National Preventive Mechanism Eighth Annual Report 2016–17 up problems that would be avoided if there was better community provision preventing the need for, or offering alternatives to, detention.127 Human rights standards are primarily focused on types of detention or establishments, and there is little in the way of international precedent or legal authority to guide the NPM or detention authorities in the UK on what is expected of them. There has been little discussion of the human rights implications of detainees moving, or trying to move, along different pathways. There are however, important principles that should clearly be applied, including the principle of ‘least restrictive environment’, standards relating to detainees’ distance from home, and the responsibility to prevent ill-treatment. Furthermore, legal protections are less clear and possibly harder to apply when a detainee is moving, or should be moved, from one place to another. In this respect, the development in Scotland to extend the right to appeal excessive security levels in medium secure hospitals is significant, as is the CPT recommendation that there be oversight from mental health tribunals of all prison-hospital transfers. The NPM’s work, conducted alongside its members’ existing inspection and visiting programmes, has only been able to look at some of the pathways and in limited detail. Our work reviewing existing literature and current practice allows us to identify issues relating to the treatment of detainees arising from pathways that warrant further study. These include: • how the distribution of national and local resources and specific commissioning arrangements influence the pathways available to detainees; • how cost imperatives influence the pathways detainees travel; • the loss of continuity of services as a result of detainee moves; • the impact on a detainee of choosing to transfer them to one or other option; • the different thresholds applied to decisions to transfer detainees from one place to another; • the availability of pathways for particular groups, including women and children; • the desirability of reducing or maintaining a child’s regime and privileges in anticipation of a move to a more restrictive setting. Recommendations and future actions The NPM makes the following recommendations to authorities responsible for aspects of the pathways identified above. Pathways from mental health to mental health settings • Strengthen the planning of secure mental health services with a view to this becoming more coordinated (including between jurisdictions for national resources) and based on better information about local and national needs. • Consider the need for extending the right to appeal against being held in conditions of excessive security beyond its existing application in Scotland. 127. See also House of Lords, House of Commons Joint Committee on Human Rights, 2017, Mental Health and Deaths in Prison: Interim Report, paragraph 22. 48