Transcript Update on the Patel Report

Drug Treatment in Prisons:
update on the Patel Report
Professor Lord Patel of Bradford OBE
The Patel Report
Prison Drug
Treatment Strategy
Review Group
• aim was to raise the ambition about
what can be achieved around drug
treatment and interventions in prison,
and to consider efficiencies and cost
effectiveness.
• a single system that encompassed all
the elements of commissioning,
outcomes, user engagement, evidence
and strategy.
• unified cross-Government drug treatment and
interventions strategy (prisons & community);
• national drug treatment and interventions
framework (community & prisons);
• national health and criminal justice outcomes
model;
• streamlined commissioning system;
• increase service users and carer engagement;
• establishing effective links to the wider criminal
justice, health and social care systems.
TRENDS IN PRESCRIBING
“As an example, of the scale of analgesic
prescribing, a snapshot from two institutions
(populations 751 and 859 respectively)
suggested that between 55,000 and more than
350,000 analgesic tablets (excluding
paracetamol and ibuprofen) were prescribed in
one month”
Managing persistent pain in secure settings: July 2013
•
impact of cut backs of prison staff on
vulnerable people with complex needs;
•
increase in prison population;
•
significant loss of experienced staff;
•
increase in inexperienced staff.
“this was exacerbated by significant, longlasting but unplanned vacancies..”
HM Chief Inspector of Prisons for England & Wales Annual Report 2014
“Increases in self-inflicted deaths, self-harm and violence
cannot be attributed to a single cause. ….. Nevertheless, in
my view, it is impossible to avoid the conclusion that the
conjunction of resource, population and policy
pressures….was a very significant factor in the rapid
deterioration in safety and other outcomes we found as
the year progressed and that were reflected in NOMS’ own
safety data. The rise in the number of self-inflicted deaths
was the most unacceptable feature of this. It is important
that the bald statistics do not disguise the dreadful nature
of each incident and the distress caused to the prisoner’s
family, other prisoners and staff. It is a terrible toll.”
HM Chief Inspector of Prisons for England & Wales Annual Report 2014
a drugs policy that is:
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evidence based
listens to views of users & carers
adaptable – meet new challenges
sustainable
evidence supports treatment rather than
criminalisation and punishment
Service User & Carer Engagement
• established a service user and carer involvement
and consultation work stream;
• over 550 responses from current and ex-drug
users both in prisons and in the community, and
carers;
• recommended that commissioners and local
partners focus on increasing the social capital of
users and carers through the identification of
‘Recovery Champions’ and appropriate
community groups.
• just over 40% of substance misuse services said that they
had been through retendering, re-commissioning or
contract renegotiation in the previous 12 months, whilst
over 60% of 89 services said that they were expecting to
go through this process in the following 12 months;
• 57% of services reported that they had had no
engagement with Health and Wellbeing Boards;
• services reported increased difficulty in accessing support
for mental health problems and decreased ability to meet
the needs of clients with complex or high levels of need.
State of the Sector 2013 (February 2014) Drugscope
..an effective system, based on the
evidence for what works, which
includes the voices of those the system
is intended to help, and is supported by
appropriate financial investments…