Report of the Inquiry into the circumstances of the Death of Bernard ...

13.16 Paragraph 4 of PSO 1700 states: “The doctor must visit each prisoner in
segregation as often as their individual health needs dictate and at least every three
days. A registered nurse or healthcare officer must make the assessment on all other
days, so that a member of healthcare staff visits the prisoner every day. Healthcare staff
must assess the physical, emotional and mental well being of the prisoner and whether
there are any apparent clinical reasons to advise against the continuation of segregation
(including cellular confinement).”
13.17 Dr Rozycki was the medical adviser at Manchester who assessed Sonny Lodge
on 28 August. He has commented on these changes in arrangements for assessing
fitness. As a specialist in psychiatry with many years’ experience, he felt that the system
in operation in 1998 may have had its flaws and has since been improved but that it was
not ineffective. He told the inquiry that, in settings other than prisons, it was not unusual
for medical or mental health assessments to be made without reference to history, which
was not always available. Dr Rozycki said that, for his part, assessments were certainly
not ‘paper exercises’. He conducted clinical assessments and would call for records or
admit a patient to healthcare if he had cause for concern.
Current practice at Manchester prison
13.18 In 1998, healthcare in prison was provided by the Prison Service. Healthcare in
prisons is now commissioned by the local Primary Care Trust for each prison. The head
of healthcare at Manchester prison, Ms Crowther, provided a written statement to the
inquiry responding to Dr Wright’s advice about risk assessment and healthcare for
prisoners in segregation. She told the inquiry that present practice at Manchester reflects
Dr Wright’s model of good practice.
13.19 Mental Health In-Reach services at Manchester prison are provided by the
Manchester Mental Health and Social Care Trust who have a service level agreement
with the Primary Care Trust. There is a Mental Health In-Reach Team. It consists of a
Consultant Psychiatrist and Associate Specialist in Psychiatry, a manager, a Clinical
Lead Registered Mental Health Nurse (RN-MH), one Dual Diagnosis (substance abuse
and mental health) Specialist Registered Mental Health Nurse, five Registered Mental
Health Nurses, one Lead Group Worker Registered Mental Health Nurse and one Group
Worker.
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