Call for equal health care in prisons

Guidance says every prisoner should be assessed by a health professional

Prisoners should receive the same standard of health care as others in society, according to draft recommendations.

The guidance from the National Institute for Health and Care Excellence (NICE), calls for every person admitted to prison to receive a healthcare assessment before they are allocated to a cell.

Director for the NICE centre of clinical practice Mark Baker, said: ‘Our prison population is getting older, meaning they are more likely to have complex, chronic healthcare needs.’

The document, Physical Health of People in Prison, states that the initial prison assessment should be carried out by a healthcare professional under the supervision of a nurse. It should identify any issues that might affect the prisoner’s immediate health and safety. Questions should cover physical health, alcohol and drug use, mental health, self-harm and risk of suicide.

Health-promoting activities

The guidelines recommend that a follow-up, second stage health assessment should be carried out within seven days of the first, including offering the inmates tailored advice based on their answers and asking if they want to attend any health-promoting activities such as the gym or smoking cessation courses. Those who are being released from prison should receive help to register with a GP and be provided with a post-release care plan, says the guidance.

The number of prisoners aged 60 and over increased by 164% between 2002 and 2015 across England and Wales. It is the largest growing age group in the prison population. It is estimated that more than 80% of male prisoners aged 60 and over suffer from a chronic illness or disability. Some research suggests that prisoners over 50 years have levels of illness comparable to 60 year olds living outside of prison.

Former HMP Stafford prison nurse and winner of Nursing Standard's nurse of the year 2011, Johanne Tomlinson, said: ‘This guidance is really excellent news for offender health and for nurses working in prisons. It is structured, covers everything, and can be referred back to.

‘Often when offenders arrive they are nervous and stressed and want to get to their wings, so a second assessment is a fantastic idea. Where services fall down is in continuity of care, so hopefully these guidelines will help with that, both in prison and on release.’

Resources and staff

RCN professional lead for criminal justice nursing Ann Norman welcomed the inclusion of initial and second stage assessments in the guideline but said nurses have to be given enough time with prisoners.

She added: ‘There needs to be the resources and staff, so we need to make sure we have got the right nurses, and the right level of expertise and skill so they understand the complexities of how people present. 

‘It is often someone with an enduring mental health problem, they may be traumatised as they have been given a long sentence and it takes quite a lot of skill to assess them.’ 

A consultation on the draft guidelines closes on June 27.


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