Keeping prisoners locked up or in overcrowded conditions limits their access to critical services. Dominic Raab, when justice secretary, wrote in February 2023 that “operating close to capacity” will result in “reduced access to rehabilitative programmes”. ¹ R v Arie Ali, [2023] EWCA Crim 232, https://caselaw.nationalarchives.gov.uk/ewca/crim/2023/232  Similarly, HMIP has sounded the alarm over the potential for overcrowding to hinder purposeful activities. ² HM Chief Inspector of Prisons for England and Wales, Annual Report 2022-23 (HC 1451), HM Inspectorate of Prisons, 5 July 2023, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/ attachment_data/file/1167739/hmip-annual-report-2022-23.pdf  Ofsted has also argued that limited access to, for example, individual learning plans linked to prisoners’ sentences may result in missed opportunities to reduce reoffending rates and successfully rehabilitate prisoners. ³ House of Commons Education Committee, Not just another brick in the wall: why prisoners need an education to climb the ladder of opportunity: First Report of Session 2022–23 (HC 86 incorporating HC 56), May 2022, p. 19, https://committees.parliament.uk/publications/22218/documents/164715/default   

Shortages of prison officers have been compounded by difficulties recruiting and retaining prison educators. Comparatively poor pay, unsafe conditions and the lack of career development opportunities inside prisons has contributed to hundreds of vacancies and increased use of agency staff to provide prison education. ⁴ House of Commons Education Committee, Not just another brick in the wall: why prisoners need an education to climb the ladder of opportunity: First Report of Session 2022–23 (HC 86 incorporating HC 56), May 2022, pp. 27-8, https://committees.parliament.uk/publications/22218/documents/164715/default 

Over the past year, there has been an increase in the number of starts on accredited programmes – interventions offered to offenders with the aim of reducing reoffending ⁵ Ministry of Justice, Prison Education Statistics and Accredited Programmes in custody April 2021 to March 2022, Official statistics bulletin, 29 September 2022, https://assets.publishing.service.gov.uk/government/uploads/ system/uploads/attachment_data/file/1107740/Prisoner_Education_2021_22.pdf  – following the near cessation of these during the first year of the pandemic. However, due to overcrowding and staff shortages, there are still far fewer prisoners undertaking training and education in prisons than before Covid. Indeed, the Justice Committee found that 84% of band 3–5 staff believe staff shortages prevent prisoners engaging in purposeful activities. ⁶ House of Commons Justice Committee, Prison operational workforce survey (PRI0066), 23 June 2023, 
https://committees.parliament.uk/work/7099/the-prison-operational-workforce/publications  Starts of accredited programmes in 2021/22 were 60% below 2019/20 levels, and 88% below 2009/10 levels. Indeed, a recent report on HMP Risley found no accredited programmes were being offered to the 40% of the prison population serving sentences for sexual offences. ⁷ HM Chief Inspector of Prisons, Report on an unannounced inspection of HMP Risley, HM Inspectorate of Prisons, April 2023, www.justiceinspectorates.gov.uk/hmiprisons/wp-content/uploads/sites/4/2023/07/Risley- 
web-2023.pdf  Similarly, Ofsted has noted the poor overall quality of education provision in men’s prisons, 60% of which are rated as ‘inadequate’. ⁸ HM Chief Inspector of Prisons for England and Wales, Annual Report 2022-23 (HC 1451), HM Inspectorate of Prisons, 5 July 2023, p. 42, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/ attachment_data/file/1167739/hmip-annual-report-2022-23.pdf   

Inexperienced staff provide less effective care to prisoners

Health care in prisons is poor. With prisons struggling to operate more than basic regimes, it is difficult to train staff to adequately cope with prisoners’ health needs (particularly mental health). Indeed, a recent analysis of Independent Monitoring Boards reports have highlighted the impact of the staffing crisis on prisoner health, with increasing reliance on agency staff, shortages in clinicians and chaperones, and inadequate suicide and self-harm training contributing to declines in both mental and physical health support. ⁹ Coomber A, ‘What do IMBs tell us about prison today?’, blog, Howard League for Penal Reform, July 2023, https://howardleague.org/blog/what-do-imbs-tell-us-about-prison-today/ 

Interviewees told us that inexperienced staff are less adept at helping prisoners in need of special care. This is concerning given the worse state of health among prisoners than in the general population. The Nuffield Trust has reported that this disparity is particularly acute in those aged over 50 who, for example, suffer higher rates of frailty than in the general population. The over-50 cohort has grown by 6.7% between March 2022 and March 2023, compared to growth of 5.6% in the number aged under 50. ¹⁰ Davies M, Hutchings R, Keeble E and Schlepper L, Living (and dying) as an older person in prison, Nuffield Trust, April 2023, www.nuffieldtrust.org.uk/sites/default/files/2023-04/Nuffield%20Trust%20-%20Older%20 prisoners_WEB.pdf 

This loss of experienced staff may also contribute to the number of deaths in prison. One report found that prison staff’s lack of understanding of procedures for monitoring suicide and failures of communication between prison and health staff are common concerns among inquests and coroners’ reports relating to deaths in prisons. ¹¹ Inquest, Deaths in prison: A national scandal, January 2020, www.inquest.org.uk/Handlers/Download. ashx?IDMF=bb400a0b-3f79-44be-81b2-281def0b924b   

Violence decreased dramatically at the start of the pandemic, but has steadily increased since