RCN backs prisons ombudsman's call for national strategy for older people in jail

A new report from the Prisons and Probation Ombudsman (PPO) calls for a national strategy to address the healthcare needs of older people in prison

The report calls for a new approach to meeting the needs of this prison population.

PPO Nigel Newcomen reviewed 314 investigations made between 2013 and 2015; where inmates aged over 50 years had been recorded as having a natural cause of death.

He concluded that while local authorities have a legal responsiblity for assessing the care needs of older prisoners and providing support, in reality this duty is struggling to be met.

'Strapped for cash'

RCN professional lead for criminal nursing Ann Norman said older people make up the fastest-growing sector of the prison population in the UK, but their specific needs were not being adequately met.

While she praised the efforts of NHS England to make improvements, especially its work on end of life care, she said the reality was that social care services were ‘desperately strapped for cash.’

Ms Norman also questioned whether prisons were the most suitable place for an older patient to be receiving care.

‘I’m not saying: "Just let them off". But is a Victorian era prison the best place for a person in their seventies or eighties?

'They are usually at very low risk of absconding and could be better cared for in places like secure care homes.

‘At the moment these bespoke kind of services that we need are just not there – this creates such a challenge for nursing staff as they try to care for people with increasingly complex conditions, such as being in wheelchairs, or with dementia.’

Six areas of improvement

In his report Mr Newcomen identified six areas to improve:

• Healthcare and diagnosis – including screening every newly arrived person for medical history and identifying any outstanding appointments.
• Restraints – used proportionately to the risk posed by each prisoner given their individual health conditions.
• End of life care – treat prisoners needing palliative care in a suitable environment.
• Family involvement – including training special family liaison officers.
• Early release – base risk assessment criteria on health condition of older prisoners.
• Dementia and complex needs – ensure personalised care plans are in place.

He attributed the number of prisoners aged over 60 tripling in 15 years as being driven largely by increased sentence length and more late-in-life prosecutions for historic sex offences.

Mr Newcomen added: ‘Prisons designed for fit, young men must adjust to the largely unplanned roles of care home and even hospice.

‘There has been little strategic grip of this sharp demographic change. Prisons and their healthcare partners have been left to respond in a piecemeal fashion.’

Further information

• The full report is available via the Prisons and Probation Ombudsman website

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