National Preventive Mechanism Tenth TenthAnnual AnnualReport Report 2018–19 2018–19 Introduction by John Wadham, NPM Chair The United Kingdom’s National Preventive Mechanism (NPM) has now been operating for more than 10 years. We have grown to become a 21-member network of independent inspectorates and lay-visiting bodies, carrying out over 66,000 visits to places of detention each year. I have been the independent chair of the NPM for over three years, after being appointed by NPM members in 2016. I am even more impressed now by the dedication of NPM members’ staff and volunteers to deliver on the requirements of the Optional Protocol to the Convention Against Torture (OPCAT) and prevent torture and ill-treatment in places where people are deprived of their liberty. The idea of preventing ill-treatment is fundamental to the work that the NPM does every day. In this report we set out the approach to our tasks and demonstrate how it prevents ill-treatment, with lots of examples of how NPM members achieve this. 1 4 Yet in 2018–19 NPM members still found too many unacceptable examples of the treatment and the day-to-day conditions for detainees. In too many instances, NPM members had raised these concerns before and they remained unaddressed. According to just two NPM members – HMI Prisons and the Care Quality Commission – in 2018–19 over 10,500 people were detained or deprived of liberty in places that were inadequate or too poor for safe detention.1 During 2018–19, NPM members noted with concern that the number of people detained under mental health legislation across the UK had increased. Limited bed availability combined with limited support for people in the community were cited as contributing factors to this rise – they result in more people with severe mental health problems not getting the right support, and being at risk of deteriorating to the extent that they need to be detained. The NPM welcomes the introduction of the Mental Health Units (Use of Force) Act 2018, which strengthens the requirement for staff in mental health hospitals in England and Wales to record the restraint that has been used. However, Last year, CQC rated 5% of mental health organisations that can detain patients under the Mental Health Act inadequate in relation to safety. There are in excess of 40,000 such detentions a year, so CQC estimates that perhaps 2,000 such detentions could be to hospitals rated as unsafe. In 2018−19 there were a further 2,131 notifications to CQC of a Deprivation of Liberty Safeguards application outcome at locations that as of 22 August 2019 were rated inadequate for safety. HMI Prisons figures show that in reports published in 2018–19 6,003 out of 29,361 prisoners in prisons inspected were living in establishments judged to be poor in safety. CQC and HMI Prisons use different methodologies and assessment standards in their inspection reports. While CQC’s lowest rating is ‘inadequate’, HMI Prisons rates establishments from 1–4, with 1 being ‘poor’ in outcomes of its four healthy prison tests.