Lewes

Response
I acknowledge the Board’s ongoing concerns regarding the provision of specialist secure mental health services for prisoners with serious mental health issues. Prisons and other places of detention are not appropriate environments for individuals with severe mental illness. I want to reassure the Board that this Government remains firmly committed to addressing this issue and ensuring timely, appropriate care for some of the most vulnerable individuals within the Criminal Justice System (CJS). The proposed expansion of mental health services within custodial settings is primarily driven by the increasing number of individuals entering detention with complex mental health needs and comorbid conditions. In response, the Commissioning Team and the Health Provider are actively collaborating to identify key areas for enhancement. One confirmed improvement is the strengthening of support at the point of entry, specifically through the Early Days in Custody model. A business case outlining the proposed improvements is expected to be submitted to the Commissioning Team by the end of July 2025. Additionally, plans are underway to formally review the recommendations from the Mental Health Service Review conducted in May 2024 by the Centre for Mental Health Studies. This follow-up review will inform ongoing discussions with the Health Provider regarding necessary staffing increases. Both the Commissioner and the Health Provider remain committed to working collaboratively to define the final staffing model, with particular emphasis on bolstering support during the early stages of custody. Clause 38 of the Mental Health Bill introduces a statutory time limit of 28 days for the transfer of individuals from prison and other places of detention to hospital. The transfer process is multidisciplinary, requiring input from numerous health and justice agencies. This clause places existing NHS England ‘Best Practice’ guidance on a statutory footing and, alongside operational improvements, aims to reduce delays and ensure swifter access to treatment. To support this reform, NHS England is implementing several measures to overcome barriers to timely transfers. These include enhancing data collection and monitoring, refining the referral process, and providing training to prison staff. Furthermore, the establishment of the Mental Health and Justice Strategic Advisory Group offers clinical leadership, advice, and oversight across the pathway. The Ministry of Justice (MoJ) and the Department of Health and Social Care (DHSC) are working with partners to develop an implementation plan outlining the operational changes required to enact this reform. The plan is expected to be rolled out 18–24 months following Royal Assent.

Response
HMPPS assures the Board that we are actively exploring all viable options to enable the swiftest possible replacement of the prison’s heating and hot water system. The MoJ has mandated a project to replace the failed district gas main, and a feasibility study is currently underway to determine the most effective solution, whether that be replacing the gas main or installing a centralised boiler plant, based on sustainability, efficiency, and speed of delivery. A bid for this project has now been received and is in the early stages of development. All requests from the establishment will be considered; however, it is important to note that maintenance demands significantly exceed the available funding. As such, HMPPS must carefully prioritise works to ensure the best use of resources, focusing on risks to life, capacity, and decency. In the interim, to improve reliability, Government Facilities Services Limited (GFSL) has recently upgraded the initial emergency installations with more efficient temporary boilers, ensuring a more consistent supply of heating and hot water at HMP/YOI Lewes.

Response
The proposed expansion of mental health services within custodial settings is primarily driven by the increasing number of individuals entering detention with complex mental health needs and comorbid conditions. In response, the Commissioning Team and the Health Provider are actively collaborating to identify key areas for enhancement. One confirmed improvement is the strengthening of support at the point of entry, specifically through the Early Days in Custody model. A business case outlining the proposed improvements is expected to be submitted to the Commissioning Team by the end of July 2025. Additionally, plans are underway to formally review the recommendations from the Mental Health Service Review conducted in May 2024 by the Centre for Mental Health Studies. This follow-up review will inform ongoing discussions with the Health Provider regarding necessary staffing increases. Both the Commissioner and the Health Provider remain committed to working collaboratively to define the final staffing model, with particular emphasis on bolstering support during the early stages of custody. The Board’s concerns regarding the adequacy of psychiatric provision are acknowledged. The unexpected departure of the previous Consultant Psychiatrist resulted in a temporary gap in service provision. However, a substantive Consultant Psychiatrist was successfully appointed by the health provider, Practice Plus Group, and commenced work in October 2024 following a standard notice period. During the interim, cover was provided by a Consultant Psychiatrist from a neighbouring site, with urgent cases prioritised to ensure continuity of care. One of the initial actions taken by the newly appointed Consultant Psychiatrist was a comprehensive review of the waiting list, which had grown during the interim period. This review has led to a reduction in waiting times, with urgent cases now being seen within two working days. Service delivery is now meeting the standards outlined in the agreed service specification. Additionally, NHS commissioners are scheduled to undertake a health needs analysis to assess whether the current mental health provision aligns with the needs of the prison population at HMP/YOI Lewes.

Response
Alongside the new regime, HMP Lewes has created more regime for enhanced prisoners. In the first 28 days of this new regime, despite us unlocking the population for longer, we have seen a positive impact on safety metrics. Use of force, prisoner on prisoner assaults and assaults on staff have declined and are the joint lowest in reported incidents against comparator prisons across HMPPS. We have seen a slight decline in self-harm, but this remains a challenge to the high volume of prisoners with significant self-harm histories and complex needs. A commissioned ‘lived experience’ expert is working with the safety team to help reduce self-harm. In January 2025 the prison will join the national pilot scheme to replace razors with electronic shavers. This aims to remove the adaption of custom weapons from prison razors and to reduce the number of prisoners using razors to self-harm by cutting.

Response
A new remand strategy, which includes a provision of resettlement needs and accommodation support, commenced implementation during September 2024.

Response
Education attendance has continued to improve over this reporting period.