National Preventive Mechanism Sixth Annual Report 2014–15 The IMBs have a specific role in segregation reviews, as they are informed of decisions to segregate and can attend case conferences and reviews where they can make their views known.65 However, one IMB in England and Wales reported difficulties in attending the first reviews of segregation (within 72 hours). Other NPM members might attend segregation case conferences during inspections as part of their observation. In July 2015, the Supreme Court ruled in the case of R (on the application of Bourgass and another) v Secretary of State for Justice that the delegation of ministerial responsibilities to extend segregation in England and Wales beyond 72 hours was unlawful in two cases of long-term segregation. [2015] UKSC 54 Although there is considerable internal review of decisions to place or extend placements in the CSC, one NPM member has expressed concern at the lack of external review of these decisions. In England and Wales, health staff should assess an individual who has been formally segregated within two hours to ensure they are mentally and physically able for segregation, using a standardised algorithm. Health staff visit all prisoners who are segregated or subject to cellular confinement daily and attend the formal multidisciplinary meetings to review ongoing segregation. In some prisons, mental health staff lead on this role, which is good practice due to the potential negative impact of segregation on mental health and the high proportion of prisoners with mental health issues held in segregation. One NPM member has observed good quality engagement from health staff, but often health staff are only present at the door of the cell along with several officers, with little opportunity for confidential consultations. In Scotland, prisoners in the separation and reintegration units are generally seen daily by health care staff and can request visits as required. A smaller number of prisoners – normally those held for extended periods – are assessed by a psychologist or psychiatrist. NPM members considered whether the governance of segregation allowed prisons to identify any disproportionate representation from specific groups of prisoners. Data recording the number of prisoners with protected characteristics66 held in segregation are not held centrally.67 In one prison, inspectors identified disproportionate overrepresentation of both black and minority ethnic and young adult prisoners in the segregation unit. Although managers of the CSC system were aware of the disproportionately high number of black and minority ethnic and Muslim prisoners held, they did not understand the reasons for this. Although formal isolation is subject to many safeguards that take into account its effect on prisoners and the need for oversight, the ‘informal’ isolation and solitary confinement that arises from restricted regimes is rarely subject to similar procedures. NPM members noted that the authorisation to 65 In the 1970s, the Boards of Visitors (which later became IMBs) themselves played a disciplinary function and could impose punishments on prisoners, including ‘loss of remission’. This role was amended in 1992 as a result of legal challenges and the recommendations of the Woolf Report. 66 The grounds upon which discrimination is unlawful. See: http://www.equalityhumanrights.com/private-and-public-sectorguidance/public-sector-providers/public-sector-equality-duty/what-equality-duty (accessed 14/10/15). 67 UK Parliament, Written Question No. 218558 18/12/2014. 28