Recommendation 20: Update guidance on fit to fly and fit for detention medical assessments
From The Brook House Inquiry Report, published 19 September 2023.
Recommendation
The Home Office must review and update Detention Services Order 01/2016: The Protection, Use and Sharing of Medical Information Relating to People Detained Under Immigration Powers, to ensure that guidance given to GPs working in the immigration detention estate in relation to their duties and responsibilities in writing 'fit to fly and fit for detention' letters is clear. It must liaise with NHS England and any relevant medical regulators as necessary. The Home Office must ensure that training about the updated guidance takes place on a regular (at least annual) basis for GPs working in the immigration detention estate and those responsible for managing them. The training must be subject to an assessment. The Home Office must monitor compliance with this updated guidance at least annually.
In brief (written by this site)
In a letter of May 2025, quoted in a High Court judgment of July 2025, Home Office minister Dame Angela Eagle stated that a new healthcare inquiry form had been in use since July 2024 to provide additional guidance on assessments (Dame Angela Eagle, May 2025). The Minister explained that the "impact of this change is being reviewed before the recommendation is considered for closure" (Dame Angela Eagle, May 2025). She had previously reported in a January 2025 parliamentary written answer that the recommendation was accepted or partially accepted and on track for closure by summer 2025 (Dame Angela Eagle response, Jan 2025; Dame Angela Eagle, Jan 2025).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 27 Sep 2026. The record below is the sources' own words.
Government response
30 out of the 33 recommendations made by the Brook House Inquiry have been accepted or partially accepted.
How this response relates to the recommendation
Site note: The written answer gives this sentence once, for 30 of the 33 recommendations together: every recommendation except 7, 19 and 30, which it says were rejected. It does not say which of the 30 were accepted in full and which in part, so the site records "Accepted, fully or in part (not specified)". The same words are recorded on recommendations 4, 5, 6, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 31, 32 and 33. Recommendations 1, 2 and 3 are among the 30 but are not given this row, because the Minister's letter of 22 May 2025 states a position on each of them.
Earlier statement from Home Office (1)
6.7.2. Within IRCs, NHS England are responsible for commissioning a healthcare service consummate to that which is available within the community. Although fit to fly letters are a medico legal practice – and outside of the responsibility of NHS England – where a clinician has concerns in relation to an individual’s detention or fitness to fly, they will, in line with safeguarding responsibilities ensure that this is shared, where appropriate, with the Home Office to support decision making.
How this response relates to the recommendation
Site note: CP 1041 is organised by ten key issues, not by recommendation, and states no position on any individual recommendation. Its only general statement of acceptance is that "The government has carefully considered and accepts the broad thrust of the recommendations". The words "in principle" do not appear anywhere in the document.
Delivery
Home Office says in progress (22 May 2025)
A new healthcare inquiry form has been in use since July 2024, providing additional guidance on ‘fit to remove’ assessments and enabling detained case workers to complete them where there are concerns an individual may not be suitable for removal. The impact of this change is being reviewed before the recommendation is considered for closure.
From: R (D1914 and AAA) v Secretary of State for the Home Department; R (AVY) v Secretary of State for the Home Department, Dame Angela Eagle, Minister for Border Security and Asylum
Site note: These are the words of the letter of 22 May 2025 from the Minister for Border Security and Asylum to Bell Ribeiro-Addy MP, as reproduced in the judgment in R (D1914 and AVY) v Secretary of State for the Home Department [2025] EWHC 1853 (Admin). The letter itself is not published: it is on GOV.UK nowhere, was not deposited in Parliament and is not annexed to the judgment, so the judgment is the record that carries it and is the source this row cites. The judgment quotes it on this recommendation at paragraph 213.
Earlier statement on delivery (1)
Home Office (15 January 2025)
the remaining 13 (recommendations 8, 9, 10, 12, 13, 15, 16, 17, 20, 21, 31, 32 and 33) on track for closure by summer 2025
Site note: One written answer of 15 January 2025 addresses all 33 recommendations in groups: it names each recommendation in one of four groups and says nothing further about any of them individually. It does not say which of the 30 it describes as "accepted or partially accepted" were accepted in full and which in part.
Site note: The source gives this passage once, for the 13 remaining accepted recommendations. The same words are recorded on recommendations 8, 9, 10, 12, 13, 15, 16, 17, 20, 21, 31, 32 and 33.
Responsible bodies
Themes and tags
Who has spoken
- Home Office
Response, delivery statement