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, long- lasting 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: 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…