Source · National Audit Office

The costs of tackling drug harms in prisons

Published: 4 Feb 2026 Recommendations: 10 Type: Value for Money Department: Department of Health and Social Care

This National Audit Office (NAO) report focuses on how the prison and health services are using public funds to tackle drug harms in prisons.

Dept: Department of Health and Social CareMinistry of Justice Topics: Crime, justice and lawHealth and social carePrisons and probation nao.org.uk →

Recommendations

10 items
Government response pending.

The NAO has not yet recorded a response to these recommendations. This report was published 4 February 2026.

Rec Recommendation Addressee Acceptance Implementation
1
To reduce drug availability and get better value for money from spending on drug treatment, HMPPS should respond with more urgency to identified security weaknesses at specific prisons, including broken windows or inadequate window grilles that currently allow drone access into prisons, specifically by: ? allowing senior operational leaders to bid for responsive security investment to ensure available funds can be used; and ? reviewing the maintenance contract to increase responsiveness and flexibility where there are urgent security-based works.
Ref Page 11, Recommendation a
HM Prison and Probation Service; Ministry of Justice Pending
10
HMPPS and NHSE should continue their programme of evaluations of measures to tackle drug misuse, including drug strategy investment funding such as Incentivised Substance Free Living. They should draw on the findings of this work to improve understanding about factors supporting and detracting from successful implementation, and take these factors forward in any further rollout of schemes to tackle drug misuse in prisons.
Ref Page 13, Recommendation e, 2nd bullet
Department of Health and Social Care; HM Prison and Probation Service; Ministry of Justice; NHS England and NHS Improvement Pending
2
There are many factors influencing drug supply and use in prisons, but HMPPS and NHSE require better information on prevalence and need to prioritise funding.
Ref Page 12, Recommendation b
HM Prison and Probation Service; Ministry of Justice; NHS England and NHS Improvement Pending
3
HMPPS should consider how it might use its drug testing resources to best effect, to get optimal information on prevalence and treatment need from the range of available drug testing options (including individual testing options and wastewater testing). It should use these resources to inform operational decisions, monitor and compare prison performance, and influence decisions on security and health treatment.
Ref Page 12, Recommendation b, first bullet
HM Prison and Probation Service; Ministry of Justice Pending
4
MoJ and HMPPS should share ?under the influence? data more consistently within and across prisons, and with DHSC and NHSE. All the partner organisations should use this information to understand changes in the prevalence of drug misuse, assess risks, and measure the impact of ?under the influence? instances on other services.
Ref Page 12, Recommendation b, 2nd bullet
Department of Health and Social Care; HM Prison and Probation Service; Ministry of Justice; NHS England and NHS Improvement Pending
5
To enable health commissioners to ensure they are getting value for money from drug treatment and recovery services they are paying for, the commissioners should: ? refocus health needs assessments (HNAs) to inform commissioning and funding allocation decisions. These HNAs should include a specific focus on drug treatment and recovery needs of local populations;
Ref Page 12, Recommendation c, 1st bullet
Department of Health and Social Care; NHS England and NHS Improvement Pending
6
refine standardised costing formulae to benchmark the cost of drug misuse services that takes account of different needs in different prisons, including the prevalence and type of drugs, and variation in prison population (such as age, gender and churn); and
Ref Page 12, Recommendation c, 2nd bullet
Department of Health and Social Care; NHS England and NHS Improvement Pending
7
include costed key performance indicators in contracts that test whether providers are delivering value for money for those services.
Ref Page 12, Recommendation c, 3rd bullet
Department of Health and Social Care; NHS England and NHS Improvement Pending
8
As DHSC redesigns responsibilities for health in prisons, HMPPS and relevant health bodies should renew and strengthen partnership arrangements, both nationally and locally. These should support better alignment of incentives to shared goals on health-related interventions, for more effective performance management and partnership working, including increased information sharing.
Ref Page 12, Recommendation d
Department of Health and Social Care; HM Prison and Probation Service; Ministry of Justice; NHS England and NHS Improvement Pending
9
HMPPS and NHSE should draw on robust evaluation to understand what works and encourage best practice. ? HMPPS should conduct a programme of evaluations of the relative success of security measures to restrict ingress of drugs. It should use the findings of this work to support evidence-led training and development for staff.
Ref Page 12, Recommendation e, 1st bullet
Department of Health and Social Care; HM Prison and Probation Service; Ministry of Justice; NHS England and NHS Improvement Pending