Section one Context The number of applications to use deprivation of liberty safeguards5 in England continued to rise, with 11,886 applications made (a 4% increase on the number of applications in 2011–12 and a 66% increase on the applications in 2009–10). The number of authorisations granted (55% of all applications) to use the safeguards remained similar to the previous year.6,7 Application rates increased sharply for people in the two oldest age bands (75–84 and 85 and over).8 Some NPM members reported their concerns that pressures were a significant factor in the inadequate provision of timely access to care and staffing levels (in mental health settings in England and Wales) and in detainees’ safety (in prisons in England and Wales). The reintroduction of night-time confinement as a cost-saving measure in high security mental health hospitals in England and Wales demonstrates the direct impact of budget cuts on detention practices.9 There was an unacceptable increase in the number of self-inflicted deaths in prisons in England and Wales, with 88 confirmed self-inflicted deaths between April 2013 and March 2014, a rise of 69% from the 52 recorded in 2012– 13 and the highest number for comparable periods since the year ending March 2004.10 Notifications of deaths of detainees under the Mental Health Act increased in 2012–13 from the previous year, with a total of 275 reported deaths, of which 48 were recorded as having unnatural causes and 27 were undetermined (in comparison to a total of 236, including 36 unnatural and nine undetermined in 2011/12).11 The run-up to the September 2014 referendum on Scottish independence12 further shaped the political context in which NPM members operated. In practice, different legal systems and devolved responsibility for health matters have always meant that Scottish NPM members have very distinct responsibilities and relationships within the NPM are very positive. At the same time, controversy about the UK’s role in the European system for the protection of human rights occurred throughout the year, particularly in relation to the implementation of the European Court of Human Rights judgment Hirst v. UK, relating to the ban on prisoners’ voting.13 A parliamentary Joint Committee was appointed in May 2013 to consider and report on the government’s proposals in its draft Voting Eligibility (Prisoners) Bill. This committee recommended extending the entitlement to vote in all UK parliamentary, local and European elections to all prisoners serving sentences of 12 months or less. 5 Deprivation of liberty safeguards were introduced in England under the Mental Capacity Act 2005 (subsequently introduced as an amendment under the Mental Health Act 2007), to provide a legal framework to ensure people are deprived of their liberty only when there is no other way to care for them or safely provide treatment. 6 Figures provided by the Health and Social Care Information Centre showed that 11,887 applications to use the safeguards were made in 2012–13 and 6,546 authorisations were granted. 7 http://www.hscic.gov.uk/searchcatalogue?productid=12141&q=title%3a%22Mental+Capacity+Act+2005%2c+Deprivation+o f+Liberty+Safeguards+Assessments%22+!Bi-annual+!analysis&sort=Relevance&size=10&page=1#top 8 Care Quality Commission (2014) Monitoring the use of the Mental Capacity Act Deprivation of Liberty Safeguards in 2012/13, p.17 (https://www.cqc.org.uk/content/deprivation-liberty-safeguards-201213) 9 Care Quality Commission (2014) Monitoring the Mental Health Act in 2012/13, p.36 (http://www.cqc.org.uk/content/ mental-health-act-annual-report-201213) 10 HM Inspectorate of Prisons (2014) HM Chief Inspector of Prisons for England and Wales Annual Report 2013–14, p.10 (http:// www.justiceinspectorates.gov.uk/hmiprisons/inspections/?post_type=inspection&s&prison-inspection-type=annual-reports) 11 http://www.cqc.org.uk/sites/default/files/documents/cqc_mentalhealth_2012_13_07_update.pdf (p.70–27) 12 The outcome of the referendum – in which 44.7% voted ‘yes’ and 55.3% ‘no’ to the question ’Should Scotland be an independent country?’ – was announced before going to print. 13 Case of Hirst v. the UK (No.2) (Application no. 74025/01) 13