Northumberland

Response
I note the Board’s continued concerns about mental health provision, particularly in the North East. I wish to reassure you that the Ministry of Justice (MoJ) and HM Prison and Probation Service (HMPPS) recognises the responsibility to ensure those in prison receive appropriate care in the right setting, at the right time. Where a prisoner has a severe mental health need that warrants detention under the Mental Health Act, they should be transferred to hospital and it is acknowledged that this currently takes too long. The MoJ and HMPPS are determined to improve the transfer process, ensure delays are reduced and avoid prison being used inappropriately. This is dependent on strong collaborative efforts with the Department of Health and Social Care and NHS England, and a White Paper titled, Reforming the Mental Health Act, was published on 13 January 2021. The White Paper builds on recommendations made by Professor Sir Simon Wessely’s Independent Review in 2018 and provides a commitment to introduce a statutory time limit of 28 days for transfers to mental health hospitals when someone becomes unwell in custody or experiences a relapse in an existing condition. This will commence once the recently published NHS England and NHS Improvement guidance has been fully embedded. A new independent role to oversee the transfer process has also been committed which will further help to reduce unnecessary delays. Locally at HMP Northumberland, patients on the waiting list for a transfer are discussed weekly at the regional Bed Management meeting. The meeting is part of the joint provider collaborative in place to manage bed availability across the North East and Cumbria secure services and is attended by provider and specialist commissioning colleagues. The prison’s mental health team is able to feed into this meeting on a weekly basis to provide updates on presentation and challenges in order to support with clinical prioritisation. The Mental Health service provider and NHS England commissioners also meet monthly to discuss waiting times and have the ability to escalate any concerns. Patients are regularly reviewed by the clinical team, including Forensic Psychiatry, and referral and transfer to the Integrated Support Unit in HMP Durham is arranged where cases are suitable for admission. Your report highlights the long-term segregation of an individual at the prison whilst awaiting a place in a specialist mental health facility. It would not be appropriate to discuss the individual’s circumstances in this response. However, I wish to assure the Board that the individual was considered safest located within the Care and Separation Unit due to the risk they posed both to themselves and other individuals. The decisions surrounding his location were made through extensive multi-disciplinary meetings to which specialist health/mental health colleagues contributed.