Prevention of Future Deaths reports · 2018

Emily Hartley

Regulation 28 report to prevent future deaths, reference 2018-0063, written 2 Mar 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report2 Mar 2018
Reference2018-0063
DeceasedEmily Hartley
CoronerDavid Hinchliff
Coroner areaWest Yorkshire (East)
CategoryState Custody related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text recovered by OCR from a scanned PDF. OCR is imperfect: check anything you rely on against the source PDF. Reproduced verbatim, including the scan's own layout.

ANNEX A
REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

NOTE: This form is to be used after an inquest.

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:

1. Mr Michael Spurr, Chief Executive National Offender Management Service,
7 Floor, Clive House, 70 Petty France, London, SW1H 9EX

2. Rt Hon Jeremy Hunt, Secretary of State for Health, Department of Health,
Richmond House, 79 Whitehall, London, SW1A 2NS

CORONER

| am David Hinchliff, Senior Coroner, for the Coroner area of West Yorkshire (East)

CORONER’S LEGAL POWERS

| make this report under paragraph 7, Schedule 5, of the Coroners and Justice Act 2009
and regulations 28 and 29 of the Coroners (Investigations) Regulations 2013.

INVESTIGATION and INQUEST

On 26" April 2016 | commenced an investigation into the death of Emily Jayne Hartley
age 21. The investigation concluded at the end of the inquest held on 15" January 2018
until 1* February 2018 before a Jury. The conclusion of the inquest was in narrative
form, a copy of which is attached.

CIRCUMSTANCES OF THE DEATH

Emily Jayne Hartley was a serving prisoner at Her Majesty’s Prison New Hall. On
Saturday 23% April 2016 Emily was allowed out of the confines of the winged building for
exercise. She was recorded as being on exercise at 15:00 hours that day, yet CCTV
material shows that she left the wing at 14:24 hours with other prisoners. They left the
wing through the main wing entrance door and were on exercise. The exercise area
extends to the rear of the winged building which is itself a large detached two story block
with a grassed area at the rear surrounded by a high perimeter fence. There was a part
of this area declared to be “out of bounds” and Emily would have been aware of this.
Nevertheless this area can be easily accessed. Once exercise is complete the prisoners
should be counted back onto the wing. At 16:45 hours staff realised that Emily had not
collected her meal and she could not be found. It was apparent that Emily had not
returned to the wing. At 16:50 hours following a perimeter check Emily was located
suspended from a torn piece of bed sheet fastened to a steel security gate in a recessed
area in the out of bounds section. Emily was cut down, CPR was commenced by prison
staff which was continued when Paramedics arrived. Her death was confirmed by
Paramedics at 17:43 hours at that location.

Emily was the subject of an ACCT plan (assessment, care in custody and team work)
and should have been observed at twice per hour intervals. Emily had mental health
issues and suffered from an emotionally unstable borderline personality disorder which
made her impulsive and prone to self-harm and suicide. Concerns were expressed that
the management of self-harm and suicide procedures, in particular the monitoring and
recording were seriously deficient and that some of the noted failings were systemic.
Information sharing was weak, there was a lack of integrated planning. The supervision
of Emily when she died and whilst on Suicide prevention was so poor that she was not
found for nearly two and a half hours. There were allegations of bullying when she was
on a wing designated as being a therapeutic setting.

CORONER'S CONCERNS

During the course of the inquest the evidence revealed matters giving rise to concern. In
my opinion there is a risk that future deaths will occur unless action is taken. In the
circumstances it is my statutory duty to report to you.

The MATTERS OF CONCERN are as follows. —

(1) It became apparent from the evidence of many Prison Officers and Healthcare
Workers that Prison was not the appropriate environment for someone with Emily's
mental health problems. The emphasis should have been on treatment but within a
secure environment which Prison, with the most well intentioned staff, cannot
adequately provide.

(2) Coincidentally ten years ago | heard an Inquest into the death of Petra Blanksby,
also at New Hall Prison. At the conclusion of this Inquest | made a recommendation
pursuant to what was then Rule 43 of the Coroner's Rules 1984. | attach a copy of my
Rule 43 recommendations which | repeat in every detail in respect of the death of Emily
Jayne Hartley. Furthermore | state that a Prison is not the appropriate place to
accommodate Emily and that there should be facilities, particularly in the Prison’s female
estate, to provide a therapeutic yet secure environment with the emphasis being on
treatment.

| repeat ten years later that the Prison’s department and the Department of Health
should conduct a collaborative exercise io achieve ite provision of suitable, secure,
therapeutic environments in order to treat those with mental health problems of the
nature of those demonstrated by Petra Blanksby ten years ago and now Emily Jayne
Hartley. | would refer you to a paper prepared by “Inquest” entitled Preventing the

Deaths of Women in Prison and the Need for an Alternative Approach which was
published in June 2013 and also a report a review of
Women with Particular Vulnerabilities in the Criminal Justice System.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe that your
organisation have the power to take such action.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by 27" April 2018. I, the Coroner, may extend the period.

Your response must contain details of action taken or proposed to be taken, setting out
the timetable for action. Otherwise you must explain why no action is proposed.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and to the following Interested
Persons:-

of Harrison Bundey Solicitors
Mills & Reeve Solicitors
of A2 MOJ Private Law Litigation

lam also under a duty to send the Chief Coroner a copy of your response.

The Chief Coroner may publish either or both in a complete or redacted or summary
form. He may send a copy of this report to any person who he believes may find it useful
or of interest. You may make representations to me, the coroner, at the time of your

response, about the release or the publication of your response by the Chief Coroner.

9 | 2™ March 2018 A b, - 2

Responses

1 response published against this report on judiciary.uk. A response is a body's written reply to the coroner's concerns; publication is at the discretion of the Chief Coroner's office, so an absent response does not mean nobody replied.

Response from Hm Prisons and Probation Service (PDF)
ae

HM Prison &
Probation Service

Michael Spurr
Chief Executive
HM Prison & Probation Service
5" Floor 102 Petty France
London
SW1H 9AJ
E-mail: ceohmpps@noms.gsi.gov.uk
David Hinchliff
Senior Coroner for the County of West
Yorkshire (Eastern District)
HM Coroners Office
71 Northgate
Wakefield
WF1 3BS

E-mail: hmcoroner@wakefield.gov.uk

18 May 2018

Dear Mr Hinchliff
Inquest into the death of Emily Jayne Hartley

Thank you for your Regulation 28 Report of 2 March following the conclusion of the
inquest into the death of Emily Jayne Hartley. | am responding to the matters of
concern that you have raised for Her Majesty's Prison and Probation Service
(HMPPS). | have liaised with colleagues in the Department of Health and Social
Care (DHSC) to provide a joint response that has been cleared by the Minister
responsible for Regulation 28 Reports within the Department.

| know that you will share a copy of this response with Emily's family. | would first like
to express my sincere condolences for their loss. Every death in custody is a tragedy
and the safety of those in our care is my absolute priority.

| am grateful to you for bringing your concerns to my attention. You have said that
because of her mental health problems, a secure facility with an emphasis on
treatment would have been a more appropriate environment than prison for Emily.

You have also repeated the recommendation that you made ten years ago, at the
conclusion of the inquest into the death of Petra Blanksby, about provision within the
female prison estate of a suitable and secure therapeutic environment for the
treatment of women with mental health problems.

Since the publication in 2007 of Baroness Corston’s report, to which you refer,
significant progress has been made in the management of female offenders in the
criminal justice system. In recognition of their specific needs, the Government is
developing a strategy to improve outcomes for women both in the community and in
custody, building on the principles set out in Baroness Corston’s report, and will
publish this in due course. This is a complex issue and one that the Government is
committed to getting right.

It might be helpful to explain first that Liaison and Diversion services, commissioned
by NHS England, are now operating across most of England. Clinical staff at police
Stations and courts identify those with mental health problems and other
vulnerabilities, undertake assessments and make referrals to treatment and support
and provide information to inform charging and sentencing decisions. When
appropriate, this enables offenders to be diverted away from the criminal justice
system altogether, or for a community sentence with a mental health treatment
requirement to be imposed instead of a custodial sentence.

In August last year the HMPPS Women's Team published a practice guidance
document, Working with Women Offenders, to help practitioners deliver services to
women in a way that captures and reflects best practice, including advising staff of
the factors to be taken into account at every stage of contact with a female offender.
The guidance emphasises the benefits of community sentence options for women,
particularly where they have caring responsibilities, and work is ongoing to reduce
the use of short custodial sentences through the provision of bespoke community
sentences that are more suited to women's risks and needs.

We are continuing work to improve the quality of pre-sentence reports for women,
including providing better and more easily accessible information about sentencing
options to probation staff responsible for writing the reports. We will also be issuing
further guidance and examples of good practice based on the findings of a pre-
sentence report audit undertaken earlier this year.

When women are committed to custody, we want to provide the best rehabilitative
regimes possible in order to break the reoffending cycle. In 2016, we changed the
way that the female custodial estate was managed, from a geographical to a
functional model, facilitating closer working between the prisons and more sharing of
good practice. All women’s prisons are resettlement prisons so that women are
situated as close to home as practicable taking into account the interventions
needed to further their rehabilitation.

We are also developing a bespoke model for offender management within the
female custodial estate. This will capture information about the factors, including the
risk of serious harm, relevant to each female offender, to inform decisions about the
level and nature of the resources needed to manage and support them.

As part of our continuing work to support those with the most complex needs,
including mental health problems, a Centralised Case Supervision (CCS) system
was established by HMPPS in September 2015. It is designed to provide centralised
supervision for women who have difficulties engaging with mainstream offender
management and prison processes. A multi-disciplinary forum ensures that they
have access to the most appropriate interventions and regimes available. We plan
to review the system later this year in order to identify areas of good practice which
might be more widely utilised as well as possible improvements and learning points.

A strategy for improving the care and management of female offenders with
personality disorders, jointly planned and delivered by HMPPS and NHS England,
was implemented in 2013. It increases the availability of, and access to, specialised
personality disorder services including a therapeutic community at HMP Send, and
supports staff to develop their knowledge, skills and confidence in working with
female offenders with personality disorders. The programme also offers enhanced
community-based services for female offenders, including the delivery of community-
based treatment programmes, specialist case management and mentoring and
advocacy services.

HMPPS has committed to developing a trauma-informed approach to working with
women, given that a high proportion of them will have experienced some degree of
trauma during their lives. We have started a programme to ensure that staff in
women’s prisons are able to understand and respond to behaviours arising from a
history of trauma and we are looking at how the key learning from this approach can
also be embedded in training for probation staff managing women offenders.

We have a wide-ranging Prison Safety Programme that is co-ordinating our activity
to address the issues of violence, self-harm and self-inflicted deaths. As part of this
programme, we have begun rolling out revised and improved Introduction to Suicide
and Self-harm Prevention training for new and existing staff. The training comprises
six modules including mental health awareness training, which is of particular
importance to increase the confidence and skills of staff in supporting prisoners in
distress and in raising their awareness of mental health issues. Over 15,500 new
and existing staff have been trained in at least one of the six modules, and over
7,000 have completed the training in full.

In partnership with Samaritans we have launched a new suicide prevention learning
tool that is designed to give staff more confidence in engaging with prisoners who
may be at risk of suicide, and we recently refreshed our partnership with Samaritans,
guaranteeing funding for their valuable Listeners Scheme until 2021.

In terms of the specific needs of women, The National Institute for Health Research
has recently granted funding unti! December 2021 to Manchester University to
enable them to deliver a psychodynamic interpersonal therapy (PIT) programme to
female offenders to determine whether it is effective for women who self-harm in
prison. The therapy which has been shown to reduce depression and suicidal
ideation and self-harm in the community will be delivered to 262 female offenders

across 7 female prisons. Manchester University will evaluate the effectiveness of
PIT.

At Eastwood Park prison a Rapid Response Project is being piloted to work with
women who are prolific self-harmers and who do not meet the criteria for other
services. We are also working with Public Health England to assist each female
establishment to develop its own suicide prevention plan. The intention is to improve
access to and engagement with community based services, especially offenders
vulnerable to suicide and mental health problems.

Finally, NHS England has also developed a Ten Point Plan for Mental Health which
will describe how the secure care pathway can be improved to ensure it works more
effectively and efficiently. This includes new guidance (including standards) for
transfers and remissions between prison and hospital (which will ensure that
recommended transfer timescales for adult prisoners with severe mental health
problems are based on clinically informed evidence and patient need), improved
data and performance monitoring, and learning from existing good practice in secure
services and prisons. The plan is due for publication imminently and will be
implemented during 2018-19.

A considerable amount of valuable work is being done in the area of improving
provision of services for women in custody with mental health problems. Please be
assured that | am aware of the importance of this issue and will keep it under review,
alongside heaith colleagues, in order to identify any further steps that can be taken
to improve work in this area.

Thank you again for bringing this matter of concern to my attention. Please be
assured that learning from the circumstances of Emily Hartley's tragic death will be
shared widely with colleagues across the prison estate, NHS England and the
Department of Health and Social Care.

Yours sincerely
M, Chot Spurs

MICHAEL SPURR

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