In March 2018, NHS England published its new service specification for mental health services in prisons. Unlike previous specifications, it adopts a modular rather than prescriptive approach. It outlines areas of focus that providers are expected to prioritise, the outcomes that are expected of providers, and examples of how evidence to deliver those outcomes may be demonstrated.
The specification reiterates that care for prisoners with mental health problems and/or learning disabilities should be equivalent to that available in the community, and must be ‘excellent, safe and effective’. The specification confirms that care should be ‘person centred’. It must be delivered by suitably competent professionals and allied staff. Those members of staff should be well-led and properly supervised and should operate within a ‘clear quality and clinical governance framework supporting safe and effective delivery’.
The core framework of the new specification specifies three objectives:
- improved mental health and emotional wellbeing
- the rehabilitation of prisoners and a reduction in reoffending through the improvement of mental health and contribution to sentence planning where appropriate
- improved continuity of care through the gate and within the prison system
In meeting the objectives and implementing the specification, providers should be familiar with the legal duties placed upon them by various applicable statutes, including but not limited to the:
- Equality Act 2010
- Health and Social Care Act 2012
- Care Act 2014
- Mental Health Act 1983
In addition, the specification makes plain that, in carrying out services, providers will be ‘exercising public functions’ for the purposes of section 149(2) of the Equality Act 2010, meaning they must pay due regard to the Public Sector Equality Duty under section 149(1) of that Act and deliver the services accordingly. In addition, the Mental Capacity Act 2005 will also be of relevance to prison healthcare teams delivering a service to individuals who may lack mental capacity to make some decisions.
The new specification will hopefully ensure that there is more flexibility in the provision of mental health services in prison, and includes helpful examples of how to demonstrate evidence of delivering positive outcomes.