HMP Lowdham Grange

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We assessed 2 quality statements for this key question. We found there was robust leadership of the service and governance processes were being embedded to strengthen the service. Partnership working with the prison was good and stakeholders felt positive about the improvements made by health leaders.

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

The judgement for Shared direction and culture is based on the latest evidence we assessed for the Well-led key question.

The interim head of healthcare (HOHC) had provided robust leadership since the start of the contract in July 2025. Healthcare staff and senior prison leaders spoke positively of their leadership and the improvements they had implemented. It was particularly impressive that the interim HOHC had taken ownership of the service in spite of their temporary position in the absence of a substantive leader. At the time of inspection, recruitment was ongoing to find a suitable candidate, and the interim HOHC had committed to remain in post until one was recruited and a thorough handover could be given.

The recent addition of a deputy head of healthcare had further strengthened the managerial oversight across the service.

Relationships with stakeholders including the Independent Monitoring Board, the chaplain and education staff had developed positively which had raised the profile of healthcare within the prison.

The judgement for Freedom to speak up is based on the latest evidence we assessed for the Well-led key question.

The judgement for Workforce equality, diversity and inclusion is based on the latest evidence we assessed for the Well-led key question.

The provider had worked hard to establish the foundations for a more stable service after inheriting significant shortfalls in multiple areas at the start of the contract in July 2025. Consistent leadership had improved partnership working with the prison and provided stability for staff. There had been sustained efforts to embed governance processes within the service and implement trust policies and procedures which had improved outcomes for patients in areas such as mental health and medicines management.

The local delivery board, led by the prison and attended by health managers and commissioners was held regularly and had become more effective. Meetings were well-attended and managers were held to account for actions assigned from the meeting.

An audit programme was now in place to systematically evaluate aspects of the service and was driving improvements in areas such as infection prevention and control, and it was reassuring that concerns identified during the inspection were already known to the provider and documented on the service risk register. The risk register, alongside a comprehensive service improvement plan clearly set out actions required to mitigate risk and improve service delivery with clear lines of accountability and escalation routes with senior managers.

The judgement for Partnerships and communities is based on the latest evidence we assessed for the Well-led key question.

The judgement for Learning, improvement and innovation is based on the latest evidence we assessed for the Well-led key question.