Section one Introduction Context although this Act will provide data on restraint in mental health hospitals in England and Wales, and some experimental data is available for England through the Mental Health Services Data Set (MHSDS), we remain concerned over the current lack of reliable figures on the numbers of times physical restraint is used in health and social care settings across Scotland, England and Wales. NPM members also highlighted the damaging trends in prisons across the UK during the reporting year. Levels of violence and the use of force and restraint were high in a number of prisons, with not enough being done to address the underlying causes of this violence. There was often inadequate governance around the use of force, leading some members to raise initial concerns about the roll-out of PAVA spray – a synthetic pepper spray which temporarily incapacitates those it is sprayed upon – in men’s prisons in England and Wales. In addition to this, the NPM expressed deep concern about the continuing and disturbing levels of self-harm in prisons. We set out these, and many other issues, in our submission to the United Nations Committee Against Torture (CAT). The CAT held its sixth periodic review into the United Kingdom’s efforts to implement this international treaty in May 2019, and our evidence – on cross-cutting issues and human rights concerns in prisons, police custody, mental health detention, immigration detention and health and social care – was particularly critical. This led directly to several of the challenging questions the committee asked the government in the public hearing, and formed the basis of some of the committee’s final and critical conclusions. We also used this important international review to re-state the need for a strict time limit for immigration detention. For many years, NPM members have documented the deleterious impact of indefinite immigration detention. Members who monitored places of immigration detention in 2018–19 also found that the safeguards put in place to prevent vulnerable people being detained were not working effectively. I sincerely hope this and other recommendations made in our CAT submission are taken up in earnest by the new Government. I have been particularly worried by the recent revelations about cases of alleged abuse at hospitals Whorlton Hall and Muckamore Abbey, both places where vulnerable people with learning disabilities and/or autism are held on the presumption that they will be cared for and will be safe and supported. BBC's Panorama revealed shocking footage of the treatment of patients by staff in Whorlton Hall, and a police investigation into CCTV footage at Muckamore Abbey has so far identified around 1,500 alleged crimes, including physical and mental abuse of patients by staff at the hospital. In another significant development a public inquiry has been announced to investigate allegations of ill-treatment of people detained under immigration powers at Brook House Immigration Removal Centre, also revealed by an undercover documentary, in 2017. Unfortunately, in 2018–19 there was still no strategy from the Government on how to strengthen the NPM by placing it on a statutory footing, giving it the powers it needs and guaranteeing its independence. A legislative basis for the NPM is the only way in which our ability to carry out our 5