The MoJ and Department of Health and Social Care (DHSC) must mandate an overhaul of the current commissioning model for prison-based substance misuse treatment services. We agree with Dame Carol Black that these services must be commissioned directly and separately from general healthcare contracts to ensure specialist focus and dedicated resources. The new model must require direct and active involvement from prison governors and relevant local authorities in the design, delivery and oversight of substance misuse services, ensuring they are user-centred, recovery-focused and align with community provision to ensure equivalence of care. (Recommendation, Paragraph 127)