Early Release Scheme

Speaking on 21 August, the chief inspector of probation, Martin Jones, explained how important it is to have accurate information on offenders before their release:

“If you are looking to release somebody from prison, a most important thing is to understand the risk that person represents. Are they a high-risk offender or are they a low-risk offender? What are their needs? Do they have mental health difficulty? Do they have drug addiction problems? If you do not understand that at the point that person is released, it is a recipe for failure and quite often will result in recall to prison or increased reoffending.”

That is a brilliant summary of our reasons for creating SONAR – and the role it will play in achieving the Government’s aims on prison capacity and rehabilitation.

Early release

The new Government’s first two months have been dominated by the need to free up prison places. An updated early release programme – by which prisoners are freed 40 per cent of the way through their sentences instead of 50 per cent – will begin next month. It is expected that 2,000 prisoners will be released early on 10 September, followed by up to 1,700 more offenders on 22 October.

The overall programme is expected to create 5,500 extra spaces. (On 23 August, there were 89,383 prison places against a total prisoner population of 88,234.)

Reductions in reoffending

While the early release programme is the first step, Ministers have said that their most important goal is to reduce reoffending – which is at the heart of SONAR.

On 5 July, Keir Starmer warned that, “For so many people who come out of prison, they’re back in prison relatively quickly afterwards.” He concluded: “That is a massive problem that we have in this country, that we do need to break.”

On 12 July, in the same speech that she announced the early release programme, Justice Secretary Shabana Mahmood said: “We will also reform the system and drive down reoffending. Our prisons today create better criminals, not better citizens. Eighty per cent of offending is reoffending – at immense cost to communities and the taxpayer. A goal of my time as Lord Chancellor will be to drive that number down.” She set out plans to recruit over 1,000 additional trainee probation officers by March 2025, aiming to provide greater oversight and management of offenders once they leave prison.

The Government also appointed James Timpson as his prisons minister. James Timpson had been CEO of Timpson Group which has an outstanding record in employing ex-offenders. In his maiden speech in the House of Lords, the new Minister said: “We have to make prisons rehabilitative and make sure that, when offenders are given a second chance, they can seize it. That is good for society because it reduces crime.”

The Role of SONAR

As Martin Jones said, successful rehabilitation depends on accurate knowledge of the needs of the offender. This is at the heart of the SONAR offer.

SONAR is designed to allow the best possible entry of healthcare information, so that records are accurate. It is also the first criminal justice health information system to allow health information to be shared across settings, including post-release. Our aim is that, for the first time, prison custody staff can easily access and update a record that is up to date with NHS information. Prison staff can access the same record, up to date with any changes in police custody. Post-release healthcare staff can do the same. It aims to solve exactly the challenge that Martin Jones set.

SONAR aims to go further by providing additional support post-release. It will help offenders find jobs by providing an appointment diary. It will inform all relevant agencies, and key family members, if appointments are missed – which can also be an important risk factor.

We look forward to engaging with the Government and with the wider Health and Justice community as we all contribute to ensuring better outcomes for those in a system under pressure.

John White

Founder and CEO

New Beginnings for Health and Justice

The new Westminster Government has been elected and announced its new programme of legislation. With a large majority, it has a real chance to change public services for the better, and I wish it well. 

I strongly support the new Government’s initial drive to raise outcomes in healthcare and to reduce reoffending in criminal justice. SONAR can do much to help. 

On the NHS, the new Secretary of State Wes Streeting’s first statement was that outcomes had to improve, and he wanted to be honest about that: 

“When we said during the election campaign that the NHS was going through the biggest crisis in its history, we meant it.  When we said that patients are being failed on a daily basis, it wasn’t political rhetoric, but the daily reality faced by millions. Previous governments have not been willing to admit these simple facts. But in order to cure an illness, you must first diagnose it. This government will be honest about the challenges facing our country, and serious about tackling them.” 

The Labour Party manifesto explained that the Party would push hard for positive change. It wants to use all of the tools at its disposal, including greater partnership with the private sector and better use of technology. 

On criminal justice, at his first press conference as Prime Minister, Sir Keir Starmer was unequivocal around the need to reduce reoffending: 

"We do need to be clear about the way in which we use prisons. For so many people [who] come out of prison, they’re back in prison relatively quickly afterwards. That is a massive problem that we have in this country, that we do need to break." 

In her first speech, Shabana Mahmood, the new Justice Secretary, gave the same message: 

“Nearly eighty per cent of offending is reoffending – at immense cost to communities and the taxpayer. A goal of my time as Lord Chancellor will be to drive that number down.” 

The choice of Prisons Minister speaks volumes. James Timpson has been chief executive of Timpson Group which has done so much to show the benefits of employing ex-offenders. 

SONAR will help because it is specifically designed to improve health outcomes by enhancing the collection, analysis and sharing of health and social care information in criminal justice settings. It will contribute towards a reduction in recidivism by improving access to healthcare and – through the SONAR ReSet (our release support app) – helping ex-offenders to keep to a stable routine including interaction with rehabilitation services.  

To give the last word to Keir Starmer: 

“Politics can be a force for good - we will show that.” 

John White

Founder and CEO

How JWPM has helped to integrate Substance Misuse Services (SMS) patient data into the patient’s clinical record, reducing administration and enabling improved patient outcomes.

Identifying a Gap

While Substance Misuse Services (SMS) teams deliver essential services within prisons, they have rarely been a part of the single patient healthcare record, hosted within the current electronic medical record system. In addition, in many instances primary healthcare providers are not commissioned to provide Psychosocial SMS Services. This leads to gap in joined up care and consequently an increased safety risk: a potentially critical aspect of a patient’s health and wellbeing is absent from their record means primary healthcare providers are less able to provide support to the patient or to the SMS Teams.

The recent Prevention of Future Deaths report into the case of Finlay Finlayson (25 March 2024) provided a case study. It highlighted the difficulty in sharing information between different case management systems:

“During the course of the Inquest the jury heard evidence about the difficulty in information being transferred over from Mr Finlayson’s GP surgery system, which uses SystmOne to the prison system (also SystmOne). The evidence was that information was not able to be freely shared between the two and it meant that there was a delay in healthcare staff in the prison accessing relevant information about Mr Finlayson’s long term health issues as well as contact with his GP as recent as a week before going into prison.”

Discussions with a number of SMS teams indicated a willingness and a preference to record their interventions in the patient’s medical record, and to cease recording clinical data in the HMPPS PNOMIS system.  

As a first of type project, it has shone light on the SMS teams indicating the lack of integration with primary care practices within the secure sites and how getting sites in an ‘IT ready’ state took longer than expected.

Bridging the Gap

The Commissioner requested JWPM to investigate potential solutions to improve outcomes for patients and providers.

Relevant SMS providers were contacted and met with at several prisons to capture and map out the “as-is” processes.  This highlighted that all the prisons had slightly different ways of handling SMS patients. SMS templates were also reviewed with service providers. These were deemed to be overly complicated and did not mirror the real-world patient journey through the service. It became clear that all current processes and practices needed to be revised.

Using the national NDTMS templates as a baseline, key stakeholders from the SMS teams reviewed the new SMS Toolkit templates built by JWPM. They were built to capture the national requirements, and more, to help ensure best practice and the real world flow a SMS patient, which follows:

• Reception

• Referral

• Dual diagnosis

• Risk assessment

• Caseload assignment

• Brief intervention (if required)

• Treatment Outcome Profiles (TOP’s)

• 5-day review

• 28-day review

• 13-week review

• Care plan

• Recalls

• Clinical reports

Joining the Shared Care Record

The JWPM designed toolkit, bespoke to SMS services, has achieved its purpose, making it easier for the SMS Teams to access the information required within a medical record and add to the record if needed. This also helped the patient’s experience, as less information was requested in duplicate.

To support the staff in using the SMS Toolkit, reports were built to support two primary areas:

• Workforce Planning (workforce planning was supported by caseload reporting and monitoring upcoming patient reviews)

• Patient Outcomes (patient outcomes were reportable using the referral outcomes and certain key CTV3/SNOMED codes to capture referral to key services, or the end to an intervention)

Benefits and Outcomes

SMS teams across all 13 prisons in the East of England now have greater access to healthcare information available within the patient’s record. We are incredibly grateful to all SMS providers that supported JWPM and took part in modelling the flows and the prisons that are benefitting from improved patient care. Enhanced access helps to facilitate integrated working with the Health and Wellbeing services within the secure site. Specific benefits noted by SMS and healthcare providers have been that it is easier to share information, and there is a reduction in time spent requesting or searching for specific information. Also, patients are identified as being referred to the SMS service a lot quicker.

Conclusion

The SMS Toolkit project has been beneficial. At the same time, it highlighted that the SMS teams, especially the Psychosocial provision, have been historically more embedded with the HMP service, using the HMP PC’s and uploading to PNOMIS.

Now that the SMS teams are on the single patient record, the next steps are to support the team in their continuing use of the SMS toolkit. If appropriate we will conduct a business review of the changes implemented and we will make any further changes required to improve the SMS service.

John White

Founder & CEO