HMP Chelmsford

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We assessed 1 quality statement for this key question. We found that patients did not always receive care and treatment that was assessed and regularly reviewed to ensure it met their health and well-being needs.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

Prior to our inspection, we received concerns that the reception process for new prisoners was not effectively identifying and addressing needs.

This busy prison saw an average of 15 to 20 new arrivals each day, with most prisoners staying approximately 77 days, and 85% were on remand. The provider was aware of its challenges and had identified risks within the reception process, so had begun making improvements. A new Early Days in Custody (EDIC) manager had recently taken up post, and they had reviewed and updated processes, as well as upskilling reception staff. Recent changes meant that new prisoners were now receiving timely comprehensive primary and secondary health screening, followed by referrals for assessments where needed by the relevant specialist teams. People were also given clear information on how to access health services while in prison.
Although some of these processes were still being embedded, which was reflected in our record review, staff told us they felt positive about the changes and could already see improvements.

Prior to our inspection we were told that staffing constraints sometimes impacted routine care. At this inspection, we found that patients did not always receive care and treatment that was assessed and regularly reviewed to ensure it met their health and wellbeing needs.

We found several examples where people did not have up‑to‑date or personalised care plans for their long‑term conditions. Some plans had not been completed at all, while others lacked sufficient detail such as clinical observations or personalised information on symptoms, triggers or risks. These gaps meant staff did not always have the information they needed to support people safely or identify changes in health. However, we also saw examples of comprehensive, person‑centred care plans that demonstrated patients were treated as individuals, with their specific needs clearly considered and recorded.

There was no structured approach to long‑term condition (LTC) management to ensure that people’s health was monitored consistently and that annual reviews took place. At the time of our visit, many patients were waiting long periods for their annual review, and there were no dedicated clinics. Instead, people needing review were placed on the emergency ledger. Staff were working hard to ensure patients were seen and they told us this was manageable, but it created a very busy workload alongside responding to emergencies. Staff described plans to strengthen LTC management, including the appointment of a new lead who was exploring the introduction of a weekly LTC clinic and ways to streamline monitoring. However, these improvements were not yet in place. As a result, individual needs and preferences were not always identified, and treatment was not consistently aligned with current clinical guidance.

We also reviewed the records for people held in segregation and could not find evidence that they were seen by a doctor as often as required by national guidance, or as often as their health needs demanded. Segregation ledgers for January 2026 showed gaps of up to 7 days between medical reviews. Regular clinical monitoring is essential to identify early signs of distress, withdrawal, self‑harm risk or physical health decline, and these gaps created a risk that deterioration could go unnoticed.

We also found that, due to staffing pressures, mental health assessments were not always carried out within the timeframes set out in their standard operating procedure. This requires a full, person‑centred assessment to be completed within 5 working days of referral, or within 24 hours if the referral is urgent. We found 34 patients were waiting for a mental health assessment, and the longest wait dated back to 8 January 2026. One patient, at the point of inspection, had been waiting 3 weeks for an assessment. Another patient, considered high risk, had been waiting 13 days. These delays meant that patients with mental health needs were not always receiving timely assessments or care that reflected their level of risk. As a result, risks may not have been identified or managed appropriately, and patients did not always receive safe and responsive mental health support. We also found that the mental health team’s workload was difficult to manage under current staffing constraints, with staff balancing assessments, triage, risk assessments, Assessment Care in Custody and Teamwork (ACCT) reviews, caseload reviews and gatekeeping assessments within limited timeframes due to the prison regime.

Since our inspection, the provider told us they had seen the patients we were concerned about. They have also made changes to address risks within the mental team, for example increasing oversight by giving the mental health lead direct responsibility for managing the rota.

Positively, a multi-disciplinary ‘complex case’ meeting took place each week to review patients with significant or complex care needs. Staff across all services were very complimentary about this process, and we found the meetings were well attended and well organised. These meetings allowed staff to highlight patients who required support from more than one team, discuss concerns, and seek advice on how best to manage complex situations. A summary record was completed for each patient discussed, and their individual clinical record was updated with the actions agreed at the meeting. We also saw minutes were completed. This helped improve oversight and coordination of care for patients.

The judgement for Delivering evidence-based care and treatment is based on the latest evidence we assessed for the Effective key question.

The judgement for How staff, teams and services work together is based on the latest evidence we assessed for the Effective key question.

The judgement for Supporting people to live healthier lives is based on the latest evidence we assessed for the Effective key question.

The judgement for Monitoring and improving outcomes is based on the latest evidence we assessed for the Effective key question.

The judgement for Consent to care and treatment is based on the latest evidence we assessed for the Effective key question.