Welcome to the February 2025 Health and Justice Newsletter from Clinks. You can get in touch with us about this newsletter, or anything it covered, by emailing the Policy team. This month:
- Our Health and Justice Work, including the final parts of the Health and Wellbeing Alliance programme and Clinks social prescribing project, the Alliance impact report, the future of the Health and Justice Newsletter, Clinks blog on the key takeaways from our conference at the end of last year, and the Justice Committee's inquiry into tackling drugs in prison.
- Latest News, including the first report from the Independent Sentencing Review, some of the latest criminal justice statistics, and a review of the Youth Justice Board.
- Sector Insights, including the annual report from the UK's National Preventative Mechanism, the Health and Social Care Committee's inquiry into community mental health provision, an impact evaluation of Project ADDER, reviews of problem solving and intensive supervision courts, updated guidance on acute respiratory infections in prisons, a report from Nacro on prison healthcare, and the latest policy into practice briefing from the Prisons and Probation Ombudsman, amongst others.
- Get Involved, including Clinks training on why gender matters in the criminal justice system, the next meeting of the Women's Network Forum, and an HM Prisons and Probation Service (HMPPS) Insights event on why HMPPS is adopting a recovery-oriented systems to address drugs and alcohol.
The VCSE Health and Wellbeing Alliance, a group of 18 voluntary sector organisations including Clinks representing communities with protected characteristics or that experience health inequalities, managed by the Department for Health and Social Care, NHS England, and the UK Health Security Agency (UKHSA), is due to conclude at the end of March 2025. Over the course of the last four years that this iteration of the Alliance has been operating, Clinks has worked across a number of different areas including older people in prison, support for people with post-traumatic stress disorder in prison, integrated care boards working with health and justice services, and social prescribing for people in contact with the criminal justice system amongst others. We are finalising our work for 2024-25 on social prescribing with some publications at the end of March.
This also means this February 2025 edition will be the final Clinks Health and Justice Newsletter. However, the health and wellbeing of people in contact with the criminal justice system will remain an area of focus for Clinks as part of our policy work. As such, to help ensure our members remain up to date on the latest health and justice news, we will be introducing a specific section on health and justice to our monthly Policy Briefing. This newsletter is available for free to all Clinks members - you can sign up to receive it here.
If there is content you would like to share and promote with the wider voluntary sector, this can be submitted to our weekly Light Lunch newsletter using this form.
In concluding our project on social prescribing for people in the criminal justice system, we are undertaking research, working in partnership with User Voice, to explore the extent to which social prescribing might already being taking place in prisons, and whether these kinds of activities are likely to benefit people serving custodial sentences.
As a member of the VCSE Health and Wellbeing Alliance, we are also delighted to share our new impact report for the Alliance. Our Impact Report shares how, by bringing together a coalition of over 18 voluntary organisations and consortia, with unparalleled networks among communities who face the biggest health inequalities, the Alliance has successfully supported the development of inclusive health and care policy, commissioning and service design. Read our report to find out more about the successes and impact of the Alliance, illustrated through a range of Alliance projects, influencing successes and testimonies, and visit the VCSE Health and Wellbeing Alliance Resource library for a full list of publications to date.
We have published a blog covering key takeaways from our busy 2024 annual conference, including Prisons Minister Lord Timpson's keynote speech, and our session on connecting health with wellbeing that explored the impact of social prescribing in reducing health inequalities in criminal justice. Take a look and see what interests you, with links to the work Clinks is doing across a number of different thematic areas.
The House of Commons Justice Committee is running an inquiry into tackling drugs in prison. Clinks submitted written evidence to the Committee, based on a roundtable held with a range of organisation providing drug and alcohol services to people in prison. Our submission will be published online in due course.
The Independent Sentencing Review First Report
The Independent Sentencing Review has published its first report, setting out some of the data around the prison population challenges, gives an explanation of why and how these challenges arrived, and advocates for an alternative approach based in all statutory principles of sentencing and public service reform.
Clinks Head of Influence and Communications, Sam Julius, published a blog summarising the key points from this report and highlights that this initial report 'seemingly lays the groundwork for proposing an approach that moves away from penal populism towards an approach focussed on rehabilitation, crime reduction, and alternatives to custody'. The final report and recommendations from the Sentencing Review team are expected in the Spring. You can read the submission Clinks made to the Review on our website.
Latest Criminal Justice Statistics
The Ministry of Justice (MoJ) published the statistics Women in the Criminal Justice System 2023, compiled from a range of data sources. These noted that a higher proportion of women in prison self-harmed in the year ending March 2024, and the number of instances of self-harm per person who self-harmed was over three times as high for women, standing at 16.4 for women compared to 4.5 for men.
At the end of the year, the MoJ published an ad-hoc statistical release looking at alcohol monitoring tags. This shows that at the end of September 2024, approximately 3,400 people were fitted with an alcohol monitoring device, with the provisional figure for the end of November 2024 standing at 3,800.
The MoJ also released the youth justice annual statistics for 2023 to 2024 for England and Wales.
Inquest into Deaths at HMP Lowdham Grange
Content warning: suicide/self-harm
Following the inquest into the deaths of Anthony Binfield, David Richards, and Rolandas Karbauskas at HMP Lowdham Grange, the Coroner has issued a Prevention of Future Deaths Report. This is the third report in four years for this prison. In summary, the jury found multiple individual and system failures had contributed to the deaths including shortcomings in culture and processes. The lawyers representing the families of two of the three men's deaths investigated in these proceedings published a summary of the inquest.
The matters of concern raised by the Coroner in their report included the recruitment, retention, and training of prison and healthcare staff, a complete failure to identify and share risk pertinent information between staff, and the use of drugs, particularly novel psychoactive substances amongst other concerns. The report also highlights a persistent failure to learn from deaths over many years, and the 'marked discrepancy between the failings that were admitted in oral evidence by the vast majority of witnesses when faced with irrefutable evidence, against the written statements submitted to the coronial investigations which contained very little, if any, reflection and candour'.
The Minister for Prisons, NHS England, Serco, and Sodexo are all required to respond to this report, setting out details of action taken, or proposed to be taken, alongside a timetable for action. These responses must be made by 4 April 2025.
In the UK, Samaritans can be contacted day and night, 365 days a year. They can be called for free on 116 123, emailed at jo@samaritans.org, or local branches found by visiting www.samaritans.org.
Alcohol and Drug Treatment in Secure Settings
The Office for Health Improvements and Disparities published the latest statistics on substance use treatment in secure settings for 2023 to 2024. These show that there were 49,881 adults in alcohol and drug treatment in prisons and secure settings in 2023-24. This is a 7% rise compared to the previous year, with the number of adults in treatment rising year on year for the past three years. A total of 31,050 adults left treatment in secure settings in 2023-24, with 38% of those who were discharged after completing their treatment free of dependence. Just over half (53%) of adults released from prison successfully started community treatment within three weeks of their release in 2023-24, a 10 point increase on the previous year.
Women's Justice Board
The Women's Justice Board (WJB) met for the first time on 21 January 2025. It aims to reduce the number of women in prison, cut reoffending, and better support children. The WJB will be supported by the new Women in Justice Partnership Delivery Group, which will include external experts from the voluntary sector, recruited by open competition, as well as senior government representatives from other departments.
The Lord Chancellor addressed this inaugural meeting of the WJB, and she emphasised the pressing need to reduce the number of women in prison, underscoring the complex pathways leading women to crime, such as addiction and abuse. The Lord Chancellor also pointed out the intergenerational harm caused by imprisoning women, noting that three quarters of children are displaced from their homes when their mothers are in custody, with many entering the care system.
Review of the Youth Justice Board
The MoJ announced a review of the Youth Justice Board (YJB), as part of the public bodies review programme. This programme aims to ensure public bodies are operating effectively, and that their functions remain useful and necessary. The Minister, Sir Nic Dakin, said the review is an opportunity to consider whether the YJB's statutory functions remain useful and necessary, where those functions should sit, and whether the YJB's current delivery model remains appropriate.
In a letter to the Chair of the Justice Committee, Sir Nic said the decision to undertake the review is based on three factors:
- The last Cabinet Office review of the YJB was conducted in 2013
- There has been a change in the nature of the youth justice system since the Board's formation, particularly with fewer children in the youth justice system with more complex needs, and Youth Offending Teams working with more children on non-statutory caseloads
- The changes to the structure and responsibilities of the YJB following provision for the children's secure estate being moved to the Youth Custody Service.
In the letter, the Minister also explained that the Review Team in the MoJ had completed a 'self-assessment' for the YJB. This found there are some areas where the Board works well, but that there are also fundamental questions around its form, the functions it undertakes, and the effectiveness of its performance metrics.
Steve Crocker, the former president of the Association of Directors of Children's Services, will lead the review. This will include a period of stakeholder engagement across England and Wales, with the review expected to be completed in Spring 2025.
Mental Health
The UK National Preventative Mechanism (UK NPM) published its annual report for 2023-24. In this report, it highlights many ongoing concerns from different settings of deprivation of liberty from across all four nations of the UK. The UK NPM said it was disappointed to be reiterating in another annual report the same systemic issues that NPM bodies have been reporting for the last 15 years. The UK NPM said the treatment of people deprived of their liberty and the conditions in which they are held must improve. The report argues recommendations alone are not enough: it is up to governments to lead, taking meaningful action to create sustainable change.
On mental health in prisons, the report notes that NPM bodies report this is poor and deteriorating. Amongst other things, it highlights that concerns have been raised repeatedly that Care and Separation Units are not appropriate places to hold people with mental health needs, with them being too often used as a default for men with severe or challenging mental health needs; and that the number of women deprived of their liberty under the 'place of safety' provision in the Mental Health Act 1983 or for their own protection on mental health grounds under the Bail Act 1976, has actually increased in some prisons.
The House of Commons Health and Social Care Committee is undertaking an inquiry into community mental health services. This aims to explore 'what good looks like' from service users' perspectives, as well as those of their families/carers. It will also consider how service users' wider health and social needs, such as employment and housing, can be addressed and the policy interventions required to improve how these needs are met. As such, the Committee wants to assess the extent to which the Community Mental Health Framework is driving improvements in the delivery of more integrated, person-centred care. The Committee has already taken submissions of written evidence, and held its first oral evidence session as part of the inquiry where the witnesses included representatives from the Centre for Mental Health, Rethink Mental Illness, the National Survivor User Network, and the McPin Foundation.
Drugs and Alcohol
The Home Office published an impact evaluation for Project ADDER. This evaluation found that in the first two years of the programme, seizures, arrests of people considered to be 'high-harm individuals', and referrals to treatment from criminal justice pathways had all increased, and this was likely due to the programme. However, the evaluation highlighted a lack of impact on the number of people entering treatment for opioid use, and impacts like reductions in crime and death have not yet been seen. The evaluation said longer-term impacts such as these are likely to take longer to appear, and should be expected in the future if other aspects, like increases in people entering opioid treatment, are addressed.
The Advisory Council for the Misuse of Drugs (ACMD) published its annual report for 2020 to 2022. This give an overview of the ACMD's work over this two year period, including on the misuse of fentanyl and fentanyl analogues, synthetic opioids, and an updated harms assessment on nitrous oxide.
Women
The MoJ and HMPPS published an updated version of the Women's Policy Framework, setting out the MoJ's expectations for staff and leaders delivering services for women in HMPPS. This latest update to the policy framework follows a review, and the new version aims to describe and mandate the application of HMPPS core principles to support working with women in prison and in contact with probation.
The Phoenix Trust published a blog highlighting data from 11 mindful and yoga mediation courses run the Trust in two prisons. The data finds that by participating in the weekly two-hour yoga and medication session, women's mental wellbeing was significantly improved across the courses. Addressing mental health is critical to justice reform, says Director Selina Sasse.
Accredited Offending Behaviour Programmes
The MoJ published a report presenting an evaluation of clinical outcomes for the Learning Disabilities and Challenges suite of accredited offending behaviour programmes. The suite contains programmes 'for adults assessed as having mild impairments in intellectual and adaptive functioning', and this report looks at the 'Becoming New Me Plus' and 'New Me Strengths' programmes. The study used an uncontrolled before-after evaluation method, meaning changes cannot be directly attributed to participation in the programmes. As such, the report notes that results should be seen as indicative, rather than conclusiveness, of the programmes' effectiveness.
The report's evaluations suggest that participation in the programmes is associated with positive changes in key targets of the interventions. Moreover, participants with reported lower levels of insight and skills appeared to benefit more.
Courts
At the recent Clinks and Weavers' Company summit - 'Justice and Women: A New Direction', Dr Ruth Armstrong and Dr Shona Minson presented findings from their report, Justice Changes Her Face. The report explores the development and evaluation of women’s problem-solving courts in the UK and internationally. Drawing on a detailed review of existing literature, evaluations, and court observations, alongside interviews with practitioners and participants, the report examines how these courts address the unique challenges faced by women in the criminal justice system. It highlights the aspects of problem-solving courts that contribute to their effectiveness, many of which reflect principles of systemic thinking, even if not explicitly designed as systems change initiatives.
The MoJ published an interim report looking at the interim findings of the process evaluation of Intensive Supervision Courts. These courts launched in June 2023 to divert people with complex needs from short custodial sentences to enhanced community-based alternatives.
Revolving Doors, in collaboration with CFE Research, is conducting the process evaluation. Covering December 2023 to May 2024, the report highlights effective partnerships in the ISC approach, with 63 individuals sentenced under the pilot by January 2024. It also identifies challenges such as resource constraints and the need for clear eligibility criteria.
Probation
HM Inspectorate of Probation (HMI Probation) published its response to its consultation on national probation inspection standards. Following this consultation, the Inspectorate decided that it will undertake a national inspection, the first of which will be carried out in early 2025. HMI Probation will comment through its standards framework on the sufficiency of national arrangements to support, enable, and drive the effective delivery of probation services by regions and probation delivery units. It will be interested in the relationship between what happens at a national level and what how this links to the effective delivery of probation services.
The MoJ and HMPPS published a new policy framework for probation court services. This aims to summarise, consolidate, and where needed, clarify existing policy instructions and practice guidance about Probation Service court services. This policy framework covers topics including pre-sentence reports (PSRs), and guidance for probation officers on determining the format in which PSRs should be given, amongst other areas.
Prisons
The UKHSA updated its guidance on acute respiratory illness in prisons, including flu and COVID-19. The latest updates make changes to:
- the sections on case and outbreak management to incorporate the Prescribed Places of Detention Outbreak Management guidance;
- add information on the RSV vaccination; and
- reflect the publication of the multi-agency contingency plan for the management of outbreaks of communicable diseases or other health protection incidents in prisons and other secure settings in England.
In January in the House of Lords, Baroness Morgan of Drefelin (Labour) asked an oral question on the assessment made of the provision of health services in prisons. The Parliamentary Under-Secretary of State for Patient Safety, Women's Health and Mental Health, Baroness Merron, responded for the Government. Key points of discussion including updating NHS health assessments for people in prison, enhancing healthcare facilities in new prisons, and ensuring end-of-life care through hospice links. Concerns were raised about high rates of substance misuse, mental health issues, and specific healthcare needs for women and those with learning disabilities.
Nacro’s latest report, produced in collaboration with Nacro's Justice ExChange, highlights serious challenges in prison healthcare. The report surveyed over a hundred people about their experiences of physical healthcare, with nearly half (43%) stating that they did not receive needed medical care, while 73% know of others struggling to obtain medication, and 60% endured prolonged pain. Hospital and GP appointments were frequently delayed or missed, with some resorting to self-administered dental care. Nacro's recommendation's focus on tackling the overuse of imprisonment, limiting the impact of prison on physical health by tackling the fundamentally unhealthy environment of prisons, and overcoming the barriers to accessing healthcare services for people in prison.
The Prisons and Probation Ombudsman (PPO) published its latest Policy into Practice briefing, this time looking into the emergency response processes in prisons. It highlights the recurring issues identified in the PPO's investigations such as delays in initiating emergency codes, hesitations in entering cells during medical crisis, and escorting emergency vehicles and ambulance staff to an emergency.
Youth Justice
The Alliance for Youth Justice has published a briefing, Adultifying Youth Custody: Learning lessons on transition to adulthood from the use of youth custody for young adults. The briefing, funded by the Barrow Cadbury Trust, explores how the Government’s decision to temporarily raise the age young people transfer from the children’s secure estate to the adult secure estate from 18 to 19 resulted in a 253% increase in the number of over 18s in the child estate. The briefing highlights the lost opportunity for systemic reform during this time and further warns of the long-term risk of blurring the boundaries between youth and adult justice systems.
Criminal Justice Funding
The Institute for Fiscal Studies (IFS) published a report that explores what has happened to MoJ funding since the early 2000s. In this report, the IFS note that justice spending peaked in 2007-08, with day-to-day spending falling by a third between 2007-08 and 2016-17. In 2025-26, real-terms day-to-day spending by the MoJ is still set to be 14% lower than in 2007-08, and 24% lower in per person terms, adjusted for population growth in England and Wales.
Whilst pointing out that the MoJ has been prioritised, to a modest degree since 2019, relative to other departments, it has not been enough to offset the previous period of spending restraint. The IFS calculate that had the MoJ's day-to-day budget increased at the same rate as the average department over the period since 2007-08, it would have been 41% (£4.5 billion) higher in 2024-25 (or 9% and £1 billion higher if it had increased in line with the average 'unprotected' department day-to-day budget).
Clinks Events and Training
Join Clinks' 'Why gender matters in the criminal justice system' training, taking place across two online sessions on Tuesday 11 March from 10:00 to 12:00 and Wednesday 12 March from 10:00 to 13:00. This course is particularly aimed at staff and volunteers who want to increase their understanding of why gender matters for women in the criminal justice system, aiming to develop an understanding of women's gendered experience of the criminal justice system and raise awareness of a 'whole system approach'. This training costs £95 for Clinks members.
The next Women's Network Forum takes place online on Wednesday 26 March, from 10:00 to 12:00. It will provide updates following the first meeting of the Women's Justice Board and the publication of the first report form the Independent Sentencing Review. It will also hear about the recently launched Prisons Capacity Review. These quarterly forums are open voluntary organisations who already provide a specific service or project for women in contact with the criminal justice system who are current Clinks members and part the Clinks Women's Network. Please see the event page for full details of the eligibility criteria for attending this event.
External Events
HM Prison and Probation Service are holding one of their Insights online events entitled, 'Why HMPPS is adopting recovery-oriented systems to address drugs and alcohol'. The event will take place on Wednesday 5 March from 10:00 to 11:30, and will aim to show 'how a recovery-oriented system of care offers (ROSC) a comprehensive, person-centred, and sustainable way to address problematic drug and alcohol use, supporting individuals to build meaningful, healthy lives while reducing reoffending and harm to society'.
About Clinks Health and Justice bulletin
This regular bulletin provides Clinks members with the latest news for voluntary organisations involved in the health and care of people in the criminal justice system.
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