Section two Focus on detention issues sufficed. This meant that though all those involved in his care agreed that prison was not an appropriate place for him, the opportunity to transfer Dean Saunders to a more suitable placement in a hospital was missed. In their evidence to the Joint Committee on Human Rights, Dean Saunders’ parents said they had been told not to worry, that ‘He’s secure until we can get him transferred’. The PPO concluded that the criminal justice system did ‘too little to protect this very vulnerable young man’ and an inquest jury found that Dean Saunders and his family were ‘let down by serious failings in both mental health care and the prison system’ and that the cause of death was ‘contributed to by neglect’. NPM members are concerned that the lapses in understanding the transfer pathway evidenced in this case are not untypical. Timeliness of transfers International human rights standards emphasise that arrangements for prisoners who are diagnosed with severe mental disabilities and/or health conditions, for whom staying in prison would mean an exacerbation of their condition, ‘shall be made to transfer them to mental health facilities as soon as possible’.117 The NPM was able to access NHS England data showing the timeliness of transfers from prison to hospital in England and Wales in 2016–17.118 This showed that from a total of 1,083 transfers from prison to hospital, 366 (33.7%) were completed within the agreed 14-day time period and 717 (66.3%) were not. Seventy-six prisoners (7.1%) waited for 140 days or longer.119 The same data indicated that men were less likely to be transferred within the guideline target of 14 days than women. Transfers of 67.7% of men were not completed in 14 days, compared with 54% of women. Some men (7.6%) and women (2%) waited for 140 days or longer. Data on delays in transfers obtained for a debate on prison safety in Parliament by Luciana Berger MP showed, in her words, ‘such ubiquitous failure [that] would never be tolerated in the outside world’.120 More specifically, the NPM understands that delays often arise for administrative reasons between the first and second assessments, which prolongs the waiting time from first assessment to transfer. These delays are hard to quantify as data is not captured centrally. A study published in 2016 examined the transfer of 64 male prisoners in England and Wales and found that the mean time from referral to hospital admission was 76 days. They noted that a sizeable number of prisoners were left in prisons for excessive periods of time with suspected mental disorders, for which treatment is readily available in hospital but cannot be administered without consent in prisons.121 117. Nelson Mandela Rules, Rule 109.1. 118. NHS England Central Database Working Document 090617 PT MH Assessments and Secure Transfers (email correspondence between HMI Prisons and NHS England). 119. This data refers to the time interval from first referral to hospital admission. 120. Hansard, 2017, Suicide and Self Harm in Prison (England). 1 March 2017, Volume 622. 121. R Sharpe, B Vollm, A Akhtar, R Puri, and B Bickle, 2016, ‘Transfers from prison to hospital under Sections 47 and 48 of the Mental Health Act between 2011 and 2014’ in The Journal of Forensic Psychiatry and Psychology, Volume 27 (4), 2016. 43