Prison ACCT process flaws
Insufficient multi-disciplinary input at Assessment, Care in Custody and Teamwork (ACCT) reviews, and over-reliance on the process.
400 items
8 sources
Strongest theme matches
Mixed across source types and ranked by classifier confidence plus text match strength.
IMB recommendation
95match
Bedford (2020)
Initiate a fundamental review of the assessment, care in custody and teamwork (ACCT; the care planning process for prisoners identified as being at risk of suicide or self-harm) process – is it ‘fit for purpose’?
Matched on
terms: acct, prison, proces
Committee recommendation
94match
#19 - Set out complementary work being done alongside ACCT to prevent over-reliance on the process.
Although many witnesses have welcomed the revised ACCT process, we note the concern expressed by some that there may be an over-reliance on ACCT, and a perception that it is seen as an outcome in itself. Whilst the ACCT should be seen as a means to achieving a successful outcome for women in prison, the Ministry of Justice...
Matched on
terms: acct, prison, proces
PFD report
93match
Stuart Baumber
Many prison cell doors lack anti-ligature strips due to an absent retrofit program. Furthermore, the ACCT process lacks a structured national pro forma, leading to inconsistent risk assessments and over-reliance on current prisoner demeanour.
Matched on
terms: acct, prison, proces
PFD report
93match
Warren Sampson
Prison healthcare lacked consistent input in ACCT reviews and a follow-up process for missed screenings. Officers were also not adequately familiar with local directives.
Matched on
terms: acct, prison, proces
PFD report
93match
Dean Saunders
Serious systemic issues include a rigid protocol preventing mentally disordered individuals' transfer from police custody, unclear hospital transfer processes, and inadequate staff training in the ACCT process, compounded by insufficient psychiatric cover in prisons.
Matched on
terms: acct, prison, proces
IMB recommendation
93match
Bedford (2021)
We echo the concerns of Her Majesty’s Inspectorate of Prisons (HMIP) regarding the implementation of the assessment, care in custody and teamwork (ACCT) process and would hope that the new version might lead to improvements. We can also see real value in involving prisoners in assessing the effectiveness of the ACCT system.
Matched on
terms: acct, prison, proces
Committee recommendation
92match
#18 - Set out clear evaluation methods for the new ACCT process's success in reducing self-harm.
The increasing level of self-harm in the female estate over the last decade is alarming and while the number of self-inflicted deaths is low, even one death is one too many. We recognise that the MoJ and HMPPS are working to address self-harm levels across the female estate and welcome the ongoing work to improve the Assessment, Care...
Matched on
terms: acct, proces
IMB recommendation
90match
Erlestoke (2024)
Just over 60% of first Assessment Care in Custody and Teamwork (ACCT) reviews do not have the benefit of healthcare input. This negates the multidisciplinary ethos behind the intended strategy of the ACCT process and which impacts on the safety of prisoners – how will this important issue be addressed?
Matched on
terms: acct, prison, proces
PPO recommendation
90match
The Deputy Director of Immigration Prison Teams (North and South)
The Deputy Director of Immigration Prison Teams (North and South) should ensure that HOIE staff: are involved in the ACCT process, including reviews, if there are concerns about a prisoner’s immigration or deportation status, and
Matched on
terms: acct, prison, proces
PFD report
89match
Callum Smith
There was a conflict in risk assessment methods for suicide/self-harm between healthcare staff and ACCT policy for prisoners. Staff required clearer guidance and detailed training on the ACCT process's lower threshold.
Matched on
terms: acct, prison, proces
Article 2 learning point
89match
Mr Quartz — HMP Doncaster - LP 5
We recommend that there should be modifications to the ACCT process nationally. In particular, there should be a comprehensive suicide risk assessment for all prisoners and young offenders on ACCT, with recognition of risk factors, appropriate interventions and contingency planning. The triggers and risk factors should be reviewed utilising the CAREMAP process and the ACCT should not be...
Matched on
terms: acct, prison, proces
PFD report
87match
Cherylin Norrell-Goldsmith
Concerns include accessible ligature points in cells, insufficient multi-disciplinary input in ACCT reviews, and critical medical information not being readily available to prison staff on non-medical records. Data retention issues also exist.
Matched on
terms: acct, prison
PFD report
87match
Tomasz Nowasad
There was an over-reliance on prisoners' self-declarations regarding self-harm risk, and insufficient consideration of all risk factors or the "big picture" during ACCT reviews and discharge. Risk assessment rationales were also not consistently documented.
Matched on
terms: acct, prison
PFD report
85match
Samuel Gale
A prisoner's ACCT plan was closed without consulting crucial healthcare and management staff, suggesting a critical lapse in multi-disciplinary oversight for vulnerable individuals.
Matched on
terms: acct, prison
PFD report
85match
Ryan Trimmer
The ACCT process at HMP Lewes was ineffective due to inadequate reviews, and many prison staff, who act as first responders, lack up-to-date first aid training.
Matched on
terms: acct, prison, proces
PPO recommendation
85match
The Governor
The Governor should ensure that staff manage prisoners at risk of suicide and self-harm in line with national instructions. In particular, staff should: • hold multidisciplinary ACCT reviews; and • set effective caremap objectives which are specific, time-bound, meaningful, aimed at reducing risk and updated at each case review.
Matched on
terms: acct, prison
PPO recommendation
85match
The Governor of HMP Holme House
The Governor should ensure that staff manage prisoners at risk of suicide and self-harm in line with national guidelines. In particular, staff should: ▪ hold multi-disciplinary ACCT reviews which take place within the set timescales. ▪ set effective caremap objectives which are specific, time-bound and meaningful, aimed at reducing risk and updated at each case review. ▪ carry...
Matched on
terms: acct, prison
PPO recommendation
85match
The Operational Manager and the Head of Healthcare
The Operational Manager and the Head of Healthcare should ensure that prison staff manage prisoners at risk of suicide or self-harm in line with national guidelines, including: reviewing and update the prisoner’s caremap at every case review; involving the prisoner’s family in the ACCT process when appropriate, and including family contact issues in the caremap; recording all relevant...
Matched on
terms: acct, prison, proces
PPO recommendation
85match
The Director and Head of Healthcare
The Director and Head of Healthcare should ensure that staff manage prisoners at risk of suicide or self-harm in line with policy, and in particular, staff should: ensure relevant staff involved in the prisoner’s care, including healthcare staff where appropriate, are invited to all case reviews; and involve a prisoner’s next-of-kin in the ACCT process when appropriate.
Matched on
terms: acct, prison, proces
PPO recommendation
83match
The Governor and Head of Healthcare
The Governor and Head of Healthcare should ensure that staff manage prisoners at risk of suicide and self-harm in line with national guidance, including that: • ACCT case reviews are multidisciplinary and include all relevant people involved in the prisoner’s care, including healthcare staff and those providing through the gate services where relevant; • A named case co-ordinator...
Matched on
terms: acct, prison
Article 2 learning point
83match
JL — HMYOI Feltham - LP 1
It is noted that the Internal Investigation, 2002, recommended attendance by the Chaplaincy at F2052SH (now ACCT – Assessment, Care in Custody and Teamwork) reviews both locally and nationally, and this recommendation is supported. In cases where drug abuse is involved a CARATS representative should also attend, and Education staff should be invited to attend or make a...
Matched on
terms: acct, prison
PFD report
81match
Yohannes Kidane
Insufficient night staffing on prison healthcare wards compromised effective ACCT observations and overall prisoner care. Additionally, staff were not taking breaks, impacting their wellbeing and the quality of care provided.
Matched on
terms: acct, prison
PFD report
81match
Lee Rushton
There is a lack of clear policy and training regarding how ACCT care plans and mandatory reviews should integrate with Cell Sharing Risk Assessments requiring single cell occupancy for prisoner protection.
Matched on
terms: acct, prison
Article 2 learning point
81match
JL — HMYOI Feltham - LP 4
Where prisoners can be shown through review to have become dependent on the added support the ACCT process provides, consideration should be given to withdrawing the process more gradually as part of the closure plan.
Matched on
terms: acct, prison, proces
Article 2 learning point
81match
JL — HMYOI Feltham - LP 2
The CARATS teams should record information about their interviews with prisoners in unit history sheets, and share assessments with staff who are managing prisoners, particularly when an ACCT (formerly F2052SH) process has been opened. These records should be available when required for any future investigations.
Matched on
terms: acct, prison, proces
Article 2 learning point
80match
Mr Everest — HMP Altcourse - LP 5
A prisoner admitted as an in-patient to Healthcare should have a full assessment, with review of the case notes and a current mental state examination. Their needs and risks of self-harm and harm to others should be established and suitable care plans developed. This assessment should inform the ACCT process, including the provision of observations, frequency of reviews...
Matched on
terms: acct, prison, proces
IMB recommendation
78match
Erlestoke (2022)
Over 40% of first assessment, care in custody and teamwork (ACCT) reviews do not have the benefit of healthcare input, which impacts on the safety of prisoners – how will this issue be addressed?
Matched on
terms: acct, prison
IMB recommendation
78match
Stocken (2023)
The number of inappropriate transfers has risen over the last year. This includes prisoners who are transferred on open assessment, care in custody and teamwork (ACCT) documents and prisoners who have only been in prison for a few days or weeks. Hence, prisoner flow is still not working as it should.
Matched on
terms: acct, prison
IMB recommendation
78match
Erlestoke (2023)
Over 40% of first assessment, care in custody and teamwork (ACCT) reviews do not have the benefit of healthcare input, which impacts on the safety of prisoners – how will this issue be addressed?
Matched on
terms: acct, prison
IMB recommendation
78match
Belmarsh (2025)
Will the Governor continue to reinforce programmes across the prison to improve the quality of assessment, care in custody and teamwork (ACCT) plan reporting, as well as the procedures for managing prisoners who self-isolate?
Matched on
terms: acct, prison
PFD report
77match
Reggie John
Poor communication and lack of written records between prisons compromised a high-risk prisoner's care. Failures included inadequate review processes and a nurse not accessing or updating crucial risk documents.
Matched on
terms: prison, proces
PFD report
77match
Greg Revell
Ineffective suicide prevention measures were evident, with a prisoner not placed on ACCT despite clear risk and a culture of avoiding such measures. Healthcare information systems were insufficient, leading to missed opportunities for vital medication and treatment.
Matched on
terms: acct, prison
PFD report
77match
Matthew Sargent
Critical information sharing failures occurred as historical prisoner data and ACCT histories were not consistently reviewed or shared with healthcare staff upon reception. Personal officers also lacked regular meetings, limiting their knowledge of individuals.
Matched on
terms: acct, prison
PFD report
77match
John Betteridge
Prison healthcare staff and a GP lacked or had insufficient ACCT training, resulting in non-adherence to mandatory ACCT procedures and indicating a clear, ongoing training need.
Matched on
terms: acct, prison
PFD report
77match
Mark Doyle
Significant failings in ACCT case reviews, inadequate healthcare information sharing, and a lack of clear criteria for prisoner transfer decisions were identified. There is also no mandatory first aid training for existing prison officers.
Matched on
terms: acct, prison
PFD report
77match
John Mayhew
Clarification, redrafting, and improved guidance are needed for the PSI64/2011 section on first case reviews of ACCT assessments to ensure consistent and effective application across all prisons.
Matched on
terms: acct, prison
PFD report
77match
Kelvin Speakman
The ACCT process at HMP Hewell suffered from inadequate documentation, poor healthcare input, and inconsistent staff communication, leading to incomplete patient information. These systemic failings are recurring despite previous assurances.
Matched on
terms: acct, proces
PFD report
77match
Daniel Davey
Healthcare staff's non-routine attendance at ACCT reviews in prison highlighted a gap in collaborative care, requiring closer integration between prison and healthcare services.
Matched on
terms: acct, prison
PFD report
77match
David Kirsch
A lack of consistent case management for the ACCT process resulted in fragmented oversight, inadequate care planning, and critical information about the deceased's deteriorating mental state and specific concerns not being recorded.
Matched on
terms: acct, proces
PFD report
77match
Darren Williams
ACCT reviews in prison were frequently held without healthcare staff present, and relevant information from prior ACCTs was not consistently used when new ones were opened.
Matched on
terms: acct, prison
Article 2 learning point
77match
Mr Atlantic — HMP Pentonville - LP 5
(a) We recommend that a single system be introduced at HMP Pentonville that records who has received ACCT training and when the training took place. This system should cover both staff in the main prison and those working on the Healthcare unit. It should also cover both temporary and permanent staff. We suggest that the same system be...
Matched on
terms: acct, prison
IMB recommendation
76match
Swaleside (2022)
The Board has concerns regarding the mental health of prisoners who have suffered long-term lockdown as evidenced by the high number of assessment, care in custody and teamwork (ACCTs) cases, self-harm cases and general violent incidents. The necessity for increased psychology and psychiatric services should be assessed.
Matched on
terms: acct, prison
IMB recommendation
76match
Bedford (2022)
The layout of the ACCT form does not facilitate care coordinators to summarise the prisoner’s story to bring together a description of triggers, coping strategies and other relevant factors into an individual ‘formulation’. We believe this remains a fundamental flaw in the ACCT process.
Matched on
terms: acct, flaw, prison, proces
IMB recommendation
76match
Brinsford (2023)
Challenge, support and intervention plans (CSIPs) are a good deterrent when they are working properly. Sadly, the Board recognises that they are often seen as less important as other processes & strategies such as assessment, care in custody and teamwork documents (ACCTs). Often the work involved is not completed within a timely manner. Some managers are totally on...
Matched on
terms: acct, proces
Article 2 learning point
76match
Mr Atlantic — HMP Pentonville - LP 13
(a) We recommend that more is done at HMP Pentonville to make it easier for staff conducting ACCT Case Reviews by clarifying for them what they are trying to achieve and how to fill in the form. We suggest this could be achieved by providing accompanying guidelines. Although it’s in a different context, a good example of this...
Matched on
terms: acct, prison, proces
Article 2 learning point
76match
AB — HMP Bedford - LP H
We recommend that a more detailed policy is developed about the allocation of cells. For prisoners subject to ACCT monitoring, any cell moves should be agreed as part of the reviewing process, other than in an emergency when they should be reported to the Case Review.
Matched on
terms: acct, prison, proces
PPO recommendation
76match
The Prison Group Director for Devon and North Dorset
The Prison Group Director for Devon and North Dorset should assure herself that meaningful action is being taken to ensure that ACCT procedures at Channings Wood improve.
Matched on
terms: acct, prison
PPO recommendation
74match
The Prison Group Director for Avon, South Dorset and Wiltshire
The Prison Group Director for Avon, South Dorset and Wiltshire should satisfy himself that meaningful improvements have been made to the management of ACCT procedures at Bristol.
Matched on
terms: acct, prison
IMB recommendation
74match
Pentonville (2020)
What will you do to improve the quality assurance of assessment, care in custody and teamwork (ACCT) processes, as highlighted in the HMIP IRP report, and ensure that all relevant participants are included in reviews?
Matched on
terms: acct, proces
PFD report
73match
Adrian Johnson
The coroner noted that initial screening did not assess for tobacco withdrawal, ACCT reviews lacked healthcare input, and there was a lack of consistency in case management, with no handover from case manager to case manager.
Matched on
terms: acct