The costs of tackling drug harms in prisons

To reduce drug availability and get better value for money from spending on drug treatment, HMPPS should respond with more urgency to identified security weaknesses at specific prisons, including broken windows or inadequate window grilles that currently allow drone access into prisons, specifically by: ? allowing senior operational leaders to bid for responsive security investment to ensure available funds can be used; and ? reviewing the maintenance contract to increase responsiveness and flexibility where there are urgent security-based works.

HMPPS and NHSE should continue their programme of evaluations of measures to tackle drug misuse, including drug strategy investment funding such as Incentivised Substance Free Living. They should draw on the findings of this work to improve understanding about factors supporting and detracting from successful implementation, and take these factors forward in any further rollout of schemes to tackle drug misuse in prisons.

There are many factors influencing drug supply and use in prisons, but HMPPS and NHSE require better information on prevalence and need to prioritise funding.

HMPPS should consider how it might use its drug testing resources to best effect, to get optimal information on prevalence and treatment need from the range of available drug testing options (including individual testing options and wastewater testing). It should use these resources to inform operational decisions, monitor and compare prison performance, and influence decisions on security and health treatment.

MoJ and HMPPS should share ?under the influence? data more consistently within and across prisons, and with DHSC and NHSE. All the partner organisations should use this information to understand changes in the prevalence of drug misuse, assess risks, and measure the impact of ?under the influence? instances on other services.

To enable health commissioners to ensure they are getting value for money from drug treatment and recovery services they are paying for, the commissioners should: ? refocus health needs assessments (HNAs) to inform commissioning and funding allocation decisions. These HNAs should include a specific focus on drug treatment and recovery needs of local populations;

refine standardised costing formulae to benchmark the cost of drug misuse services that takes account of different needs in different prisons, including the prevalence and type of drugs, and variation in prison population (such as age, gender and churn); and

include costed key performance indicators in contracts that test whether providers are delivering value for money for those services.

As DHSC redesigns responsibilities for health in prisons, HMPPS and relevant health bodies should renew and strengthen partnership arrangements, both nationally and locally. These should support better alignment of incentives to shared goals on health-related interventions, for more effective performance management and partnership working, including increased information sharing.

HMPPS and NHSE should draw on robust evaluation to understand what works and encourage best practice. ? HMPPS should conduct a programme of evaluations of the relative success of security measures to restrict ingress of drugs. It should use the findings of this work to support evidence-led training and development for staff.