51 Visits, Follow-ups and Results in 2020 Recommendations that require additional resources Some of the NPM’s recommendations cannot be resolved solely by the institutions but are dependent on framework conditions that are not determined by the institutions. Follow-up after the visit to Oslo Prison in November 2018 showed that the prison and health section had implemented a number of measures, both immediate measures and more comprehensive long-term efforts to improve conditions at the prison. At the same time, the prison and health section notified that they had been unable to implement several of the recommendations due to staffing, building and financial limitations. According to the prison administration it was for instance not possible to improve the shower facilities that the Ombudsman had criticized. The Ombudsman concluded the visit emphasizing that shower facilities were untenable, and that the ongoing pandemic heightened the seriousness of the situation. Follow-up over an extended time period Occasionally, the Ombudsman’s follow-up of institutions extends over a longer period of time. This may be due to the fact that some recommen­ dations involve changes that require more time to implement. The Ombudsman wants to be kept informed also of more extensive changes and will therefore wait in some cases to conclude the visit. In other cases, the dialogue may be prolonged because the institution has provided insufficient in­ formation on their follow-up of recommendations. The reason may also be disagreement concerning the actual circumstances or a lack of willingness to change established practices. As a consequence, the Ombudsman's work on visits can in some cases prolong for more than a year after the visit has been conducted. All letters exchanged between the Ombudsman and the institution in this follow-up process are public and published on our website.5 During 2020, five visits have led to a need for such prolonged dialogue: the visit to the child welfare institutions Stendi Nymogården and Jong Youth Centre, section for children and adolescents at Helse Stavanger HF, and the security sections and section for geriatric psychiatry at Østfold Hospital, Kalnes. Oslo Prison located in Grønland, Oslo. 5 The letters are published via the link “Follow-up” of each individual visit: https://www.sivilombudsmannen.no/en/visit-reports/