Dear Mr McLoughlin

Thank you for your Regulation 28 Report of 23 April 2021 addressed to at HMP Leeds and the Secretary of State for Justice, at the time the Rt Hon Robert Buckland QC MP following the recent inquest into the death of Guy Clifton Paget at HMP Leeds on 16 March 2021. I am responding as Director General of Prisons at HM Prison and Probation Service (HMPPS).

You have shared a copy of this response with Mr Paget’s brother, and I would like first to express my condolences for his loss. Every death in custody is a tragedy and the safety of those in our care is my absolute priority.

You have expressed concern about the arrangements for facilitating the exit of emergency vehicles from HMP Leeds, on the basis that there was a delay in preparing the necessary authorisation for the exit in Mr Paget’s case and that this was due to the urgency not being made clear to prison managers. You also consider that nationally, an efficient and tested system to manage this process is essential in order that serving prisoners are provided with an equivalent level of care to that which they could expect in the community.

Regrettably HMPPS appears not to have been notified in advance of the inquest into the death of Mr Paget taking place, and we would have welcomed the opportunity to fully engage with the Coroner’s investigations in order to assist in clarifying the circumstances of Mr Paget’s death.

Once inside the ambulance, I am informed that Mr Paget’s condition deteriorated quickly, to such an extent that ambulance staff were reluctant to take him to hospital because a Do Not Resuscitate (DNR) order was in place – you will be aware that practice in the community is for a patient to be allowed to remain at home in such circumstances. There was an initial delay whilst ambulance staff sought advice from their managers, and a decision was taken that Mr Paget would still be escorted to hospital, albeit that it was expected that he would pass away due to his condition.

There was then an issue with the time taken to open the gate because it required a manual override. The Local Security Strategy (LSS) at HMP Leeds has been revised and now clearly outlines the system that allows staff to utilise a manual override to facilitate emergency vehicle entry or exit in the event of any mechanical failure. This is necessarily a somewhat slower process, but still allows entry or exit within a reasonable time period. This is in accordance with the National Security Framework, which is clear that each prison must

have an LSS that describes a contingency plan for a manual override; that staff should be trained to operate it; and that it should be tested regularly.

Sadly in Mr Paget’s case, once the manual override had been authorised his condition had further deteriorated, and the ambulance staff took the decision not to leave the prison, but to reverse into the establishment’s sterile area, where they were better able to provide end of life comfort to him (rather than to continue, with the likelihood that he would pass away in transit to hospital).

With regard to the paperwork needed to authorise Mr Paget’s move to hospital, our records do not indicate that there was a delay: it was generated as soon as the emergency code was called and was in the possession of the escorting officer, who was at the healthcare centre before the ambulance.

I hope that this response has explained how our understanding of the circumstances of Mr Paget’s death differs from what you have described. I trust that I have also provided reassurance that measures are in place at HMP Leeds, and in all other prisons, to facilitate the prompt entry and exit of ambulances.

I once again would like to offer my sincere condolences to Mr Paget’s brother.