Another Graphic Illustration of Failings

With quite astonishing testimony coming in on the state of probation, including cocaine use and 90% of the job being work on the laptop, one cannot escape the conclusion that fundamental restructuring cannot be far off. As the latest SFO review from the new HM Chief Inspector confirms, the present state of affairs is untenable. Here's the press release:-  

Independent serious further offence review of Joshua Jacques

Background:

On 25 April 2022 police forced entry to a property in Bermondsey, London, where the bodies of Denton Burke (aged 68), Dolet Hill (aged 64), Tanysha (Raquel) Ofori-Akuffo (aged 45), and Samantha Drummonds (aged 27) were found. All four victims had suffered stab wounds and lacerations. Joshua Jacques was charged with these murders.

In June 2022, the Lord Chancellor and Secretary of State asked the Chief Inspector of Probation to undertake an independent review into how the Probation Service managed Joshua Jacques, as he was under probation supervision when he was arrested for these offences. This review was completed in November 2022 and can now be published following the completion of criminal proceedings.

Statement:

Chief Inspector of Probation Martin Jones CBE stated:

“There were serious failings in the supervision of Joshua Jacques. Despite concerns about repeated non-compliance with his licence conditions, enforcement practice was inconsistent and opportunities to recall Jacques to custody were missed.

“Joshua Jacques was incorrectly allocated to a newly qualified probation officer who had only finished their training three months before being assigned the case. Under guidelines by HM Prison and Probation Service (HMPPS), Jacques should have been allocated to an experienced, qualified probation officer. The probation practitioners in this case lacked the required experience to respond adequately to the complexity of the case. The management oversight of the probation practitioners involved in this case was also insufficient. Probation staff reported a lack of confidence in decisions made by their line manager, contributing to a reluctance to seek out further management oversight.

“There was a lack of professional curiosity in all areas of probation practice in this case. This meant several events, such as an arrest for further offences, disclosure of declining mental health, problematic behaviour towards neighbours, a new relationship, and the unpermitted use of social media, were not responded to or explored sufficiently.

“Joshua Jacques was appropriately assessed as posing a high risk of serious harm to the public prior to his release from custody. However, his risk in other categories, including to staff or potential partners was underestimated. No risk assessment was completed for Jacques following his release which resulted in no risk management plan or sentence plan in the community being completed.

“Probation practitioners were aware of Jacques’ mental health history, including that he had been sectioned in 2018 and that he had behaved violently during a period when his mental health was not stable. Jacques had also reported that random aggression could be a symptom of declining mental health. In February 2022, Jacques disclosed to probation court staff that he was experiencing a decline in his mental health; however, no action was taken. Inspectors found during this review that probation staff felt ill equipped to understand and respond to mental health concerns, with limited training and support being available to them.

“The case records show that Jacques was routinely using cannabis whilst on probation, and his licence contained a condition to engage in a drug abuse intervention on release from prison. No such intervention was organised by the Probation Service and our inspection found no evidence of a referral to a drugs agency.

“Sadly, this case is symptomatic of the issues we have observed across the probation service in recent years. A reliance on an inexperienced cohort of probation staff, a lack of support for mental health and substance misuse issues alongside insufficient management oversight are concerns which have been highlighted repeatedly. As a result of this review, eight recommendations were made to HMPPS. They have accepted all these recommendations and responded with an action plan for implementing them.”

The following extracts are from the full report and although lengthy, give a graphic illustration of the fundamental flaws in how the probation service as simply not fit for purpose as part of HMPPS and under civil service control.  

1. Foreword 

In April 2022, Joshua Jacques was charged with the murders of a family of four: Denton Burke, Dolet Hill, Tanysha Ofori-Akuffo, and Samantha Drummonds. On 21 December 2023 he was found guilty of murder following trial. 

Joshua Jacques was under probation supervision when he was arrested for these offences, having been released from prison on licence in November 2021. Ordinarily, the Probation Service would conduct a review of the management of the case, in the form of a Serious Further Offence (SFO) review. In this case, the Secretary of State for Justice asked HM Inspectorate of Probation to complete an independent review into how the Probation Service managed Joshua Jacques. 

The impact of these shocking crimes cannot be underestimated and will have had a profound impact on their family and the wider community. We offer our sincere and heartfelt condolences and recognise that the family need information about how Joshua Jacques was supervised in the community and answers as to whether there were failings in this practice.

This report presents the findings of our independent review and sets out that the practice in this case fell below the expected standards. 

As a result of recent recruitment drives and of experienced staff leaving the Probation Service, many probation teams now have large numbers of newly qualified officers (NQO) or recently qualified officers. In the Southwark Probation Delivery Unit (PDU), this situation impacted on the level of experience in the teams available to manage high risk and complex cases, something our core inspections have also routinely found. 

We found Joshua Jacques’ case was incorrectly allocated to an NQO, and the lack of good quality management oversight of this member of staff impacted on the quality of decisions made. There was a notable absence of professional curiosity1 across all areas of probation practice from court through to sentence management, and a failure of the probation practitioners overseeing the case and their manager to meet fully their expected responsibilities. As a result, several significant events, such as an arrest for further offences, disclosure of declining mental health, problematic behaviour towards neighbours, a new relationship and use of social media when not permitted to do so, were not responded to sufficiently. 

While appropriate referrals were made to Multi Agency Public Protection Arrangements (MAPPA) and to Approved Premises (AP) by the probation practitioner, these critical elements of increased supervision did not fulfil their potential in supporting the management of risk of serious harm posed by Joshua Jacques. An initial OASys assessment was not completed upon his release, which meant that his management in the community was not supported by a robust risk management plan, nor a sentence plan to inform his supervision on licence. The pace and level of engagement of Joshua Jacques with his licence was seemingly determined by him, rather than the probation practitioners, who viewed his engagement and progress too optimistically.

There were concerns Joshua Jacques was not complying with the conditions of his licence and, though this happened repeatedly, they were each dealt with in isolation. Practitioners did not see the bigger picture and missed opportunities to respond sufficiently to his concerning behaviours, for example through a recall to prison. 

Many of the findings of this review mirror those of our thematic and regional probation inspections. This review makes eight recommendations to His Majesty’s Prison and Probation Service which we require implementation of as a matter of urgency to ensure learning is implemented quickly and nationally, not just in the PDU where this case was supervised.

Martin Jones CBE 

HM Chief Inspector of Probation

5. Summary of Key findings 

JJ’s supervision was characterised by several practice deficits and missed opportunities which impacted on how JJ was managed on licence. Nine key themes identified from the independent review are outlined below. 

Risk of serious harm assessment 

In custody, two OASys assessments were completed which concluded that JJ posed a high risk of serious harm to the public, specifically identifying the public to be drug users and peers operating in drug supply. This was an appropriate assessment, however it failed to identify all factors that were linked to the risk of serious harm such as his mental health, substance misuse and current accommodation. JJ was assessed as posing a low risk of serious harm in all other categories, which was an underestimation of the level of risk he posed. 

An initial OASys assessment was commenced upon release, however, this was never fully completed and remained an incomplete document. This was poor practice and was not in line with organisational expectations. 

The failure to complete an OASys assessment on release resulted in no assessment of risk of serious harm and no risk management plan in the community to inform how the risk posed should be safely managed while on licence. Additionally, there were no sentence plan objectives to support and inform the supervision appointments, which should have been targeted to address those factors most likely to contribute towards further offending. Further reviewing did not take place following MAPPA meetings, nor in response to changes of circumstances and significant events. Completing a review would have enabled the probation practitioner to consider the significance of new information, and review the sentence and risk management plans accordingly, to ensure the necessary arrangements were in place to protect the public. 

The pre-sentence report prepared for court, and the OASys completed following sentence to the suspended sentence order, both replicated the pre-release assessment and did not take the opportunity to consider all available information to support an updated and holistic assessment. 

MAPPA meetings considered the level of risk of serious harm posed by JJ; however, this did not negate the need for an OASys assessment to be completed. This is essential probation practice to ensure that the management of each case is supported by a robust and defensible assessment of risk of serious harm and need. In the absence of a formal assessment using the OASys tool, inspectors would have expected to see other evidence of assessment and planning within case management records. However, there were no such records to satisfy us that a clear understanding of how to manage the risks posed were in place. 

Professional curiosity and optimism bias 

PO1 and PO2 put a strong focus on addressing JJ’s needs, such as accommodation and employment. Though these were important factors and progress was made, the supervision sessions were not underpinned by a sentence plan and there was no evidence of interventions which focused on offender behaviour being delivered. Inspectors found that this strong emphasis on relationship building and addressing JJ’s needs was not balanced against the need to manage risk of serious harm. 

Probation practitioners viewed JJ’s behaviour on licence through an over optimistic lens and did not fully understand the expectations on them to be professionally curious and proactive. As a result, they did not adequately explore issues such as why he had purchased a vehicle, or his problematic behaviour in his accommodation and they failed to inform police of a second breach of the criminal behaviour order (CBO). 

These skills of professional curiosity grow and develop with practitioner confidence and experience, and with the effective support and oversight from peers and managers. There was a lack of experience within the probation practitioner staff group at Southwark PDU and lack of robust management oversight further contributed to this. Where a workforce has limited experience, they need guidance from those with a more established level of knowledge to provide support and oversight to aid their development. 

Enforcement 

Good probation practice seeks to motivate people on probation to comply and engage positively with the requirements of their sentence. While this should include a focus on desistance from further offending, it should also include appropriate enforcement action being taken when required. Instances of non-compliance should be responded to in a proportionate, fair, and transparent manner.

Enforcement practice in this case was inconsistent, with instances of non-compliance considered in isolation rather than seen in the round. Opportunities to escalate and consult with the delivery unit head (HOS1) were not sought. There was a failure to act upon a pre-release assessment that identified that swift enforcement of the CBO and licence were required to manage the risk of serious harm posed by JJ. Enforcement guidance issued in October 2021 was not followed. Our inspectors felt the decision not to recall JJ following his arrest for further offences was defensible. However, in making the decision, senior manager oversight should have been sought by SPO1 and the failure to do so was against expected practice. The enforcement practice in this case did not analyse the behaviour being displayed by JJ, nor did it explore whether additional supportive or restrictive measures short of recall were needed to manage his licence. 

Resourcing and workload 

Southwark PDU had been operating under ‘green’ status under the national prioritising probation framework but had several vacancies, particularly at probation officer and probation service officer grade. Many staff within the PDU were at early stages of their career and there were limited numbers of experienced staff available. The probation practitioners in this case lacked the required experience to respond adequately to the complexity of the case and behaviours being presented. In addition, the pace and volume of work impacted on the quality of work undertaken in this case. 

HMPPS’s Tiering framework and case allocation guidance was not followed, and JJ’s case should have been allocated to a more experienced probation practitioner. The allocated probation practitioner in this case was within their newly qualified probation officer (NQO) period and in allocating the case, the SPO should have been assured that PO1 had the required knowledge, skill, and experience to manage the case effectively. JJ’s tier increased following the initial MAPPA meeting and this should have prompted re-allocation of practitioner in line with the expected practice for NQOs. 

Management oversight 

Management oversight was of an insufficient standard. Staff reported a lack of confidence in decisions made by their line manager, contributing to a reluctance to seek out further management oversight. When sought, decisions made by the probation practitioners would generally be approved without the necessary discussion or scrutiny needed to ensure that the most appropriate course of action was being taken. Opportunities to escalate to HOS1 were also missed. 

Similar to the findings from the Inspectorate’s broader local inspection programme, the workload, and responsibilities of line managers in this Probation Delivery Unit were found to be concerning. SPOs were managing large teams and were expected to provide support and oversight of their staff and manage human resource issues, as well as provide oversight and scrutiny of each probation practitioner’s caseload. SPOs also have additional lead responsibilities, such as MAPPA, which impact on their ability to perform their role to the expected standards. 

Inspectors also found insufficient processes in place to manage staff absence. PO1 was absent from work for a period of three months. While during this time PO2 had maintained contact with JJ on their own initiative, the process for caseload reallocation during an absence was not clear, which resulted in a lack of clear ownership of this case and many of PO1’s other cases during this period. 

Multi Agency Public Protection Arrangements (MAPPA) 

JJ’s index offence (the last set of criminal actions that brought him into contact with the criminal justice system) meant that he was not automatically eligible for management under multi agency public protection arrangements (MAPPA). Therefore, it was good practice for JJ to have been referred to MAPPA as a Level 2, Category 3 case. However, there was insufficient evidence that this MAPPA referral positively impacted upon the management of the case. 

The MAPPA referral for JJ was completed late, only one month prior to release. To allow effective coordination this should have been done six months prior. In recognition of the complexity of the case and imminency of need, it was positive to see that JJ was listed promptly for discussion once he had been referred. However, the initial delay in referral resulted in little time for MAPPA to effectively contribute to the pre-release planning, with PO1 having already set licence conditions with the prison, without a contribution from the MAPPA panel. 

The minutes from each of the four the MAPPA meetings held to discuss JJ were of an insufficient standard, providing limited evidence that partner agencies were active in supporting the management of risk of serious harm he presented. 

There were missed opportunities for meaningful actions to be set in response to new information, and a lack of oversight of outstanding actions. JJ was de-registered from MAPPA oversight without an adequate rationale, whilst two actions which had already been carried forward remained outstanding. 

Approved Premises 

The Approved Premises (AP) placement was an opportunity to positively contribute to the management of JJ’s risk of serious harm. Key work sessions were held by AP staff which were appropriately focused, with structured sessions on the immediate needs of JJ; exploring issues such as registration with a GP, finance, and education, training, and employment (ETE), which supported his resettlement into the community. However, professional curiosity was not applied during AP staff interactions with JJ. There is no evidence that there was sufficient exploration of his behaviour and movements, which would have aided the probation practitioner’s understanding of how JJ was spending his time away from the AP. 

AP staff should play a significant role, both in providing relevant risk information to the probation practitioner and in contributing to effective risk management. It is essential that they understand the risk of serious harm presented, are actively involved in the delivery of the risk management plan and are part of MAPPA meetings. An AP representative was not able to engage in pre-release planning due to the delayed referral, and subsequently did not attend the MAPPA meetings held, which impacted on pre-release planning, information exchange and the effective risk management of the case.

Mental health 

JJ had been sectioned previously in 2018 and had informed probation practitioners that feelings of anxiety and paranoia were normal for him. Prior to release, JJ’s mental health was described to be stable, and probation practitioners stated that there were no obvious signs of a mental health decline upon release into the community. 

However, he was described by PO1 as presenting as ‘low’ on occasion, which was attributed to boredom and need for structure in the community. Days prior to the SFO, JJ was described as talkative and going off on irrelevant tangents in his conversations with probation staff. Furthermore, JJ informed PSR1 that when committing the further offences on licence, he had been experiencing poor mental health. This was not explored further and there was a lack of significance given to this statement, resulting in no analysis or action. 

Probation practitioners were aware of JJ’s mental health history but lacked any detailed information. They were also aware that he had behaved violently during a period when his mental health was not stable, and JJ himself had reported that random aggression could be a sign of his mental health declining. However, this was not identified as a factor linked to risk of serious harm within OASys assessments. Additionally, the correlation between his continued use of illegal substances and his mental health was not sufficiently explored or responded to. Prior to JJ’s release from custody, information on JJ’s mental health was sent by the prison mental health in-reach team to his registered GP, however they were not aware that the GP had retired. Upon registration with a new GP, this prior information on JJ’s mental ill health was not passed to them. 

There was a reliance on JJ recognising and self-reporting a decline in his mental health and on the one occasion he disclosed such concerns no action was taken. Probation practitioners stated that there was a gap in services available to support those with mental health, particularly if there were also substance misuse concerns. As emphasised by the report published in 2021, A joint thematic inspection of the criminal justice journey for individuals with mental health needs and disorders, mental health can present significant challenges for probation practitioners, and is often characterised by insufficient information exchange and the need for better training and support. Inspectors found during this review that staff felt ill equipped to understand and respond to mental health concerns, with limited training and support being available. 

Substance misuse 

JJ had used cannabis since he was a child and was described to be lacking insight into the harmful effects of his substance misuse. Probation records and a psychiatrist’s assessment indicate a link between JJ’s substance misuse use and mental health, and that JJ’s sectioning in 2018 had been preceded by the consumption of medication, alcohol, and cannabis. Additionally, much of JJ’s offending was linked to substance misuse. 

Probation case records show that JJ was routinely using cannabis while on licence. He had completed substance misuse intervention programmes in custody and his licence contained a condition to engage in a drug abuse intervention on release from prison. However, such an intervention was not organised by probation practitioners, and we could find no evidence of a referral to a drugs agency. 

Inspectors found that probation practitioners did not explore the underlying reasons for JJ’s substance misuse, and minimised and tolerated regular use while he was on licence. This was underpinned by a failure to adequately analyse the impact of substance misuse to the risk of serious harm he posed.

Predictable, Populist, Confused

Does this sound familiar?

"But the solutions proposed are politically driven catchphrase-based policy making"

It's a statement that could be applied to any number of probation-related issues over the last few years and it's regarding a topic we've not covered for some time : drugs. Of course it's a well known fact politicians talk nonsense on the subject and the latest headline-grabbing government initiative is no different. I can't be bothered to read it, but I notice Transform have and the quote is from their recently published analysis:-  

REVIEWING THE GOVERNMENT’S NEW ‘TOUGH’ CONSEQUENCES FOR DRUG POSSESSION

The Home Office has set out its plans to reduce the current levels of recreational drug use across the UK in its new White Paper Swift, Certain, Tough: new consequences for drug possession. The paper follows on from the Government’s most recent drug strategy; it was promised at the time to address the objective of ‘demand reduction’- reducing use - which the drug strategy mostly overlooked in its focus on service provision.

The White Paper’s demand reduction strategy for ‘so-called recreational users’ proposes a model for public consultation (to be piloted in three locations) for how drug possession offences would be dealt with, summarised in this graphic:

Some elements of the proposals appear relatively promising. At first glance, there seems to be a desire to try and avoid the tens of thousands of people caught committing minor possession offences from being drawn into the criminal justice system. Implicit is an acknowledgement that criminalisation of minor possession is both expensive and counterproductive; there is no evidence that blanket punitive sanctions are an effective deterrent and there is substantive evidence that they fuel stigma, create obstacles to proven public health interventions, and undermine the life chances, particularly of people from socially and economically marginalised communities.

This is why ending criminalisation of people who use drugs is recommended best practice from the Government’s own expert advisers (the ACMD), all 31 lead agencies of the UN including The World Health Organisation and UN Office on Drugs and Crime, as well as the Royal College of Physicians, the UK Faculty of Public health, the Royal Society for Public Health - and many other authoritative voices.

Moves in this direction are already underway in 14 police authorities - a range of ‘drug diversion schemes’ where people caught in possession are ‘diverted’ into health interventions rather than the criminal justice system and prosecution. While the law criminalising the act remains in place (often lurking as a threat behind some of the diversion programs), perhaps the best we can say is that diversion represents a form of partial or de facto decriminalisation. Transform has a dedicated page of information and resources about these initiatives.

Notably, the schemes have been lauded by the Drugs Minister, Kit Malthouse, recommended by the Government’s own recent expert review from Dame Carol Black, and are prominently flagged in last year’s new Government drug strategy. So the idea in principle is not a new one.

The White Paper, however, makes no mention of either decriminalisation or diversion schemes (although it does refer to ‘diversionary cautions’, see below). Instead, it promotes language around ‘swift certain and tough’ consequences - proposing the escalating tiers of sanctions described above. The first tier looks a lot like many existing diversion programmes but, worryingly, with a series of financial penalties as well as an offender-paid drug awareness course, which most diversion schemes do not implement. Tiers 2 and 3 move increasingly far away from emerging best practice and, indeed, the entire underlying conceptual thinking around diversion/decriminalisation relating to avoidance of harmful engagement with the criminal justice system, criminal records, stigma, and so on.

Before critiquing some of the details (where the devil inevitably resides), it is worth noting that we can all agree that there should not be a ‘postcode lottery’ for how police deal with drug offences. Currently, you can get very different treatment responses to possession offences depending on where you are caught - ranging from a life-impacting prosecution, to an informal telling-off. This variation is obviously problematic; equality before the law is a fundamental part of the rule of law and the aspiration in the White Paper to address this problem is welcome.

But the White Paper proposals, even acknowledging the vague nod towards diversionary pragmatism, are a step backwards from the best practice lessons emerging around the country. We should not pursue national consistency at the cost of entrenching bad practices more widely and undermining the positive work already being done throughout the UK. Equality should be about equally good policy, not equally bad. If rolled out these proposals would, in many areas, represent a form of levelling down (the proposals have already been rejected by the Scottish Drugs Minister - as a regressive step backwards from their existing diversion program).

We are all too familiar with problems created by drug prohibition - such as the empowerment of organised crime and related violence and exploitation - being blamed on the drugs or people who use them. These problems of punitive enforcement are then routinely used to justify even more punitive enforcement. But with this White Paper, the Government seems to be tacitly acknowledging the harms of criminalisation and the benefits of reform - but showing a pathological inability to make the case for such reforms, show leadership, and call them what they are. It is so invested in the drug war narratives that it seems unable to perceive reform as anything other than weakness or surrender. The result is this strange and confused mess of proposals.

A key problem of the White Paper is that it confuses, or deliberately conflates, issues relating to people who use drugs recreationally with issues relating to people with drug dependencies or problematic use. The paper, including its prominent ‘Swift, Certain, Tough’ title, draws heavily on the US literature on 'swift, certain and fair’ (SCF) sanctions. But while this scholarship on SCF has explored maintaining abstinence amongst drug-dependent offenders (enforced with drug testing - and sanctions, such as 48 hours of immediate custody, for positive results) the focus of the White Paper is specifically on ‘so-called recreational users’ who are not the focus of the SCF literature. Hawaii’s HOPE programme is referenced twice and appears to have been a big influence, but it is a programme for people with histories of dependence in probation-mandated treatment having left prison. None of that is relevant to recreational users - most of whom will not have criminal records, and none of whom, by definition, need treatment.

The White Paper has also pointedly replaced the ‘fair’ element of ‘swift, certain and fair’, with ‘tough’ - a reframing symptomatic of the performative ‘tough on drugs’ populism that runs through the whole paper and its accompanying media messaging. Even for the drug awareness courses mandated in Tier 1 (not dissimilar to the diversion programme in place in Avon and Somerset for example), there is a proposal to not just make the offenders pay for the course but for them to pay more than the cost of the course - an overtly punitive element thrown in for good measure.

The second tier, for those caught in possession a second time, includes what is called a ‘diversionary caution’. This is a formal police record that would appear on certain forms of background checks - in other words, a criminal record. It also involves random drug testing (presumably supervised urine samples - with all the indignities and human rights issues this entails) over a three-month period. A formal charge will be brought in the event of a positive test. So, far from progressive reform, this would de facto criminalise ‘internal possession’ and use (i.e. a positive test) in a way that only a small number of countries, such as Sweden, do at present.

Seemingly drawing on the disastrous and discredited ‘three strikes you’re out’ US policy from the 90s, third-time offenders would not only be automatically charged and receive a criminal record but would additionally be subject to a range of new, non-coincidentally headline-grabbing, punitive sanctions that include:

• Exclusion orders - Preventing access to certain ‘night time economy’ venues. The paper acknowledges there’s no evidence these would work, and it’s not clear how they would be enforced.

• Drug tagging - Remote monitoring of drug use with technology that they concede does not exist yet.

• Passport and driving licence confiscation - Ideas seemingly borrowed from some EU countries (such as Italy - which is unable to show they were effective), these seem particularly disproportionate, having the potential to devastate someone’s life or career - for a possession offence as minor as being caught smoking a joint.

And who is likely to move beyond tier 1, be criminalised, urine-tested, and subject to an additional raft of draconian new punishments? It is not going to be the ‘middle-class drug users’ that the Government seems so keen to single out, but whose drug use tends to take place with the protection that private space and privilege offers. In reality, it will be people who are already most exposed to drug policing and the glaring disproportionality in stop and search; those from economically and socially marginalised communities, and urban black youth in particular. These are also people less able to pay punitive fines or course fees, and therefore more likely to default and end up with a criminal record regardless, even from tier 1. It will be regressive in its impact on the poor and institutionalise the criminalisation of poverty. Yet more levelling down.

It is appropriate to welcome some elements of this White Paper - the acknowledgement of rising use and some of the problems with criminalisation and postcode lotteries, and the commitments to support problematic users. But the solutions proposed are politically driven catchphrase-based policy making, which ignore existing best practice. The proven diversion/decriminalisation approaches that the paper seems to want to benefit from, by their nature require a paradigm shift away from punitive enforcement. That’s the whole point. But the Government's obsession with maintaining its ‘tough on drugs’ posturing has perversely led to proposals that will be incredibly expensive, and are likely to lead to increased criminalisation and harms for the most vulnerable in society - with few, if any, corollary benefits.

Transform will be submitting a more detailed response to the consultation, and we encourage others with relevant personal or professional experience to do the same.

Don't Tell Tory Voters!

Oh look, the government are about to launch a new drug policy, accepting it's a health condition not a criminal justice problem, but really hope voters, especially Tory ones, don't notice. This from the BBC:-

Government to overhaul drug policy to focus on getting users healthcare

The government will announce a new drugs strategy on Monday overhauling the drug recovery and treatment system, the BBC has learned. The announcement is expected to pledge £700m over three years to tackle problem drug use. Measures will include a large focus on diversion, a tactic designed to remove drug users from the criminal justice system and get them into healthcare. Ministers are also set to announce investment to tackle drug gangs.

The overhaul has been drawn together by at least six government departments, the BBC understands. It will form part of a wider week of law and order announcements for the government, which a source involved in the drug strategy said had frustrated some of those who worked on it - who wanted to make clear these measures would lead to fewer crime-focused drug policies. The government has been asked to comment.

The diversion strategy is expected to be twofold - short prison sentences for drug use will be largely replaced with court orders putting users into recovery programmes and there will be less emphasis on prosecuting people caught with substances. 

In Scotland, prosecutors can refer people accused of drugs offences for "diversion" and their Lord Advocate said people caught with Class A drugs could be given a police warning instead of facing prosecution - a move the Conservatives had previously said amounted to "de facto decriminalisation."

'Chronic health condition'

In his party conference speech, Boris Johnson accused Labour of "decriminalising" hard drugs after the Labour leader Sir Keir Starmer said Scotland's decision was "probably the right thing to do" but was an "independent decision." 

It is understood there will also be more emphasis in the strategy on helping drug users leaving prison to find work and safe housing. The Times newspaper has reported drug treatment courses could be offered to those whose offending was fuelled by drugs, giving people the option of changing their behaviour or facing tougher punishments. 

One source heavily involved in forming the review told the BBC "ministers have now accepted this [problem drug use] is a chronic health condition". However, they added that because of concerns over how that would be viewed by the public and Conservative voters, it was unlikely the government would want it to be the focus of the announcement. The Home Office have been asked to comment.

As well as an overhauling of drug treatment plans, ministers are expected to outline more investment to tackle county lines drug gangs - urban drug dealers who sell to customers in more rural areas via dedicated phone lines.

The strategy has been drawn up as a response to the Dame Carol Black review of drugs, which reported in the summer and made 32 recommendations. The BBC understands the government has accepted at least 31 of these. The Times also reported the government was seeking to amend its Police, Crime, Sentencing and Courts Bill to give judges extra powers to order drug testing of anyone serving a community sentence. It said drug testing could be required on arrest for all crimes, and the government could outline plans to use drug dealers' phones to identify and support addicts - and warn people they were not anonymous when buying drugs.

The BBC has been told there will be no announcements on heroin-assisted treatment or drug consumption rooms. Politicians in Scotland have been pushing for the latter to be introduced but a source involved in forming the drugs strategy said Number 10 and the Home Office were "very against" them and a move in that direction may have needed a change to the Misuse of Drugs Act. Both departments have been asked to comment. 

Those drawing up the drug strategy were instructed to find ways of introducing new policies without having to make major change to legislation. It's also understood there will likely be no specific funding in this strategy for prisons to replace methadone with "abstinence-based rehab", a plan reported by The Telegraph newspaper earlier this week. However, Dominic Raab, the justice secretary, is expected to publish a separate strategy on problem drug use in prisons in a government White Paper.

A government source told the BBC this would allow governors in prison to be more empowered to take action against drug use. The Times reported it could also involve further "airport-style" security in prisons for visitors and staff to prevent drug smuggling.

Police Talking Sense on Drugs

Preamble

A week on, the AGM blog post continues to attract attention with total site traffic yesterday exceeding 3,100 hits. What it means is always an imprecise science, but I suspect something not unconnected to the long-standing Napo tradition of not saying very much about difficult issues. Whatever happened to the General Secretary's Blog?

Talking of difficult issues, politicians have always found drugs firmly in that category and best avoided. William Haigh raised the subject "Decriminalising drugs is the only way forward" back in August because it seems the topic can only be raised when your political career is over. Fortunately, the continuing independence of Chief Constables who hold office under the Crown, despite all the elected PCC nonsense, often can and do speak up on such matters whilst in post, as here in the Guardian:-

As a chief constable, I’ve seen enough: it’s time to end the ‘war on drugs’

I know addicts can commit odious acts. But treating drug use as a criminal justice problem causes thousands of needless deaths

When I first met Andy, I got the sense that he hadn’t been born at all but rather quarried out of a mountainside: a big man with a warm smile who, as we spoke, was injecting medical-grade heroin into a line in his lower leg. As a serving chief constable, this was one of the more unusual introductions I’ve made with a member of the community.

Andy must have sensed my confusion at his apparent health and physical stature for a person on the heroin-assisted treatment programme in Middlesbrough, the first of its kind in England and Wales. “Heroin doesn’t make you skinny,” he said. “It’s just that heroin comes first and last and there’s never any money left for food. That’s why addicts are thin.”

If the “war on drugs”, first declared a full 50 years ago, has an established fighting front, it’s Andy’s home town of Middlesbrough. The latest statistics from 2020 show that 123 people died from drug-related deaths on Teesside – the highest number since figures have been collated, and one of the highest rates in the country. Across England and Wales, there were more than 4,500 drug-related deaths in the same 12 months.

The vast majority of those deaths would have been entirely preventable. In 21 years of police service I have slowly, perhaps too slowly, come to the conclusion that framing this crisis as a criminal justice problem has not simply been unhelpful, but counterproductive. This nationwide epidemic is a public health crisis.

Having said that, if it’s to be labelled as a problem, perhaps it’s best characterised as a political one. It must be recognised how hard it is for mainstream parties to initiate a conversation on drugs policy reform when votes are often won by being “tough on crime”. I agree with the sentiment, but there are different ways of achieving this. Some early advocates for reform do exist across the political divide, including MPs Crispin Blunt (Conservative) and Jeff Smith (Labour), but there is a growing appetite beyond Westminster to fundamentally reconsider our response.

In my time as Cleveland’s chief constable, we have increased the number of stop and searches and seen a large increase in the amount of illicit drugs seized – I’m proud of this. Stop and search can have an impact and ensure that vulnerable people are safeguarded. Likewise, closing cannabis farms can work: not only are drugs seized and gang members jailed, we safeguard those left to “farm” the cannabis who are often trafficked into the UK.

However, working alone as a single agency has had little impact on the problem as a whole. The production of heroin in Afghanistan, and cocaine in South America, has increased; organised crime activity and violence is at an historic high; and deaths continue to rise.

If we are to be serious about tackling this crisis, a fundamental change of approach is required. The government’s response to Carol Black’s independent drugs review proposes a cross-departmental drugs unit and reinvestment in treatment services that were cut during the years of austerity. The reinvestment is a particularly welcome recommendation and is a prerequisite to reducing deaths.

Most of us have allowed the message on drugs being bad (which they clearly are) to be conflated with addicts themselves being bad simply for using drugs. Let me be clear: some of the most odious and evil acts I’ve encountered in my police service have been perpetrated by drug addicts; but this is not universally true. Many, like Andy in Middlesbrough, have made bad choices in their lives – but by helping people like him, we help ourselves.

Andy is now on the path to stabilisation, supported by Danny Ahmed, a visionary who runs the treatment programme in the town. Danny explains that it required a brave set of people two years ago to sign off on his plan to give “heroin” to addicts. But viewing drug dependency as a chronic health condition, as Danny does, allows us to view the problem through a different prism: we would not hesitate to help patients manage other conditions that require ongoing medication.

As Danny explains, the patients are given diamorphine, the same drug that pregnant women often receive during labour to manage pain. Most people feel differently about his programme when this is explained. While watching Andy’s syringe being prepared (during which time he’s not allowed to be in the room) I asked the nurse what would happen to me if I took the diamorphine. So high is the dosage, I’m told it would probably kill me.

Andy chats happily as he prepares to self-administer the diamorphine in what amounts to a doctor’s surgery. He doesn’t fall back in a stupor on to a dirty mattress, as depicted in Hollywood movies, nor does he lose consciousness. At all points he’s lucid and talkative. Andy and the others on the programme do this twice a day, every day of the year: a phenomenal commitment for people who are used to living chaotic lives.

Andy invites me to stay for a cup of tea. He talks about a difficult upbringing in one of the poorest towns in England but acknowledges that not all those who have a difficult start in life end up abusing heroin. The ruinous path to addiction started as a means to “fit in” and fill a void in his life.

The programme has meant his life has stabilised, he’s rebuilding relationships with family members, and can look with confidence to the future. “I understand that you’ve got a job to do,” he almost pitifully suggests, before tailing off from the sentence – with the futility of the police’s work to stamp out drug abuse all too evident.

The heroin-assisted treatment programme offers hope, if scaled up on a national level, that demand for heroin can be cut. When the state offers a meaningful alternative to the street drugs that can be bought from organised crime groups, the demand for them decreases. What remains to be seen is how organised crime groups will adapt to plug a huge drop in profits.

Middlesbrough, a town so often discussed as a “problematic” area with “problematic” people, could possibly represent the beginning of the end for the “war on drugs” that has already taken too many lives.

Richard Lewis is chief constable of Cleveland police

--oo00oo--

It's worth bearing in mind that, unlike the Police, as civil servants the Probation Service at any level is now completely silenced in terms of making any contribution towards social policy discussions, despite having an unparalleled wealth of experience and insight into such matters. Increasingly, it's the Police Service as de facto community social workers that we must look to for enlightened social policy making, a role once very firmly in probation's bailiwick.    

Reality Behind Love-in

Blimey. Someone at Napo has torn themselves away from the week-long self-congratulatory probation love-in, that hard-pressed staff have no time for, and issue a response to that HMI report on drugs. I can't help but notice publication didn't interrupt the endless chirpy upbeat stuff on the official Twitter feed though and it was instead emailed to all members this afternoon:- 

Napo’s response to the HMIP Thematic Report on Drugs

Napo members will be frustrated to read this report detailing the many failings of the failed experiment in probation privatisation that was Transforming Rehabilitation (TR). This report is released just weeks after Dame Carol Black has issues her Review of Drugs part two making recommendations for multi-agency, whole system partnership approach with ring-fenced funding.

Declining service provision before and through TR

Many Napo members will recall the former Drug Intervention Programme (DIP) which operated up to 2013. This offered a genuine multi-agency approach to supporting those leaving prison who had drug misuse issues. DIP reduced acquisitive crime by a third but ended in 2013 and even though there were some local attempts to replace it these largely ended in 2014-15 because of TR.

TR brought with it a wholesale disinvestment in provision of probation services. This applied across the CRCs and the NPS. The NPS had to invest early on in infrastructure and was always behind in achieving the appropriate staffing levels. Almost every year since 2014 when the NPS was created Trade Unions were told that staffing would reach steady state in the next 2 years but that steady state was never achieved. Some CRCs made staff redundant early on, some left it until later in their contracts, others relied on not replacing the huge numbers of staff who left. Across all employers there was an increase in retirements and an increase in turnover generally. In 2014-15 there was a TR related baby boom as many women staff timed their plans to take maternity leave to give them respite from the chaos in the workplace. The loss of skilled and experienced staff from the probation system will take many years to recover from and unification is not the answer some might think it is. We are now losing staff who just cannot cope with more organisational change, and also staff who cannot tolerate the excessive workloads and are disappointed to find that the new unified service just brings all of the staffing issues together – it resolves nothing.

Courts and Pre Sentence Reports

Drug treatment requirements have become more difficult for Probation staff working in Courts to arrange. This is because the staff working in Courts are employed by the National Probation Service and up to unification the CRCs were responsible for delivering the requirements. Added to this the push for ever speedier justice means that adjournments for pre-sentence report enquiries are rare. Adjournments are generally needed to allow for proper assessments for treatment requirements but for lower risk cases it can be a huge challenge for Court staff to persuade sentencers to have any type of pre-sentence report, never mind one which will require an adjournment for a few days. The HMIP report highlights the number of people sentenced without any pre-sentence report and this is a real concern, no one can be sentenced to a treatment requirement without a pre-sentence report so they should be mandatory in cases where drug misuse is a factor.

Drug review Courts have also disappeared in most cases and these should be reintroduced to support sentence confidence in treatment requirements as well as to promote engagement and progress for those subject to the requirements. There is real value in sentencers seeing the progress made, sharing in the discussion of challenges being faced and the work done to motivate and support clients to make positive changes to their lives. There is also huge value for clients in participating in this dialogue and feeling themselves to be an active participant with equal stake in the process post-sentence. Much is made of developing social capital and attending drug review Court hearings is a very real way of doing this.

Specific interventions and sentence management

Prior to TR most Probation Trusts operated with specialist teams to work with clients subject to Drug Rehabilitation Requirements and other relevant sentences. These teams were often co-located with the partner agencies who provided the treatment and wrap around services. It is encouraging that a return to this model is recommended and we hope this can be achieved however there will need to be further and significant investment into the system to replace what has been lost. In particular the mantra of resource following risk will be a barrier, most of the cases that are covered by this report will not have been assessed as high risk so will not attract the level of resource that is required to achieve some of the goals.

The report details the need to address some of the underlying issues relating to drug use such as trauma but such work takes time and skill. Contrast this with staff carrying workloads measured at 150% or more of their capacity and the lack of specialist training available to them and the scale of the problem becomes clearer. The Government response that they are recruiting 1000’s of additional Probation Officers is of little use when many of the cases being discussed will be managed by PSO staff. In any case increased recruitment will take some time to make a genuine difference due to the significant loss of staff over the last seven to ten years. The report also highlights the importance of co-ordinating treatment and interventions and supporting and motivating engagement with them. This again is work that required time and skill, and the development of a positive working relationship which is especially challenging when staff have 70 or more clients to work with at any one time.

Some of the recommendations in Dame Carol Black’s review of drugs will support recommendations in the HMIP report however it is difficult to see how staff so overworked and facing significant organisational change as a result of unification of probation will be able to capitalise on this. Training is one way to ensure that probation staff develop and maintain skills in this work but the current focus is solely on system and process based and mandatory training for the staff recently transferred to the Probation Service from other employers and in the professional qualification for trainee Probation Officers. Career development training and the ability to focus on specialism or semi-specialisms seems very far away for most Probation staff at the moment and it will take an estimated 18 months to reach the intended operating model for the unified Probation Service.

Unified Probation Service Operating Model

A search of the unified service operating model reveals only one reference to drugs, in the section describing the limited work of the Community Sentence Treatment Requirement (CSTR) programme. This began in 2017 but has yet to expand to cover all areas. The HMIP report notes that where it exists there are positive improvements but the lack of focus on work with people whose drug misuse is related to their offending in the operating model is very concerning.

Genuinely local multi-agency arrangements need to be reinstated. These must take into account local needs and priorities and will necessarily be different in different areas. This is tricky to do with a centralised model for operations and contracting. The promised improvements to contracting via the dynamic framework of Commissioned Rehabilitation Services (CRS) will not necessarily be the panacea imagined as contracts are awarded centrally and regions can only purchase services or not in the early years, with innovations funds restricted to activities not concerned with delivering the order of the court. This gives little opportunity for local collaboration to meet specific needs.

Napo HQ

Rain Falls on Probation Parade

It doesn't look like HMI Justin Russell got the HMPPS memo about this being a celebratory week for probation:- 

Probation services – ‘disappointing’ work with drug users ‘lacks focus and funding’

Probation services are responding poorly to drugs misuse and addiction cases, according to inspectors.

Probation services across England and Wales supervise nearly 156,000 people in the community. HM Inspectorate of Probation estimates that almost 75,000 of these individuals have a drugs problem, yet fewer than 3,000 people were referred by probation services to specialist drug misuse treatment in 2019/2020.

HM Inspectorate of Probation partnered with the Care Quality Commission to examine how probation services supervise this cohort.

Inspectors found:

• too few people on probation receive help to tackle drugs misuse – and when referrals are made, the quality of services is often not good enough
• funding for treatment has reduced and criminal justice programmes to identify and refer people for treatment have “withered on the vine”
• very few drug users on probation are being tested for drug use – just one in six of the inspected sample of known users
• key information is missing, not captured properly or used to commission services. Probation services were unable to tell inspectors how many Class A drug users were on their caseload or how many were in treatment
• six out of 10 magistrates that the Inspectorate surveyed said they were not confident probation was delivering the necessary treatment.

Chief Inspector of Probation Justin Russell said: 

“Drug-related crime causes widespread misery and costs the public purse more than £9bn a year. Yet there is a lack of focus and funding across the whole criminal justice system to tackle drug use and supply. The current system is not working well and the findings of this inspection were very disappointing.”

In the inspected areas, two-thirds of prison leavers received treatment for drugs misuse while in custody but did not continue to receive help on release. Inspectors were concerned to see poor follow-up arrangements in the community, with the situation considerably worse in England and better in Wales.

For several years, HM Inspectorate of Probation has reported on heavy workloads in parts of the probation service. Some probation officers managed upwards of 70 cases, which affected the overall quality of their work.

The findings in this inspection were consistent with the overall picture, with probation services often overstretched. Practitioners did not always have the time to examine individuals’ back stories and identify factors that could help support them into recovery, stay safe and move away from drug-related offending. Probation court teams made too few recommendations for treatment.

Two-thirds of the practitioners interviewed during this inspection felt they needed more training on the impact of drugs and how to support individuals with trauma and recovery. At the time of the inspection, probation services were delivered by the National Probation Service and privately-owned Community Rehabilitation Companies. Major reforms took place at the end of June and probation services are now unified into one public-sector service.

The Inspectorate has made 14 recommendations in its report to improve the quality of supervision including more drug rehabilitation court orders, greater use of testing, and increased funding for treatment.

Mr Russell said: 

“Probation services have an important role to play in supporting positive change for individuals caught up in drugs and their supply. The new Probation Service must strengthen every aspect of its work with drug users. It needs to build a comprehensive picture of this crime-generating cohort and commission the right services to reduce their drug use. Justice and health organisations must work more closely together, for example to ensure continuity of support for prison leavers.”

Mr Russell added: 

“Earlier this year, the government provided additional funding to improve drugs treatment. While the announcement was welcome, the money is for just one year – we need sustained commitment to fund drug treatment and recovery for people on probation. I welcome Dame Carol Black’s recent call for additional ring-fenced government funding for substance misuse treatment. People on probation should be an urgent priority for any future increase in investment, which would cut crime, save lives and more than pay for itself in the long run.”

Dr Rosie Benneyworth from the Care Quality Commission said: 

“Where services were available and people could access them, we found dedicated health workers providing good quality care for people in need of substance misuse services. However, the vital holistic support provided around this can vary greatly and be a barrier to keeping people engaged and on their recovery journey. Concerns around the availability of these services, along with concerns around continuing engagement with people as they move from one part of the system to another, means that as it stands the right care is not reaching everybody that it should.”

Oliver Standing, Director of Collective Voice, said: 

“Effective drug treatment and recovery has real transformational power – reducing mental and physical health harms, supporting people into super-charged citizenship, healing families and creating savings for the public purse. And crucially it has a strong, proven link to reducing crime – keeping vulnerable people out of the criminal justice and leading to fewer victims of crime in the future.

“The findings of the report are stark. It is estimated almost half of those supervised in the community by the probation service have a drug problem. The fact that only slightly more than two per cent were referred into specialist support in 2019/20 surely represents a systems failure. Although community services have experienced a decade of profound disinvestment, Dame Carol Black’s recent review has set out a compelling vision of a refreshed and renewed system and made the case for major investment. This important thematic review will help to shape that brighter future.”

Common Sense Drug Policy

It's been some since we mentioned drug policy here in the UK and, apart from a couple of police initiatives, anything positive happening. Whilst this situation is most unlikely to change, especially with a Tory government in control, it's worth reminding ourselves that there is an enlightened alternative as outlined in a Transform report published last week on the Portuguese experience. (Graphs and references are not shown).  

DECRIMINALISATION IN PORTUGAL: SETTING THE RECORD STRAIGHT

BACKGROUND

In 2001, Portugal decriminalised the personal possession of all drugs as part of a wider
re-orientation of policy towards a health-led approach. Possessing drugs for personal use is instead treated as an administrative offence, meaning it is no longer punishable by imprisonment and does not result in a criminal record and associated stigma. Drugs are, however, still confiscated and possession may result in administrative penalties such as fines or community service.

Whether such a penalty is applied is decided by district-level panels made up of legal, health and social work professionals, known as ‘Commissions for the Dissuasion of Drug Addiction’. Where an individual is referred to a Commission for the first time and their drug use is assessed as non-problematic (low risk), the law requires their case to be ‘suspended’, meaning no further action is taken. Fines can be issued for subsequent referrals. Where some problematic trends are identified (moderate risk), brief interventions are proposed — including counselling — but these are non-mandatory. In ‘high risk’ cases, where more serious problematic behaviours and dependence are identified, individuals may receive non-mandatory referrals to specialised treatment services.

In the vast majority of instances, problematic drug use is not identified, and cases are simply ‘suspended’. Individuals referred to the Commissions overwhelmingly view their purpose as helping to reduce use and educate on drug risks. They are non-judgemental in nature, and a primary focus is safeguarding the right to health of those referred.

Importantly, the decriminalisation of personal possession is only one part of broader health-centred drug policy reforms that involve an increased focus on harm reduction and treatment provision. By ‘accepting the reality of drug use rather than eternally hoping that it will disappear as a result of repressive legislation’, Portuguese reform allows drugs to be treated as a health, rather than criminal justice, issue. The benefits of these reforms, therefore, arise from both decriminalisation itself and the establishment of a wider health-based response to drug problems.

Portugal was not the first country to decriminalise some or all drugs, and it has not been the last. However, it is one of the most prominent and influential. The Portuguese model directly influenced the 2020 decriminalisation measure passed in Oregon, for example, as well as proposed decriminalisation in Norway. Portugal is regularly held up as the leading example of drug decriminalisation, so understanding the outcomes is vital.

DRUG-RELATED DEATHS

In the first five years after the reforms, drug deaths dropped dramatically. They rose slightly in the following years, before returning to 2005 levels in 2011, with only 10 drug overdose deaths recorded in that year. Since 2011, drug deaths have risen again but remain below 2001 levels (when there were 76 recorded deaths).

In 2001, Portuguese drug death rates were very similar to the EU average. While rates fell in Portugal following reform, they increased across the rest of Europe in the same timeframe. From 2011 onwards both Portugal and the rest of the EU have trended similarly, rising until 2015/6 — however, the gap between the two remains considerably wider than it was pre-reform. In real terms, drug death rates in Portugal remain some of the lowest in the EU: 6 deaths per million among people aged 15-64, compared to the EU average of 23.7 per million (2019). They are practically incomparable to the 315 deaths per million aged 15-64 experienced in Scotland, which is over 50 times higher than the Portuguese rates.

CRIME

The move away from criminalising and imprisoning people who use drugs has led to a dramatic change in the profile of the prison population. In 2001, over 40% of the sentenced Portuguese prison population were held for drug offences, considerably above the European average, and 70% of reported crime was associated with drugs. While the European average has gradually risen over the past twenty years (from 14 to 18%), the proportion of people sentenced for drug offences in Portuguese prisons has fallen dramatically to 15.7% in 2019 — now below the European average.

Most of this decline occurred in the first decade following decriminalisation and the establishment of a health-led approach. Since 2010, the actual number of people in prison for drug offences has remained relatively steady, but a rise in overall prison numbers means the proportion of people serving sentences for drug offences has continued to fall.

It has also been suggested that reform has led to a reduction in drug seizures. However, drug seizure data is difficult to analyse so any conclusions should be treated with caution: reduced seizures may be a result of fewer drugs on the market or they may simply be down to reduced police activity.

DRUG USE

Levels of drug use in Portugal have been consistently below the European average over the past twenty years. This is particularly the case among younger people: Portugal has some of the lowest usage rates in Europe among those between the ages of 15-34.

In the first five years after drug policy reform, use of illegal drugs rose slightly among the general population but fell again in the following five years. Use among 15-24 year olds fell throughout the decade, and among the general population was lower in 2012 than in 2001.

However, consumption trends in Portugal have been keenly disputed and often misrepresented. While drug use during individual lifetimes among the general population appeared to increase in the decade following reform, use within the past 12 months fell between 2001 and 2012. Both the World Health Organization and the United Nations Office on Drugs and Crime consider use in the past 12 months (recent drug use) or within the past month (current drug use) as better indicators of trends among the general population.

Since 2012, past-year use appears to have risen, particularly among those over the age of 25. This is, however, based on relatively limited data from SICAD (the Portuguese drug dependence agency) and only one further dataset — in 2016. In any event, Portugal continues to retain one of the lowest rates of drug use in Europe.

Consumption figures alone tell us relatively little about the level of harm experienced through drug use. A rise in drug use among individuals using only occasionally, and recreationally, is unlikely to lead to large rises in deaths or other harms. For this reason, measuring levels of high-risk drug use, particularly among people who inject drugs, is important. As of 2015, there were an estimated 33,290 ‘high risk’ opioid users in Portugal. Per 100,000 population, this is above the European average. However, it is lower than when decriminalisation was established in 2001. Researchers have also noted a fall in the proportion of individuals referred to Dissuasion Commissions found to be dependent on drugs, suggesting a general reduction in problematic drug use — though this may, in part, be linked to police not repeatedly referring the same individuals if they are already in treatment. In 2018, 90% of individual cases were found to not demonstrate problematic use.

Drug policy reform in Portugal was combined with a change in approach to drug education, moving away from abstinence-based ‘just say no’ campaigns. Drug use in schoolchildren has been consistently below the European average for the past twenty years. Rates in 2019 were roughly the same as 2001. In line with European trends, as reported by the European school survey on alcohol and drugs (ESPAD), they have shown a gradual, consistent decline in the last 10 years. ESPAD also reports that perceived availability of drugs among children in Portugal is lower than the European average.

HIV TRANSMISSION

Drug policy reform in Portugal included wide-reaching needle and syringe programmes aimed at reducing risk of infection among people who inject drugs. In 2001, Portugal had 1,287 new HIV diagnoses attributed to injecting drug use. It had over 50% of all new HIV diagnoses attributed to injecting drug use in the EU in 2001 and 2002 despite having just 2% of the EU population. In 2019, with only 16 new diagnoses, it only had 1.68% of the EU total.

While HIV diagnoses have gone down across Europe in this period, the trend in Portugal is much stronger. Owing to its previously extremely high levels of transmission, Portugal retains some of the highest HIV prevalence rates in Western Europe among people who inject drugs (at 13%). However, this still marks a significant downturn since the millennium, when half of all new HIV diagnoses were attributed to injecting drug use. AIDS diagnoses in people infected through injecting drug use have also fallen dramatically over the past twenty years: from 518 in 2000 to just 13 in 2019. Again, this is a stronger downward trend than the EU average: in 2000 Portugal had 15% of new EU diagnoses; in 2019, it had less than 5%.

HEPATITIS B AND C

Hepatitis C prevalence among people who inject drugs has been estimated as the highest in Western Europe and is a result of multiple epidemics in the late 20th century linked in part to unsafe drug injecting practices up to the 1990s. Prevalence of hepatitis B (which, unlike hepatitis C, is commonly spread through means other than blood-to-blood contact) is below the Western European average. The EMCDDA reports that the number of new yearly hepatitis B and C reports have fallen consistently over the past twenty years.

TREATMENT AND HARM REDUCTION PROVISION

A key feature of the new Portuguese drug policy, alongside decriminalisation, was the expansion of treatment services. Between 2000-2009, outpatient treatment units increased from 50 to 79. However, the number of individuals in treatment for drugs steadily decreased between 2009-2018, which may be linked to significant reductions in health and welfare budgets following the impact of the global financial crisis. Following the absorption of the country’s independent Institute for Drugs and Drug Addiction into the National Health Service (which itself saw budget cuts of 10% in 2012) health spending continued to fall until 2015 — to under 9% of GDP, from roughly 9.9% in 2009.

A reduction in absolute treatment numbers may also be related to reduced levels of problematic drug use, as discussed above. A study comparing patients entering treatment for heroin dependence pre- and post-reform found an overall decrease between 1992 and 2013, which the authors suggest could be linked to a fall in the number of newly dependent individuals. EMCDDA data also indicate a changing profile of individuals entering drug treatment, with admissions for opioids steadily falling over the past ten years but admissions for cannabis going steadily up.

According to the latest available yearly data there are an estimated 17,246 individuals in opioid substitution treatment in Portugal. Using this data, combined with EMCDDA estimates on levels of problematic opioid use in European countries, it can be estimated that over half of people with problematic opioid use in Portugal are in some form of opioid substitution treatment, slightly above the European average.

Harm reduction has also been a central tenet of the Portuguese drug policy reforms. The latest available data indicate that 1.3 million syringes are being distributed per year. This is significantly down since 2003, when the figure was at 2.6 million, but is still one of the highest in the EU.45 Portugal also has an estimated 2,137 needle and syringe programmes in operation, roughly three times the number of Spain — despite being a quarter of the size in population. Nonetheless, some advocates have been ‘frustrated by what they see as stagnation and inaction since decriminalisation came into effect’, particularly in relation to overdose prevention centres, naloxone provision, and needle and syringe programmes in prison. Portugal did finally open its first mobile overdose prevention centres, in Lisbon and Porto, in 2019. Other harm reduction efforts have been praised — including in relation to the provision of safer smoking kits — but it is clear that continued investment is needed.

SOCIAL COSTS

A 2015 study found that the social costs of drug use in Portugal fell 12% between 2000 and 2004, and 18% by 2010. While the former figure was largely driven by the reduction in drug-related deaths, the latter was linked to a ‘significant reduction’ in costs associated with criminal proceedings for drug offences and lost income of individuals imprisoned for these offences.

CONCLUSION

Portugal has set a positive example for what can be done when drug policies prioritise health rather than criminalisation. At the turn of the century, Portugal was facing a crisis, including high levels of HIV infection among people who use drugs. Many impacts of reform were felt immediately: new HIV infections, drug deaths and the prison population all fell sharply within the first decade. The second decade saw slower improvement in key measures, as well as an upturn in drug deaths. However, many of these factors need to be put into context. Drug policy is still only one variable interacting with a complex mix of social, economic, cultural and political factors, and cuts to wider health provision in that period will have played a part in this. Nevertheless, Portugal is in a much better position than it was in 2001 and recorded drug use and drug deaths as a proportion of the general population are both well below the European average.

Portugal’s experience is a lesson in what can be achieved when policy innovation and political will are aligned in response to a crisis, and hopefully it will continue to evolve and lead on this issue. However, while ending the criminalisation of people who use drugs is hugely important both in its own right, in reducing stigma and as an enabler of any effective public health response, it only addresses part of the harms caused by prohibition. With innovation taking place elsewhere, including regulated cannabis sales in North America and safe supply of opioids and other drugs in Canada, there is also room for Portuguese drug policy to learn from and build upon other reform efforts, and continue in its global leadership role.

Russell on the Future

So, how did Her Majesty's Prison and Probation Service do yesterday in the Spending Review? It's a pay freeze for probation staff and £4billion over four years for 18,000 new prison places - to create jobs of course. This forced marriage really isn't working too well on any level is it? Whilst the reality sinks in, HMI Justin Russell recently gave an interview to Civil Service World:-  

Probation inspector Justin Russell on coronavirus, Transforming Rehabilitation and the Spending Review

After years of funding cuts and the looming renationalisation of outsourced probation services, Russell calls for extra funding to be “baked into the baseline” for the Spending Review

This summer, HM Inspectorate of Probation did something it had never done before: it began conducting entirely remote inspections of probation services for the first time. The change came around a year after Justin Russell was appointed to lead the inspectorate – for the first few months of which, the job was pretty much what he expected. “And then obviously, Covid happened”

When Russell speaks to CSW, the inspectorate has just published its first entirely-remote report on the North Yorkshire Youth Offending Team. It’s now inspecting several other youth-offending services, as well as thematic inspections of the impact of coronavirus on probation services. “We’ve found we can do that – we can do the focus groups and analyse the case remotely,” he says.

And HMIP has been looking at how probation services are adapting to the pandemic, having gone into six local areas over the summer to see how both public and outsourced services were coping. After examining around 60 cases in detail, Russell says “we were positive about how they reacted”.

“They've had to react at a very great pace, they've had to completely switch their operating model. So apart from a small number of high-risk people, everyone is being contacted by phone. They have had to suspend some basic services – certainly during lockdown, they weren't providing any unpaid work sentences for the courts, and they weren't able to start accredited behaviour programmes. They are now starting to be able to do those, but it's been a slow process of recovery.”

And the new arrangements have worked for some people, he says. Many of the probation staff that inspectors spoke to were happy about the arrangements, as well as service users who had a “reasonably stable home life – some of them actually, in some ways, preferred being supervised by phone because it meant I didn't have to sort out childcare or find public transport”.

But the changes have been harder for more vulnerable users, including those with mental health problems. “They definitely struggled a bit more and missed having that personal, face-to-face contact with the probation officer.”

One of the happier consequences of this that Russell has seen is that coordination between public agencies seemed to improve during lockdown. Probation services had more check-ins with police and social services to share information about call-outs they had had, and attendance at multi-agency risk panel meetings went up when they were held virtually. “So that felt like a positive thing.”

And providers are finding other ways to adapt to the pandemic, restarting services they had to cancel during lockdown, using smaller groups and online courses where they can.

But the inspectorate is also aware that the effectiveness of remote supervision in probation is not well understood. A literature review it did a couple of years ago found “there hadn't been any robust research” on the subject, Russell says. There have been no randomised trials exploring whether it provides better outcomes than face-to-face supervision, for example. “So we really didn't know whether phone supervision would be effective or not – and to be honest, we still don't know.”

But while feedback from both probation staff and service users has been “reasonably positive”, problems can arise when the two haven’t met before. “So where professionals have already met someone face to face and done the initial assessment, it’s easier to continue liaising with them over the phone; where you've never met and you’re doing the whole thing over the phone, I think people find that a bit more difficult. So that's where the gap is.”

Many probation services have tried to address this by having an initial meeting in an office before moving to remote supervision, and keeping up in-person appointments for people who have just left prison. Asked if he thinks there should be a standard policy, Russell says it’s for probation services to decide. “What we will continue to do is inspect the quality of the work they're doing, whether they do that face to face, or by telephone.” As it inspects more cases, the inspectorate will be able to build up some of the evidence it lacks on how the mode of delivery affects services, he says.

In fact, HMIP began a two-month study at the end of September on how probation services are recovering from lockdown. The national inspection is looking at six local areas and 250 cases – some that started before and others after lockdown measures were introduced – to see how well services’ planning and recovery is panning out.

“That will start to give us some insights into the quality of work that they're doing, as well as the quantity of it,” Russell says. “It's a big enough sample that we'll be able to hopefully start to get into what's the quality of work that's been done over that period. You know, recovery is a slow process. I think all the regional directors I'm talking to are saying, ‘This isn't going to happen overnight’.”

In the last couple of months, services have started increasing their face-to-face delivery, starting up unpaid work placements, and opening up behaviour programmes again. And with the courts now sitting again, new community sentences are coming through that the inspectorate will have to keep an eye on. But Russell acknowledges that the delivery of in-person services could start “going backwards a bit” now that the second wave of coronavirus has hit.

All this is forming the backdrop to services’ preparations for some massive reforms that will come into play next year when the National Probation Service regains responsibility for low and medium-risk offenders, which was handed to private Community Rehabilitation Companies in 2012. The Transforming Rehabilitation outsourcing programme is widely acknowledged to have been a failure – Russell’s predecessor, Dame Glenys Stacey, concluded last summer that it was “irredeemably flawed”.

But Russell says preparing for the transition next June is a “really big challenge for probation leaders and directors” already dealing with the consequences of the pandemic. The inspectorate will be following their progress closely and will be doing an inspection on transition planning by the end of this year.

He also warns that bringing services back under public control is no easy fix because “structural change by itself very rarely solves all of your problems – you need the resources to back it up.” Probation officers in both CRCs and the NPS have been struggling with huge caseloads due to a lack of resources, and services have suffered as staff have become more and more stretched – but HMIP’s inspection reports of CRCs have been particularly critical.

While there are signs of improvement in some areas – some CRCs have improved their performance in the most recent round of inspections – some just aren’t getting better. He says a “three-tier” probation service has emerged, “with the NPS continuing to perform okay – although it's got its own issues; two or three providers actually do reasonably okay now; and then some that are still really struggling.” Of particular concern are those in the Midlands and some of the Purple Futures partnerships, which are led by Interserve, the contracting giant that was sold last year after financial trouble threatened it with collapse.

Russell is concerned that shifting the CRCs’ massive caseloads to the public sector without a serious funding injection to hire more staff and spread the load is “not necessarily going to improve quality”.

“And you're going to potentially have issues as people are transferring over, there might also be a loss of focus during that transition process,” he adds. CRC staff moving over to the NPS must get adequate training before they take on high-risk service users.

As with most things, Russell says the success of the latest reforms rests in no small part on whether they are properly funded, noting that “the history of probation funding over the last 10, 20 years has been one of increasing cuts.” For one thing, the Ministry of Justice’s budget has not been protected under the austerity measures that began in 2010. The impact on violence in prisons has been well documented, but Russell says there have been some “big impacts” on probation too.

In fact, there has been a 40% real-terms drop in probation funding per case since 2003 – as HMIP’s submission to the Treasury for the upcoming Spending Review points out. “That's a big gap to make up going forward, and that's why it's so important that the Spending Review does start to address that gap.”

That funding is critical because when probation officers are having to supervise 70 or 80 people at a time, it doesn’t just affect staff wellbeing – although Russell notes the inspectorate has seen very high sickness rates. “It just becomes unsustainable if you're trying to keep an eye on what's happening in their lives,” he says. Things can get missed – things like if a service user changes their address, meets a new partner or moves in with someone who has children, or if the police fail to share the information about an arrest.

“In every service, we look at a sample of the cases they’re supervising and we are consistently finding the area of weakest performance is around managing the risk of harm to people's families or to the wider community,” Russell says. At private providers, fewer than half of cases are being satisfactorily supervised in relation to risk of harm. That figure is slightly lower at the NPS, but still too high.

As well as the funding issue, services are finding it hard to fill vacancies. HMIP has no nationwide data for CRCs, but found the NPS had 600 vacancies in June 2019, and was having to use agency staff to plug the gaps.

Does Russell believe ministers have grasped the enormity of the problems in front of them? “Very much so, and the HMPPS leadership certainly does as well.” He points to a £150m funding increase for probation this year, as well as a capital funding boost that he hopes will address the “pretty shocking” conditions on some premises. And HMPPS has meanwhile committed to hiring 1,000 probation-officer trainees by January.

But he stresses that the extra funding cannot be a one-off, but has to be “baked into the baseline” for the Spending Review. Not only do services have a shortfall to make up after years of cuts, he adds; the government’s pledge to reverse cuts to police forces by recruiting 20,000 more officers in three years will generate extra work “over and above just closing existing funding gaps”.

He says it’s difficult to know whether the Spending Review will deliver that critical extra funding – and adds that it’s not only probation-specific funding that matters. “It's the funding for all of the other services that they work with. There's a whole ecosystem of support that goes around probation and mental health services, drug services and support services. And all of those suffered as well over recent years.”

Homelessness is one such area, he says. HMIP published a study earlier this year showing 11,000 people leave prison into homelessness, including 3,000 higher-risk offenders. It also found the proportion of people who got called back into prison or reconvicted was twice as high for people who didn't have stable accommodation after they left prison services, “so it’s potentially a really big driver of crime and reoffending”.

“So there's a huge need for decent and stable housing for people coming out of prison, which needs to be invested in. Ten or 15 years ago, the probation service actually had its own budget to commission its own accommodation for offenders. That's gone.” Instead, it can only commission a small number of so-called “approved premises beds” for the people at highest risk, which can only accommodate people for 12 weeks.

Another “really big gap” is support for substance abuse, he says. He points to Dame Carol Black’s ongoing review for the Home Office on the misuse of illegal drugs, which has shown funding for drug treatment had plummeted, while Class-A drug deaths are at a record high.

“So it's all very well funding probation, but you also need to fund the services they refer on to, to make a big difference,” Russell says. He hopes the cross-government group on crime and reoffending – which is chaired by the prime minister and is being given evidence on these matters – is a sign things could change.

This is a subject Russell knows well, having spent a year at the University of California Berkeley earlier in his career on a fellowship looking at substance-abuse treatment programmes for offenders in the US, and what could be learned for the UK. “That was a really key year in my career, where I went from being someone with a research interest to a much broader policy interest and realised the difference the government could make in some areas,” he says.

The ideas he brought back from that led directly to the introduction of the drug testing and treatment order, a community sentence including treatment and rehabilitation for people with a record of drug-related offending, in the 1998 Criminal Justice Act. Russell was a policy adviser to then-home secretary Jack Straw at the time. “So that's very satisfying to see that translate into a direct policy initiative,” he says.

“The reason that was so seminal a year was that it sparked off that interest in evidence-driven policymaking and looking at different innovations at the front line and thinking about how you can translate that into practice – and how things roll out, and the interaction of politics and government and evidence and social-policy experts... that ended up being what I've done in my career.”

Beckie Smith