Policy paper

Living with COVID-19: Managing Safe Operations in Prisons and Youth Custody Settings in England and Wales

Published 22 June 2022

Applies to England and Wales

Introduction

COVID-19 has presented the biggest challenge faced by Her Majesty’s Prison and Probation Service (HMPPS) in recent times. At the outset of the pandemic, HMPPS took immediate steps to manage the situation and preserve the life and health of those working and living in prison, and this has continued to be the priority.

Governments across the UK have moved into a new phase of managing COVID-19 as they learn to live with the virus while protecting the most vulnerable and maintaining resilience.

The vaccination programme, coupled with surveillance measures and effective outbreak management, have reduced the risk that COVID-19 will cause severe and prolonged outbreaks in custody. But unvaccinated people and the vulnerable population remain at risk of serious infection.

In December 2021 HMPPS published the Prison Strategy White Paper, setting out the strategy for prisons over the next two years, as well as the longer-term 10-year vision. We know that COVID-19 is likely to become endemic in the UK, and prisons will continue to see COVID-19 cases during that period and so must be able to manage the virus like other infectious illnesses.

To deliver on the ambitions of the White Paper, HMPPS needs to continue to provide rehabilitative activity while maintaining sufficient capacity and the ongoing stability and safety of the estate. We have done so throughout the pandemic and will continue to do so in a way that is proportionate and embeds lessons learned to date.

As set out in the White Paper, decision-making is best managed at a local level, supported by national oversight and outcome measures. This will allow prison and youth custody leaders to focus on designing and delivering meaningful regimes but doing so safely while best supporting the needs of their local population.

Our journey

Throughout the pandemic, HMPPS have been guided by a commitment to protect the wellbeing of staff, prisoners and children in custody. In April 2020, modelling with the University of Manchester and Public Health England suggested we could see up to 2,700 deaths in custody from COVID-19.

HMPPS took immediate action to:

• Put in place controls on regime activity to reduce contacts and introduce social distancing;
• Limit the number of transfers and movement between establishments; and
• Separate new arrivals to custody, the most vulnerable, and those with symptoms.

In June 2020, HMPPS published the National Framework, which set out how decisions would be taken on the necessary degree of restrictions over time. With the hard work of staff working on the front line, and the support of partners, throughout the large majority of the pandemic visits have been able to operate, as well as rehabilitative activity such as education and training, while limiting fatalities to less than 10 percent of the modelled deaths.

There are many factors that have helped to mitigate and manage risk. These have included the successful vaccine rollout, enhanced testing, Covid-related self-isolation, pro-active contact tracing and the wide availability of protective equipment such as masks and face coverings. Nationally, a much deeper understanding of the disease now exists and this has allowed prisons and youth custody settings to better prevent infection and control its spread.

Prisons and youth custody settings remain a high risk setting for communicable diseases and will continue to see outbreaks of COVID-19 as they do other infectious diseases. However, with a suite of tools to manage and mitigate risk, including the successful (and continuing) rollout of the vaccine, the most recent Omicron wave has been very different.

In the six months between October 2020 and March 2021, sadly 120 prisoners lost their lives after having contracted COVID-19. In the six months between October 2021 and March 2022, 33 prisoners lost their lives.

Living with COVID-19 in custody

In line with the wider community, HMPPS are moving to a more sustainable position but adapted for the specific requirements of prisons and youth custody settings. This means decommissioning the National Framework and moving to a local risk-based approach. We will retain a focus on core protective measures but be ready to respond quickly and act at a system level if the overall risk increases and requires it.

HMPPS will maintain and reinforce controls against COVID-19 across the estate to protect staff and those in its care, while offering a regime that is less disrupted than earlier in the pandemic. The changing balance of risk justifies a move to a more sustainable approach, but remaining ready to intervene quickly to tackle and contain outbreaks.

Supporting the wellbeing and capability of HMPPS staff is essential in this new phase, including important mandatory training. HMPPS will also continue to support the wellbeing of prisoners and alongside its core responsibility to serve the courts, providing enough places to safely hold prisoners and children in custody.

Build protection through vaccines, surveillance and essential COVID controls

Since the start of 2021, there has been a substantial campaign to promote vaccines across the prison and youth secure estate working in partnership with the NHS, and this will continue. It is essential that all eligible staff as well as prisoners, children and others who visit or work in establishments are encouraged to take up the offer of vaccines for COVID-19 and ‘flu to protect vulnerable people and prevent outbreaks.

HMPPS will maintain ongoing COVID-19 surveillance through wastewater-based surveillance and a level of testing. Handwashing and other core infection prevention and control measures will also be maintained along with the necessary safety equipment and PPE.

As health is a devolved area, in some places government guidelines and recommendations may vary between England and Wales, and prisons and youth secure sites may at times follow different health instructions.

Safely expanding regimes in establishments

Covid control measures will no longer directly limit the delivery of regime, except when there is an outbreak or significant risk of increased transmission. This will enable the increased delivery of regimes in line with the ambitions set out in the Prison Strategy White Paper, and the new prison performance framework.

We believe that with reduced Covid controls, it is not necessary to proactively maintain some of the measures used earlier on in the pandemic, such as widespread social distancing, which entailed consequences for the regime prisons could offer. Instead, Governors may apply additional control measures only where required and proportionate to responding to local circumstances.

HMPPS will support governors and senior managers to expand regimes and work with NHS England/NHS Improvement commissioners and UKHSA to support health providers across the secure estate in continuing their effective management of the direct and indirect health consequences of the pandemic. HMPPS will maintain a strong focus on safety and wellbeing, applying lessons learned from the pandemic to how prison regimes can better operate safely, with a focus on achieving high quality in delivery.

To support safely expanding regimes, this will also draw on information from HMPPS’s internal audit, regime reporting functions and the independent Inspectorates.

Monitoring and responding to risks

HMPPS will continue to be vigilant for signs of infection and ready to intervene quickly, undertaking substantial oversight and reporting centrally if needed.

Each establishment will work with their local Health Protection Team to refresh their local communicable disease contingency plans to ensure that they are up to date and ready to respond to any new threats. Where it is necessary and advised by multi-agency outbreak control teams, establishments may still need to amend parts of the regime and, as a last resort, re-impose further controls to contain outbreaks.

We believe this approach will allow custodial settings to manage the risk of outbreaks effectively and in line with local risk. However, prisons will continue monitoring and act decisively if the level of risk increases substantially and ultimately can intervene nationally to bring back wider restrictions if necessary. This is expected to be an exceptional response and will be used only when there is a national requirement to do so.

This approach will continue to protect the health of staff, prisoners, and children and allow more extensive regime delivery, and mean local establishments can respond in an agile way to their particular risks and needs.