A rapidly ageing prison population was largely behind the 15% increase in deaths of prisoners from natural causes in 2014-15. This has meant that prisons designed for fit young men must increasingly adjust to the roles of care home and even hospice, said Prisons and Probation Ombudsman Nigel Newcomen, as he published his annual report. He added that, while suicides reduced by 16%, the number remained unacceptably high.
The Prisons and Probation Ombudsman (PPO) independently investigates the circumstances of each death in custody and identifies lessons that need to be learned to improve safety. In 2014-15:
there were 250 deaths in 2014-15, 11 (5%) more than the year before;
the PPO began 15% more investigations into deaths from natural causes (155 deaths), largely as a consequence of rising numbers of older prisoners;
the average age of those who died of natural causes was 58 compared to 37 for all other deaths;
there were 76 self-inflicted deaths, a welcome 16% decrease from the previous year, but high relative to recent years;
there were four apparent homicides, the same number as the previous year; and
a further seven deaths were classified as ‘other non-natural’ and eight await classification.
Nigel Newcomen said:
“It is remarkable that the fastest growing segment of the prison population is prisoners over 60 and the second fastest is prisoners over 50. Longer sentences and more late in life prosecutions for historic sex offences mean that this ageing prisoner profile – and rising numbers of associated natural cause deaths – will become an ever more typical feature of our prison system.”
“My investigations into deaths from natural causes have identified some lessons which have not previously been of such widespread importance. For example, the need for improved health and social care for infirm prisoners; the obligation to adjust accommodation and regimes to the requirements of the retired and immobile; the demand for more dedicated palliative care suites for those reaching the end of their lives; and the call for better training and support for staff who must now routinely manage death itself.”
On suicides, he said:
“The number of self-inflicted deaths in custody remains unacceptably high and, in 2014-15, there were still 38% more than in 2012-13. I am, therefore, pleased that the review of the Prison Service’s suicide and self-harm prevention (ACCT) procedures, which I called for in last year’s annual report, has begun. I am also pleased that Lord Harris’s important review of self-inflicted deaths among 18 to 24-year-olds in prison has been published. Together, these reviews should put suicide prevention in prisons centre stage and ensure that ACCT procedures – now over a decade old – are fit for purpose in a prison system with many more prisoners and fewer staff.”
The other principal part of the PPO’s remit is the independent investigation of complaints. In 2014-15, a substantial backlog of complaints was eradicated, and:
the total number of complaints received increased slightly to 4,964, a 2% increase on the previous year;
however, the number of cases accepted for investigation rose by 13%;
2,380 investigations were started, compared to 2,111 the year before;
overall, 2,159 investigations were completed, an 11% improvement compared to 2013-14;
39% of complaints were upheld, compared to 34% the previous year; and
the largest category of complaints was about lost, damaged and confiscated property, making up 28% of investigations.
Nigel Newcomen said:
“The types of complaint I am called upon to investigate vary year to year, although property complaints consistently predominate. Last year, there were more complaints about regime issues and transfers, which was predictable at a time of cutbacks and crowding. Perhaps of greatest concern was the 23% increase in complaints about staff behaviour, including allegations of assault and bullying.
“My staff have responded well to the increasing demands. Not only were almost all draft fatal incident reports on time (97%), we also eradicated a substantial historic backlog of complaints which has enabled a gradual improvement in complaint timeliness. These improvements have been achieved by changing the way we work, for example by being more proportionate and declining to investigate more minor complaints so we can focus on more serious cases and – of course – by the sheer hard work of my staff.
“There is much more to do, but we are well placed to deliver on our vision of supporting improvement in safety and fairness in prisons, immigration detention and probation, even at this particularly challenging time.”
The recommendations made as a result of PPO investigations are key to making improvements in safety and fairness in custody. The past year also saw the publication of a range of learning lessons publications which build on the analysis and recommendations in individual investigations to look thematically and more broadly at areas for improvement. Five of this year’s seven publications focused on self-inflicted deaths. Other publications explored learning from complaints about prisoners’ difficulties in maintaining family ties and why some groups of prisoners, such as women and children, rarely make complaints at all.
A copy of the report can be found on the PPO website. Visit www.ppo.gov.uk.