Recommendation 21: Update mental vulnerability and mental capacity DSO guidance
From The Brook House Inquiry Report, published 19 September 2023.
Recommendation
The Home Office must review and update Detention Services Order 04/2020: Mental Vulnerability and Immigration Detention: Non-Clinical Guidance to set out comprehensive guidance for detention and healthcare staff where there are concerns that a detained person is suffering mental ill health or lacks mental capacity. This must include an appropriate system for: the routine handover or sharing of relevant information between detention custody staff and healthcare staff (for example, in Security Information Reports and Anti-Bullying Support Plans); the identification and follow-up of missed medical appointments; the assessment of mental capacity where indicated; and mental health assessment where indicated. The Home Office must ensure that training about the updated guidance takes place on a regular (at least annual) basis for detention and healthcare staff, as well as those responsible for managing them. The training must be subject to an assessment.
In brief (written by this site)
In a letter of May 2025, quoted in a High Court judgment of July 2025, Dame Angela Eagle, Minister for Border Security and Asylum, stated that the Home Office was reviewing the process for sharing medical information, with work aimed at completion in summer 2025 (Dame Angela Eagle, May 2025). Earlier, in a January 2025 parliamentary written answer, the Minister reported that the recommendation had been accepted or partially accepted and was 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)
6.7.3. The Home Office and DHSC are considering the policy around detained people with mental ill health as part of a wider piece of work around vulnerable adults and, along with NHS England, are scoping out the requirements for any further work.
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)
We are currently reviewing the process for sharing medical information to ensure that the most appropriate legal basis is used in any situation and to mitigate operational challenges. Ongoing work includes reviewing the DSO on Medical Information Sharing (DSO 01/2016) with the aim of completion in summer 2025.
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 218.
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