NHS England is improving prison mental health services through nationally developed service specifications, which are being rolled out across the prison estate in England, ensuring that there are national standards against which services can be measured.

In addition, the Government’s Mandate with NHS England commits NHS England to develop better healthcare services for people in the criminal justice system. We have also asked the National Institute for Health and Care Excellence to develop guidelines on improving the mental health for people in prison, which it expects to publish in 2016.

Liaison and diversion services seek to identify offenders who have mental health, learning disability or substance misuse vulnerabilities, and who come into contact with the criminal justice system, so that they can either be supported through the criminal justice pathway or diverted into treatment, social care service or other relevant intervention or support service. NHS England is currently rolling out a new standard model of liaison and diversion service to ensure that services are consistent and can support people of all ages. From April 2015, there will be 22 liaison and diversion sites across England covering over 55% of the population. If the model is successful, services will then be rolled out nationally by 2017/18 subject to HM Treasury approval of the full business case.

Work is currently underway with the Ministry of Justice on developing mental health care in the criminal justice system, which will ensure that prisoners receive mental health treatment equivalent to what they would receive in the community and support continuity of treatment between custody and community.

Across government, we have sought new ways to help rehabilitate offenders from drug dependency to live drug and crime free lives. As part of this, wing-based, abstinence-focused, drug recovery services have been piloted. These focus on providing dedicated prison accommodation, treatment and support to those who are dependent on drugs and alcohol while in custody and connecting them with community support on release.

Building on the drug recovery wing ethos, the Department and Ministry of Justice have jointly funded an initiative to improve the “through the gate” provision for prisoners who are dependent on drugs and alcohol. Ten prisons in the North West are currently piloting a range of innovative interventions to provide more intensive support and supervision for people leaving custody which include the use of peer mentors, recovery housing services and take-home naloxone as they return to the community. The learning from this approach will be used to inform wider roll-out in the new system in line with implementation of the Transforming Rehabilitation Programme.

The Integrated Drug Treatment System (IDTS) programme, implemented in prisons between 2006 and 2010, sought to improve the standard and quality of drug treatment in prisons. Through IDTS, prisoners could get access to evidence-based opioid substitution treatment in prison, which they could continue in the community after release. The principles of IDTS continue to be adopted by partners responsible for commissioning health services.

Data on drug treatment in prisons is now collected by the National Drug Treatment Monitoring System (NDTMS). Figures for clinical interventions for opioid dependence in prisons for 2013-14 are presented in the following table. Data collection started in 2011-12 but 2013-14 is the first year for which robust and accurate data is available.

National clinical guidance recommends that prisoners on sentences of less than six months receive methadone or buprenorphine maintenance as their first line treatment to enable them to engage in treatment upon release. Most offenders receiving drug treatment in prison are there for three months or less, either serving short sentences or on remand for a few weeks and not in the system long enough to complete a structured drug treatment programme.

The guidance also reflects the drive towards a more recovery-orientated approach and, as a result, unless there are clinical reasons to the contrary, prisoners serving a sentence of more than six months will be expected to work towards becoming drug free.

Prisoners with drug misuse problems present a high risk of suicide and self-harm in the first weeks of custody and are particularly vulnerable to overdose on release. In these circumstances, it is good clinical practice to continue the treatment the prisoner was receiving before arrest, or to prepare them for the treatment they will receive on release. For opiate users, this will often mean that maintenance prescribing is the appropriate treatment response.

This information was not routinely collected prior to April 2014.

Public Health England, NHS England and the National Offender Management Service have co-produced a new health service evaluation tool for use in adult prisons in England called the Health and Justice Indicators of Performance (HJIPs).

The HJIPs were introduced in June 2014 and data will be collected against these indicators retrospectively from April 2014. Data will be collected on waiting times from diagnosis to assessment by specialist services for those infected with hepatitis C and human immunodeficiency virus. However, because the system needs time to establish new baselines and consistent use of new data definitions, valid and reliable data are not expected to be published before summer 2015-16.

The information requested is not available. Such information as is available is as follows.

We are advised that in the area served by Devon and Cornwall Constabulary, in 2013-14 30 people aged under 18 were taken to a police station as a place of safety, following a detention made under section 136 of the Mental Health Act (MHA) 1983.

The MHA does not, under any circumstances, allow for the use of prison for the detention of people of any age.

We are also advised that the Northern Eastern and Western Devon Clinical Commissioning Group is currently looking at the possibility of commissioning an existing unit within its area as a Place of Safety, to ensure that the risk of delays between Tier Three and Tier Four services is reduced as much as possible. Discussions with NHS England and Plymouth Community Healthcare about this are ongoing.

Devon and Cornwall have now signed their local crisis care declaration, demonstrating a commitment to deliver improved outcomes for people in crisis at a local level. The Crisis Care Concordat includes a standard that no child under the age of 18 should be place in a police cell as a result of experiencing a mental health crisis.

Health assessments are undertaken during an individual’s reception into prison or a youth offender institution. This includes a mental health assessment, which identifies any treatment and support needed. Information on the proportion of people with mental health difficulties entering prison or a youth offender institution is not available centrally.

The Government is rolling out liaison and diversion services in police stations and courts across England, commissioned by NHS England and with full coverage by 2017. Funding for these services in 2014-15 is £25 million. These services identify offenders with vulnerabilities, including mental health problems, in order to facilitate referral into relevant treatment services as soon as possible.

Since April 2013, NHS England has commissioned health services within prisons and young offender institutions. As in the community, prison mental health services are provided through a combination of primary care and specialist teams and most prisoners’ needs can be met by primary care. Care for prisoners’ more serious mental health conditions is usually provided by specialist in-reach teams, but if prisoners’ need psychiatric inpatient care they can be transferred to a secure mental health hospital if they meet the criteria to be detained under the Mental Health Act 1983.

For offenders leaving custody, National Health Service guidance sets an expectation that prisoners are either registered with a general practitioner (GP) practice before they leave or are provided with the necessary information to register with a GP on release and, where possible, provided with support in doing so. This will help facilitate continuity of care on release.

Released prisoners can access the full range of mental health services available in the community. Offenders with identified mental health problems, who need secondary mental health services, are subject to the Care Programme Approach (CPA) during their stay in prison and on release. CPA enables the planning of treatment and continuity of mental health care for the individual. On release from prison, offenders needing CPA should have a care plan and, pre-release, the prison mental health in-reach team should inform and share information with the individual's GP to ensure continuity of care.

This information is not collected centrally.

NHS England is improving prison mental health services through nationally developed service specifications, which are being rolled out across the prison estate in England, ensuring that there are national standards against which services can be measured.

Identification of those offenders with problems including mental health, learning difficulties and other vulnerabilities by liaison and diversion services may facilitate relevant support to these offenders, rather than a criminal justice system intervention. This has potential to reduce caseload numbers and effectively divert away from custody or community sentences.

NHS England has rolled out a new, all age national Liaison and Diversion standard service specification and operating model to 10 trial schemes, serving 22% of the English population. Following evaluation of these schemes by 2015 and Treasury approval of a full business case in 2015, NHS England will roll out to cover 100% coverage of the population by 2017-18.

Improving offender mental health is a priority for the Government, as set out in the mental health strategy No Health, Without Mental Health in 2011. We have acted upon the recommendations of Lord Bradley’s 2009 review of people with mental health problems and learning disabilities in the criminal justice system, to ensure that prisoners have the same access to mental health services as the rest of population.

In addition, the Government’s Mandate with NHS England commits NHS England to develop better healthcare services for people in the criminal justice system. We have also asked the National Institute for Health and Care Excellence to develop guidelines on improving the mental health for people in prison, which it expects to publish in 2016.

I refer the hon. Member to the answer I gave to the hon. Member for Liverpool, Wavertree (Luciana Berger) on 7 July 2014, Official Report, columns 45-46W.

This information is not collected centrally by NHS England.

The Department has no current plans to assess the potential use of mindfulness in prisons. Assessing the potential use of mindfulness therapies in prisons in reducing violence, improving prisoners’ mental health or reducing reoffending are matters for other organisations including the Ministry of Justice, the National Offender Management Service and NHS England to consider.

The implementation of an effective system for the timely transfer of prisoners to hospital is dependent on close working and co-operation between a number of organisations and agencies, including the Department of Health, Ministry of Justice (National Offender Management Service and Her Majesty’s Prison Service), the Home Office in some cases, the national health service and independent sector health providers.

In 2011, the Department updated good practice guidance for the transfer and remission of adult prisoners under sections 47 and 48 of the Mental Health Act 1983. The guidance is available on the gov.uk website:

www.gov.uk/government/publications/the-transfer-and-remission-of-adult-prisoners-under-s47-and-s48-of-the-mental-health-act

Following the NHS reforms, this is now being updated further by NHS England. NHS England plans to consult on draft guidance this year.

The Ministry of Justice has also published guidance for those working with mentally disordered offenders, including the transfer and remission of prisoners under the Mental Health Act 1983, which is published on its website:

www.justice.gov.uk/offenders/types-of-offender/mentally-disordered-offenders

NHS England collects data on the number of people in England and Wales waiting to be transferred from prison to hospital. The latest data, for quarter 3 of 2013-14, shows that between September and December 2013, 186 people were waiting more than two weeks, from assessment for suitability, to be transferred from prison to hospital.

The implementation of an effective system for the timely transfer of prisoners to hospital is dependent on close working and co-operation between a number of organisations and agencies, including the Department of Health, Ministry of Justice (National Offender Management Service and Her Majesty’s Prison Service), the Home Office in some cases, the national health service and independent sector health providers.

In 2011, the Department updated good practice guidance for the transfer and remission of adult prisoners under sections 47 and 48 of the Mental Health Act 1983. The guidance is available on the gov.uk website:

www.gov.uk/government/publications/the-transfer-and-remission-of-adult-prisoners-under-s47-and-s48-of-the-mental-health-act

Following the NHS reforms, this is now being updated further by NHS England. NHS England plans to consult on draft guidance this year.

The Ministry of Justice has also published guidance for those working with mentally disordered offenders, including the transfer and remission of prisoners under the Mental Health Act 1983, which is published on its website:

www.justice.gov.uk/offenders/types-of-offender/mentally-disordered-offenders

NHS England collects data on the number of people in England and Wales waiting to be transferred from prison to hospital. The latest data, for quarter 3 of 2013-14, shows that between September and December 2013, 186 people were waiting more than two weeks, from assessment for suitability, to be transferred from prison to hospital.

Improving the mental health of offenders is a priority for this Government, as set out in the mental health strategy No Health, Without Mental Health in 2011. We have acted upon the recommendations of Lord Bradley’s review, published in 2009, of people with mental health problems and learning disabilities in the criminal justice system, to ensure that people in prison have the same access to mental health services as the rest of population. The review also recommended the development of liaison and diversion services nationally, the national liaison and diversion programme is currently trialling an all age service model with the intention of national roll-out by 2017.

The Government’s Mandate commits NHS England to develop better health care services for offenders and people in the criminal justice system, which are integrated between custody and the community, including through development of liaison and diversion services.

We have also asked the National Institute for Health and Care Excellence to develop guidelines on improving the mental health for people in prison, which is expected to be published in 2016.

NHS England is responsible for commissioning health services, including mental health services, for people who are detained in prison or other secure accommodation. NHS England published Securing Excellence in Commissioning for Offender Health, which sets out its commissioning intentions to secure the best possible health outcomes for prisoners, detainees and children and young people in secure settings. This document is published on NHS England’s website:

www.england.nhs.uk/wp-content/uploads/2013/03/offender-commissioning.pdf

NHS England, the National Offender Management Service and Public Health England established a national partnership agreement for the co-commissioning and delivery of health care services in prisons in England. The partnership agreement sets out the shared strategic intent and joint commitment of these organisations to deliver effective health care for offenders and improving health outcomes and reducing inequalities. A copy of the partnership agreement is published on the National Offender Management Service’s website:

www.justice.gov.uk/downloads/about/noms/work-with-partners/national-partnership-agreement-commissioning-delivery-healthcare-prisons2013.pdf

The Department commissioned the Office for National Statistics in 1997 to conduct a survey of the prevalence of psychiatric problems in prison. There are no plans to commission a further survey.

The Liaison and Diversion programme has recently commissioned an evaluation of liaison and diversion services. The implementation of improved screening as part of these services will provide a level of information on offender health needs within that evaluation.

This information is not collected centrally by the Department or NHS England.

This information is not collected centrally by the Department or NHS England.

Clinicians and healthcare staff treating prisoners in English prisons who self-harm are expected to take National Institute for Health and Care Excellence (NICE) clinical guidelines into account when making treatment decisions. Copies of this guidance, “Self-harm: the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care” NICE clinical guideline number 16 (2004) and “Longer-term care and treatment of self-harm” NICE clinical guideline number 133 (2011) have been placed in the Library.

Clinical guideline 133 on longer term care and treatment is due for review by NICE in 2014 and NICE plans to review clinical guideline 16 in 2015. NHS England has no current or confirmed plans to introduce further treatment guidelines specific to treating self-harm in prisons.

Decisions about transferring prisoners with severe mental illnesses (SMI) to secure psychiatric units are clinical decisions based on clinical judgement about the prisoner's need for hospital treatment. Most SMI conditions are treatable within prison. Prisoners are considered for transfer to secure psychiatric units when a prison cannot provide appropriate treatment in the judgement of the consultant psychiatrist in charge of the prisoner's treatment.

NHS England is currently analysing data on self-inflicted deaths across the prison estate to identify trends and to ensure that lessons are learned. This will include initiatives to reduce self-harm amongst prisoners. NHS England is also working with the National Offender Management Service and the Royal College of General Practitioners Secure Environment Group to improve commissioning for prisoners who self-harm and ensure that their physical and mental health needs are met.

Clinicians and healthcare staff treating prisoners in English prisons who self-harm are expected to take National Institute for Health and Care Excellence (NICE) clinical guidelines into account when making treatment decisions. Copies of this guidance, “Self-harm: the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care” NICE clinical guideline number 16 (2004) and “Longer-term care and treatment of self-harm” NICE clinical guideline number 133 (2011) have been placed in the Library.

Clinical guideline 133 on longer term care and treatment is due for review by NICE in 2014 and NICE plans to review clinical guideline 16 in 2015. NHS England has no current or confirmed plans to introduce further treatment guidelines specific to treating self-harm in prisons.

Decisions about transferring prisoners with severe mental illnesses (SMI) to secure psychiatric units are clinical decisions based on clinical judgement about the prisoner's need for hospital treatment. Most SMI conditions are treatable within prison. Prisoners are considered for transfer to secure psychiatric units when a prison cannot provide appropriate treatment in the judgement of the consultant psychiatrist in charge of the prisoner's treatment.

NHS England is currently analysing data on self-inflicted deaths across the prison estate to identify trends and to ensure that lessons are learned. This will include initiatives to reduce self-harm amongst prisoners. NHS England is also working with the National Offender Management Service and the Royal College of General Practitioners Secure Environment Group to improve commissioning for prisoners who self-harm and ensure that their physical and mental health needs are met.

The Government is testing liaison and diversion services in England, to identify and assess the health issues and vulnerabilities of all offenders, including women, when they enter the criminal justice system.

Liaison and diversion services in police stations and courts will mean that people with mental health illnesses, learning disabilities and substance misuse problems receive the treatment they need at the earliest possible stage. The Government has recently announced 10 plot areas at a total cost of £25 million with a plan to roll these services out across England by 2017 subject to the full business case.

Liaison and diversion assessments will be available to magistrates and judges to consider when sentencing offenders, and will help to ensure that offenders receive the most appropriate treatment as soon as possible. This could include treatment outside of prison, subject to the sentencing court's discretion.

NHS England will be commissioning liaison and diversion services against a service specification that

requires service providers to demonstrate that they are responding appropriately to meet the range of women's health needs.