(1) Letters dated 16.10.17 and 27.11.17 from Mr. Warburton's treating clinician at the Queen Elizabeth Hospital, Birmingham to then Governor of HMP Hewell Gareth Sands, highlighting concern about the prescription error; asking for more information about the error; and seeking assurances that Mr: Warburton continue to receive all required medication, were neither acknowledged nor answered by the Governor; (2)_Furthermore,although such letters ought to have_ been passed on to the prison To and being: my would healthcare team, the evidence suggested that this was not done: Investigations carried out by current Governor Anthony Morrow failed to establish what had happened to these letters; (3) As to the suggestion that perhaps these letters were never received by the prison, it was apparent that the same letters had been sent to, and received by , members of Mr: Warburton's family; (4) Accordingly, am satisfied that it is probable that these letters did reach the prison, but were not dealt with satisfactorily; (5) am concerned that; as long as there is a risk that letters which seek or contain important information about a prisoner's health and welfare are not dealt and go unanswered, there remains a risk to prisoners' lives at HMP Hewell: