Prisons & health struggle with rapidly changing drug threats

The usage of assets

HMPPS has sought to cut back the amount of medicine entering into prisons, however has been too gradual in responding to pressing threats, leaving some prisons weak. Jail governors mentioned they don’t have adequate assets to reply to threats in an agile method. The NAO recognized examples of damaged safety tools not being repaired and work to enhance window safety taking a number of years.

The NAO is crucial of the truth that Incentivised Substance Free Residing (ISFL) wings or drug restoration wings haven’t been correctly applied and HMPPS doesn’t know whether or not they characterize good worth for cash.

Equally, well being commissioners have restricted proof to exhibit that drug therapy companies are enhancing or offering finest worth for cash.

Partnership work

Capability pressures and a scarcity of alignment between efficiency metrics for jail and well being employees are hindering efficient joint working. In February 2025, NHSE commissioners reported severe strain on healthcare supply in 35 prisons, of which 14 have been “very more likely to end in hurt to sufferers”. In 2024-25, NHSE recorded almost 160,000 substance misuse appointments as ‘Did Not Attend’ (DNA), round 35% of all appointments.

The NAO discovered that partnership working was weak with jail employees reporting they lacked the affect wanted to enhance health-related companies, and NHS employees not at all times feeling sufficiently concerned in choices on jail operations and being reliant on jail employees to allow these companies to be delivered safely.

Suggestions

The NAO makes 5 predominant suggestions:

HMPPS ought to reply with extra urgency to recognized safety weaknesses at particular prisonsHMPPS and NHSE require higher info on prevalence and have to prioritise fundingCommissioners want higher well being wants assessments with a deal with substance use and standardised formulae to benchmark the price of companies and higher KPIsCloser partnership preparations which assist higher alignment of incentives to shared objectives on health-related interventionsHMPPS and NHS to attract on sturdy analysis to know what works and encourage finest follow.

Due to Andy Aitchison for type permission to make use of the header picture on this submit. You’ll be able to see Andy’s work right here