In its Annual Report 2025 published 10th June 2026 (see its press release below), the Independent Monitoring Boards (IMB) warns of systemic failings across immigration detention that continue year after year and that these issues are becoming more acute.  It is beyond comprehension that we are in a position where longstanding issues – some of which a public inquiry found could amount to inhuman and degrading treatment – could get any worse.

Yet Medical Justice is sounding the alarm once again that the severity and prevalence of harm is indeed set to worsen as the government opens more immigration detention sites and plans to decimate already-failing safeguards. Medical Justice has been providing undisputed medical evidence of the severe harm caused by immigration detention for over two decades; the government cannot pass the harm off as accidental.

We should all be deeply troubled by the devastating and avoidable harm caused to vulnerable people who may never recover from it and as a society we should not accept it. Together with experts such as the British Medical Association, Medical Justice calls for immigration detention to be phased out.

Medical Justice receives 400-500 referrals a year from people in detention.  Our latest audit of medico-legal reports shows that of those assessed by our independent doctors:

  • 82% were survivors of torture.
  • Healthcare screenings on arrival in detention failed to identify critical vulnerabilities, missing 77% of the survivors of torture and 89% with a reported history of trafficking.
  • 99% had at least one mental health condition, including post-traumatic stress disorder.
  • 97% suffered a deterioration in their mental state while in detention.
  • 74% had an increased risk of suicide since they were detained.
  • Only 6% of clients that Medical Justice clinicians assessed as having been harmed by detention had a safeguarding report as required by Rule 35 (1) of the Detention Centre Rules.

 

IMB 2025 National Annual report.   

Harm without accountability: force, failed safeguards and prolonged detention in the immigration system

In the 2025 national annual report published today (10 June 2025), Independent Monitoring Boards (IMBs) present a troubling picture of systemic failings across immigration detention that continue year after year, exposing detained people to avoidable harm while falling short of the minimum standards that are meant to be upheld in detention.

Drawing on evidence from immigration removal centres (IRCs) and short‑term holding facilities (STHFs), Boards report that practices intended for use only under exceptional circumstances, including the use of force and isolation, are increasingly applied as a matter of routine, often for operational convenience rather than necessity. Despite repeated scrutiny, many of the most serious concerns raised by IMBs in previous years remain unresolved. Boards increasingly encountered challenges in discharging their statutory scrutiny role: access to information was at times lacking or curtailed, subject to undue delays and questioning, or denied altogether.

In 2025, 22,996 people entered immigration detention, an increase of 11 per cent on the previous year. As detention numbers rose,  existing weaknesses were compounded.  The issues identified by IMBs, and their impact on people in detention, were such that my predecessor did not always wait for the annual reporting cycles of individual Boards to raise these concerns. Instead, they were escalated in real time, in line with our statutory duty to safeguard people in detention, leading to the publication of our first thematic review on immigration detention, focused on the use of force.

The IMB reports the following:

Prolonged and unnecessary detention caused avoidable harm

Despite a rise in enforced removals, most people detained were ultimately released, often after prolonged periods in detention.

  • IMBs flagged excessive stays in detention, including one individual detained for more than 15 months, raising concerns about whether the conditions required for detention to remain lawful – namely a realistic prospect of removal within a reasonable time – continued to be met.
  • Many people remained in detention long after being granted bail, including one person who was held for well over a year whilst local authorities and health agencies disputed responsibility for providing care.
  • Boards repeatedly identified administrative inefficiencies that unnecessarily prolonged detention, including for individuals who were willing to return to their country of origin voluntarily.

IMBs concluded that lengthy, indefinite and unnecessary detention drove much of the emotional distress observed across the immigration detention estate.

Force used as routine practice rather than a last resort

IMBs found that fundamental principles governing the use of force, including necessity, proportionality and the requirement that force be used only as a last resort, were frequently overlooked. Detained people were routinely subjected to force for reasons of operational convenience, with limited effective oversight.

  • Routine handcuffing during transfers, including hospital visits, was widespread, with little evidence of meaningful, individualised risk assessments.
  • At Brook House IRC, detained people told the IMB they would only be taken to hospital if they agreed to be handcuffed. The Board considered this practice coercive.
  • Boards documented cases in which people avoided healthcare appointments altogether because of the stigma, distress and humiliation of being handcuffed in public.

Isolation and confinement increasingly used for operational ease

Separation, which is intended to be used only as a last resort safety measure, was frequently applied to manage removals and anticipated disruption.

  • At Heathrow IRC, one individual was held in a separation unit for eight nights prior to removal.
  • Boards observed people with complex mental health needs spending prolonged periods in isolation, including one individual at Heathrow who had yet to be transferred to a psychiatric unit after five weeks.

Safeguards repeatedly failed vulnerable people, including children

IMBs continued to raise serious concerns about the effectiveness of safeguarding systems intended to prevent further harm. Boards found that shortcomings in screening processes frequently allowed extremely vulnerable people to enter detention.

  • At Heathrow IRC, children remained detained for nearly two weeks while awaiting age assessments, despite clear policy expectations that their detention should be avoided at all costs.
  • Boards across the estate identified additional failures, such as detained people being left without proof of welfare checks for hours.
  • Mechanisms intended to ensure medical considerations are central in decisions to detain or release those deemed unfit for detention are often ineffective; in most cases, people remain detained even when doctors warn that continued detention would cause serious harm to their health.
  • Under the UK – France returns pilot scheme, the IMB at Gatwick found that 12% of cases involved age disputes, of which over 20% were later assessed to be children, indicating serious safeguarding gaps.
  • Many individuals included in the pilot were recognised as highly vulnerable, from asylum seekers to victims of modern slavery, yet were held in detention for longer than average, unclear as to what would happen to them when returned to France.
  • Other vital safeguards such as access to interpretation and legal advice were severely hampered: detained people struggled to access information in a language they could understand.

Healthcare delays caused deterioration

Access to healthcare was frequently delayed or obstructed, with significant consequences for detained people’s health.

  • Even in emergencies waits could be excessive: in one case it took nearly three hours to secure an emergency medical response for a suspected stroke.
  • Another individual had to wait one month to see a doctor for a broken finger.
  • In STHFs, people continued to be systematically denied access to their prescribed medication, regardless of whether these may be for serious and life‑threatening conditions.
  • Boards also reported breaches of medical confidentiality, and that healthcare staff sometimes assessed individuals’ mental health needs as manageable in detention until deterioration reached a level requiring sectioning under the Mental Health Act.

Distress, self‑harm and suicide attempts remained widespread

Across immigration removal centres, IMBs reported high levels of serious self‑harm and suicide attempts.

  • Uncertainty about case progression and length of detention was a major driver of distress, with Boards observing an increasing number of people requiring constant supervision.
  • At several sites, incidents linked to attempts to avoid removal, including self‑harm and climbing on the netting.
  • Across Boards, increased levels of self-harm are raising questions as to whether the care available was sufficient, despite prompt responses from staff in many cases. Practical measures to prevent furnishings being used for ligatures were at times delayed or ineffective.

Interim IMB National Chair, Jane Leech MBE says:

“Having monitored immigration detention for just under two decades, and having served on local Boards, and the National Board, I have a well-grounded understanding of the issues that have shaped the immigration detention estate over time. While IMBs do identify individual examples of good practice, these are unfortunately not reflected consistently across the system.  We have seen patterns repeat, warnings ignored, and risks re-emerge in different forms. The evidence available to us strongly suggests that many of these longstanding issues are not only unresolved but are becoming more acute. We repeatedly see health deteriorating in closed settings, delays in accessing medical care, rising distress, and vulnerable individuals becoming more unwell the longer detention continues. These are outcomes we observe directly, not theoretical risks.

This is not a moment for complacency. It is a moment that requires honesty about the deterioration of conditions, and confidence in the evidence.

The Home Office must exercise stronger oversight and clearer accountability in how detention is used in practice. Without decisive action to address problems that have been evident for many years, people in immigration detention will continue to experience avoidable harm.”

Download the IMB Annual Report 2025 here.