Recommendations 16 items · 15 repeated
Recommendations were extracted from the report by AI, and responses and their status from the ministerial response by AI. Each recommendation shows whether its wording has been checked against the report.
Response: In progress
Addressee: Ministry of Justice · Topic: Healthcare · Repeated from a previous year
Recommendation (the Board's words)
What long term solutions are being proposed to manage the increasing numbers of elderly and frail prisoners who cannot be managed fairly or humanely in the main prison estate?
Government response (as published)
I fully recognise the Board’s concern around the growing number of older and more vulnerable individuals in custody and the challenges this presents. I would like to reassure the Board of the extensive collaborative work between Oxleas NHS Foundation Trust, His Majesty’s Prison and Probation Service (HMPPS) and Wiltshire Council to meet the complex needs of this cohort. Social care referrals are managed by the Safety Team and the monthly Social Care Meeting ensures timely oversight. The Memorandum of Understanding with Wiltshire Council has been reviewed and the Governor or Deputy Governor personally attends multi-disciplinary meetings for complex cases to minimise delays and ensure adequate provision. Nationally, strategic work is being approached to address the needs of older prisoners, following recommendations from the Independent Sentencing Review. This will be published in due course and will set out long-term solutions to ensure humane and fair treatment for this growing population.
Response: In progress
Addressee: Ministry of Justice · Topic: Mental Health · Repeated from a previous year
Recommendation (the Board's words)
What solutions are being sought to provide more suitable accommodation and support for those with the most complex needs? Last year, the Board asked about long term plans to establish more appropriate mental health provision within the secure estate. This issue remains despite local improvements.
Government response (as published)
I understand the Board’s continued concern around mental health provision and complex needs. To address this, Oxleas NHS Foundation Trust has embedded an Integrated Mental Health Model at HMP Erlestoke, ensuring access to care through a specialist, multi-disciplinary approach. The service is responsive to emerging needs and when a patient shows signs of relapse, support is increased through regular reviews. The Mental Health Bill, currently progressing through Parliament, introduces a statutory 28-day time limit for transfers from prison to hospital. This places NHS England’s best practice guidance on a legal footing and alongside operational improvements, aims to reduce delays and deliver swifter access to treatment. The Mental Health and Justice Strategic Advisory Group, chaired by NHS England’s National Medical Director for Mental Health and Neurodiversity, will oversee implementation, agree a joint work plan and hold partners to account. The Bill also includes reforms to prevent courts from detaining people with severe mental illness in prison as a place of safety, end the use of ‘remand for own protection’ under the Bail Act and improve access to treatment under the Mental Health Act. The Chief Medical Officer’s forthcoming report will provide further recommendations to strengthen mental health care in custody.
Response: Implemented
Addressee: Ministry of Justice · Topic: Resettlement · Repeated from a previous year
Recommendation (the Board's words)
What tangible outcomes have been delivered for IPP prisoners since publication of the revised IPP Action Plan3? Once again, the Board highlights the plight of IPP prisoners, many of whom continue to languish in prison with little hope of achieving release.
Government response (as published)
I remain deeply concerned about the plight of those serving Imprisonment for Public Protection (IPP) sentences. The refreshed IPP Action Plan, published in July 2025, places renewed emphasis on effective frontline delivery and includes measurable targets for transparency and accountability. Our latest IPP Annual Report outlines the specific outcomes delivered. At HMP Erlestoke, IPP prisoner representatives and an IPP forum have been introduced to support this cohort. Progression Panels, attended by the Senior Probation Officer, assess referrals to the Progression Regime. Suitability is determined by the Head of Progression Regime and a Forensic Psychologist with spaces offered based according to sentence plan objectives and readiness to engage. Where insufficient IPP prisoners meet the criteria, Life Sentence and Detention for Public Protection prisoners may access the regime to maintain its ethos and culture. Regionally, a robust governance structure monitors the Area approach to IPP progression. A monthly IPP Progression Board coordinates multidisciplinary work and oversees the local iteration of the national Action Plan. It monitors performance against national targets and initiates staff training to embed policy into practice. Nationally, the number of unreleased IPP prisoners fell by 14% and the number of recalled IPP prisoners fell by 6% in the year to June 2025. The re-release of 602 recalled IPP prisoners in 2024, the highest ever, reflects the impact of these reforms.
Response: Implemented
Addressee: Ministry of Justice · Topic: Food · Repeated from a previous year
Recommendation (the Board's words)
What plans are in place to increase the budget for food which continues to be woefully insufficient when basic food costs have risen significantly?
Government response (as published)
I acknowledge the Board’s concern regarding the food budget. Budgets for prisoner food have increased incrementally, rising from £2.18 per prisoner per day in 2022–2023 to £3.01 in 2024–2025. Budgets for 2025–2026 have been increased in line with inflation funding received by HMPPS. Governors retain the flexibility to manage their overall budget and may supplement food provision if needed. At HMP Erlestoke, the Farms & Gardens team has developed a growing plan with the Catering Manager to supply fresh produce to the kitchen. Soup has been introduced at lunchtimes to increase portion sizes and reduce waste. A self-service breakfast offer allows prisoners to determine their own portion size of cereal. These initiatives improve nutrition, reduce waste and support prisoner wellbeing. I am committed to ensuring that collaborative work continues between catering managers and public health partners to promote healthy eating and share good practice across the estate.
Response: In progress
Addressee: HMPPS · Topic: Safety · Repeated from a previous year
Recommendation (the Board's words)
What action can be taken to improve the quality and safety of the constant watch cell, given that the three proposed new house blocks are on hold?
Government response (as published)
Although the new houseblocks are currently on hold, each has been designed to include a dedicated observation cell with improved sightlines, enhanced privacy and safer environments for individuals at risk. Funding has been secured to refurbish the existing constant watch cell at Erlestoke with works scheduled for completion this financial year. MOJ Property Services has commissioned alterations to the Constant Watch Cell in the Care and Separation Unit, including changes to furniture to eliminate blind spots and improve staff visibility. These works are being delivered in collaboration with the establishment and project colleagues and are expected to be completed within this financial year.
Response: In progress
Addressee: HMPPS · Topic: Estate · Repeated from a previous year
Recommendation (the Board's words)
What plans are there to address the defective state of the healthcare building? It is increasingly not fit for purpose, both in terms of its crumbling structure and its ability to provide secure and confidential areas for managing the complex cohort of prisoners.
Government response (as published)
While there are currently no bids with Estates for a full replacement, a series of improvements have been planned and funded to address the most pressing issues. Funding has been granted for roof repairs in the 2025/2026 financial year with internal decoration to follow. Safety rails and fencing have been installed to support roof access and repairs. MOJ Property Services have removed redundant equipment from the roof to prevent water ingress and will undertake further sealing and repairs to the internal guttering system. Additional works will include ceiling and wall repairs in staff areas and redecoration of damaged zones. To maximise available space, the establishment has converted a former officer locker room into a confidential consultation room and is utilising additional clinic space in the Silbury Hub. Further space will be repurposed once racking works are completed in the main store room. Although a new healthcare building was not included in the Small Secure Houseblocks project, each new unit will include a treatment room and dispensary. Pharmacy storage capacity has also been enhanced following a joint assessment with the Governor.
Environmental risks associated with the healthcare environment are captured on both the prison and Oxleas NHS Foundation Trust risk registers and are discussed regularly with NHS England and HMPPS at Local Delivery & Quality Board meetings. Oxleas NHS foundation trust continues to conduct regular Infection Prevention Control audits with findings shared with operational partners.
Response: In progress
Addressee: HMPPS · Topic: Healthcare · Repeated from a previous year
Recommendation (the Board's words)
What guarantees can be given that there will be sufficient funding for escorts to take prisoners to hospital appointments, to avoid the numerous cancellations that have taken place over the last year?
Government response (as published)
A joint HMPPS and NHS England review of escort, bed watch and constant supervision is underway with recommendations due by March 2026. This will inform future resource models and improve access to care. HMPPS is actively engaging with the NHSE Specialist Care Pathway group to improve access to specialist services and drawing on learning from the Airedale telemedicine pilot to reduce the need for hospital escorts. Dialogue with local NHS Trusts, including University Hospitals Bristol and Weston NHS Foundation Trust is ongoing to explore joint working opportunities. At HMP Erlestoke, the Resourcing Team works collaboratively with healthcare colleagues to plan hospital appointments in line with the agreed profile of 10 escorts per week. Emergency appointments are facilitated according to clinical priority. Cancelled escort data is monitored via the Local Delivery & Quality Board and action is taken to address contributing factors.
Addressee: Governor / Director · Topic: Staffing · Repeated from a previous year
Recommendation (the Board's words)
What can be done to reduce the pressure on the Offender Management Unit (OMU), enabling offender managers to manage more consistently their caseload, particularly given the likelihood of further changes to sentence and release criteria?
Addressee: Governor / Director · Topic: Estate · Repeated from a previous year
Recommendation (the Board's words)
What processes and checks will be put in place to ensure improvements are made to the poor state of the induction cells?
Addressee: Governor / Director · Topic: Substance Misuse · Repeated from a previous year
Recommendation (the Board's words)
What further actions are being considered to reduce the ingress of illicit substances? While the Board recognises enhanced security measures which have been put in place, drugs remain readily available throughout the prison.
Addressee: Governor / Director · Topic: Complaints · Repeated from a previous year
Recommendation (the Board's words)
What assurances can be given that the cell clearance process will be given a higher priority, in order that it is done effectively and securely with minimal loss of prisoner property?
Addressee: Governor / Director · Topic: Staffing · Repeated from a previous year
Recommendation (the Board's words)
What process will be implemented to ensure both the quality and quantity of key working improves?
Addressee: Governor / Director · Topic: Regime · Repeated from a previous year
Recommendation (the Board's words)
What urgent action will be taken to establish the new format of the prison council, so that prisoners can have an appropriate outlet for their concerns?
Response: In progress
Addressee: NHS / Healthcare Provider · Topic: Substance Misuse · Repeated from a previous year
Recommendation (the Board's words)
Is access to nicotine replacement therapy being considered, given the high incidence of issues relating to vapes (especially debt)?
Government response (as published)
Nicotine Replacement Therapy is currently available for prisoners to purchase via the canteen list, although it is not automatically provided on arrival. There is no current one-to-one provision for those wishing to stop vaping. Oxleas NHS Foundation Trust will explore, with NHS England and Public Health colleagues, the feasibility of offering structured support to individuals who wish to cease vaping. This is an important area for development, particularly given the link between vaping and debt.
Response: In progress
Addressee: NHS / Healthcare Provider · Topic: Healthcare
Recommendation (the Board's words)
What plans are being considered to ensure that prisoners arriving at HMP Erlestoke will have access to their essential medicines without a period of delay?
Government response (as published)
At HMP Erlestoke, systems are now in place to administer prescribed medication during the first seven days of arrival, provided the sending prison has supplied signed evidence of the current prescription. Oxleas NHS Foundation Trust works closely with transferring establishments to obtain up-to-date medication information prior to transfer. The establishment continues to experience high levels of arrivals outside of commissioned service hours. In these cases, the priority remains to assess and restart essential medicines as quickly as possible. Handover processes are being strengthened to prevent delays and HMPPS will continue to support improvements in this area.
Response: In progress
Addressee: NHS / Healthcare Provider · Topic: Healthcare · Repeated from a previous year
Recommendation (the Board's words)
While there has been considerable improvement in the attendance of healthcare at first ACCT reviews; just over one fifth still lack this essential input. How is this to be addressed, especially when reviews occur over weekends?
Government response (as published)
HMPPS welcomes the improvements made in healthcare attendance at first ACCT reviews at HMP Erlestoke. A Local Operational Protocol is in place to support reviews on both weekdays and weekends. When the mental health team is not on site, a registered nurse from the Primary Care Team attends the review. Audits have identified that non-attendance typically occurs when healthcare is not notified of the review. To address this, ACCT timings are now allocated during the daily 07:40 prison handover meeting, which is attended by the Primary Care Team. This information is relayed to the mental health team and confirmed in the 09:00 Duty Governor brief. Healthcare attendance is monitored daily at the Operational Briefing and via the Local Delivery & Quality Board. Duty Governors are required to ensure that all scheduled weekend ACCT reviews are communicated to healthcare colleagues to support attendance. HMPPS remains committed to ensuring that healthcare input is consistently available during ACCT reviews and will continue to monitor and support improvements in this area.