resettlement pathways available through the CRS framework.
The Contract Management Team in the North West have already engaged with the IMB about the approach Interventions Alliance (SEETEC) is taking to resolve the issues identified. For instance, recruitment activity to fill the vacancies and the setting up of a team to operate for a period of three months to address the backlog of resettlement referrals (in addition to the business as usual staffing complement).
Additionally, the Director and his team are working closely with Probation staff to make sure HMP Altcourse has the right resource to enable good release planning. Discussion have identified some changes to the initial plan and extra resource allocated particularly to accommodation needs.

HMPPS acknowledges there has been an increase in redirections to HMP Altcourse over the last 12 months. This increase has been unavoidable in the context of ongoing operational pressures in the North West. These pressures have included Covid-19 outbreaks and capacity reductions at both HMP Preston and HMP Forest Bank, with neither prison able to accept any transfers for extended periods during the summer of 2021. Although the consequences of these redirections are noted, these decisions are still preferable to prisoners being locked out in police cells or being sent further away from their home areas.
HMPPS Custodial Capacity Team are working closely with operational colleagues to mitigate capacity pressures across the country and minimise the number of redirections that take place. The Director and his staff are working with this team and the Reconfiguration Team to manage the right offender flows into HMP Altcourse. However, this is currently proving difficult due to population pressures mentioned above.