April has come round again, the sun is out (well, for today, at least!), and already 2015 seems like a long time ago…

Policy changes can come thick and fast and it’s hard to keep on top of everything that’s happening sometimes; so here’s a quick reminder of six of the key developments in health and justice over the last year:

1. The Care Act (2014) came into force in April 2015, requiring local authorities to provide care support to prisoners living in any prison in their local authority area (regardless of where that person had lived before imprisonment or where they are being released to).  Any prisoner can now refer themselves for a care needs assessment; or they can be referred by a member of prison, healthcare or voluntary sector organisation staff - contact your local authority to find out how to make a referral.  Implementation has so far been patchy, with some prisons generating many more referrals than others; and most have focused on prisoners with mobility difficulties or obvious physical disabilities, with very few referrals for support for people with learning disabilities or other more hidden conditions. See our briefing on the Care Act
    
2. The Mental Health Taskforce published their final report in February 2016, setting out a 5-year national strategy for mental health services in England.  The report acknowledged the disproportionate mental health problems suffered by people in contact with the Criminal Justice System, and included a recommendation for the Ministry of Justice, Home Office and Department of Health to work together to develop a more complete health and justice pathway to improve care for people with mental health needs. Read more about the taskforce here
    
3. The national roll-out of liaison and diversion schemes continued, with a further 16 areas joining the national programme in April 2015 (alongside the 10 areas from the previous year).  Liaison and diversion schemes operate in courts and police custody, to help identify and respond to offenders in these settings who have mental health needs, learning disabilities, and other vulnerabilities.  NHS England are currently waiting for a decision from HM Treasury on the full business case for expanding the programme across the whole of England; if approved, this will now take place in further stages between now and 2021.
    
4. Prisons across Wales were designated as the first smoke-free prisons in January this year, following a legal challenge from a non-smoking prisoner, with 4 prisons in the South West due to follow shortly. The prisons concerned are taking different approaches to implementing the change, and enforcing it in practice is likely to prove challenging. More recently the Court of Appeal has upheld that prisons are exempt from the smoking ban; and the timetable for introducing smoke-free prisons more widely has not yet been announced.
    
5. Elsewhere, the rise in new psychoactive substances (NPS), or legal highs, has been causing significant concern. HM Inspectorate of Prisons' thematic report into substance misuse in prisons in December 2015 found that NPS 'are now the most serious threat to the safety and security of our prison system that our inspections identify'.  Comparatively easy to supply, but difficult to detect using current testing methods, and hugely variable in composition, NPS have been linked to a number of deaths in custody and a marked rise in serious heath incidents in prisons. Read the HMIP thematic report
    
6. The Care Quality Commission introduced a new approach to inspecting health and care services in secure settings, with a greater emphasis on engaging with service users and voluntary sector groups to hear about their experiences.  The Care Quality Commission is responsible for inspecting, monitoring and regulating all health and care providers, both in prisons and YOIs, and in the community.  Share your views on healthcare services by emailing healthjustice@cqc.org.uk

And what might come in 2016-17?

NHS England is taking a keen interest in the prison reform agenda, and the potential for new regimes and new prison environments to enable an improved response to the health needs of prisoners.  A new prison healthcare IT system is also under development, along with changes to the process for registering with GPs both in prison and on release; both of which have the potential to improve continuity of care into the community, or at least to remove some of the existing barriers to this. In the community, devolution and a range of other programmes aimed at testing new models for delivering integrated health and social care in local areas could bring about significant changes to how health services are structured, funded and accessed.

Whatever happens, people in contact with the Criminal Justice System are likely to continue to experience greater health risks and needs than the general population, and addressing these needs will need to remain a high priority if we are to support them to successfully desist from crime and rebuild their lives.

Do you work in health and justice, or support offenders, ex-offenders or their families with health needs?  If so, I'd be really interested to hear your thoughts on the key changes you'd like to see; please comment below, or email me at hazel.alcraft@clinks.org.

Clinks members also receive a monthly offender health bulletin to help keep up-to-date with all the latest news and developments in health and justice throughout the year. Find out if you're a member or join Clinks today