National Preventive Mechanism Tenth Annual Report 2018–19 The use of force by staff was high in many prisons and there were concerns about weaknesses in the governance of its use. The rollout of PAVA spray – a synthetic pepper spray which temporarily incapacitates those it is sprayed on – in the adult male estate (following a pilot) and the associated guidance to prisons was announced this year and was due to commence in April 2019;59 IMBs raised significant initial concerns about the lack of robust governance guidance. found that support available to women to maintain contact with families and friends varied from prison to prison, and that due to distances from home this was problematic in many cases. At HMP Eastwood Park, the Independent Monitoring Board noted that there were 50 to 60 open ACCTs (case management for prisoners at risk of self-harm) every month, and that a rise in violence was linked to the return to custody of women who had been recalled.62 However, the introduction of key workers (a prison officer assigned to each prisoner to provide regular support and engagement) through the new OMiC model was seen as a promising development by HMI Prisons and IMBs. In Scotland, the four inspections conducted by HMIPS in the year found that prisoners reported feeling largely safe and that there was evidence of positive and respectful relationships between staff and prisoners. Nevertheless, HMIPS and its Independent Prison Monitors reported that overcrowding had begun to compromise the delivery of full and effective regimes. For example, they noted adverse impacts such as staff having less time to deal with individuals, prisoners being located further away from home, and an increase in the waiting list for offender behaviour programmes. Consistent delivery of health care was noted as a particular challenge across the majority of the estate. The most frequent request for assistance by prisoners from Independent Prison Monitors related to medical issues, in particular differences in prescribing practices by health care providers. HMIPS was also concerned about the management of equality and diversity issues within prisons, and noted the While two-thirds of prisoners were positive about the way they were treated by staff, HMI Prisons reiterated the frequent finding that prisoners from black and minority ethnic backgrounds did not have such positive views of their treatment and conditions. For example, only 56% of men from a black or minority ethnic background felt that most staff treated them with respect, compared with 74% of white men.60 Outcomes in women’s prisons inspected in England were generally better than for men. However, levels of self-harm were very high and had increased throughout the women’s estate by 24% in 2018.61 Inspectors 59 HM Government, October 2018, Prison officer safety equipment rolled out, https://www.gov.uk/government/news/ prison-officer-safety-equipment-rolled-out [accessed 05/12/19] 60 HM Inspectorate of Prisons, July 2019, HM Chief Inspector of Prisons for England and Wales Annual report 2018-19, https:// assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/814689/hmip-annualreport-2018-19.pdf [accessed 18/10/19]. 61 Ministry of Justice, Safety in Custody Statistics, England and Wales: Deaths in Prison Custody to March 2019, Assaults and Self-Harm to December 2018, https://www.gov.uk/government/statistics/safety-in-custody-quarterly-update-tomarch-2019 62 Independent Monitoring Boards, June 2019, Annual Report, https://s3-eu-west-2.amazonaws.com/imb-prod-storage1ocod6bqky0vo/uploads/2019/06/IMB-NATIONAL-ANNUAL-REPORT-PUBL-5-JUNE-2019.pdf [accessed 18/10/19] 26