Nurses are central to protecting physical health of prisoners

Nurses must ensure patients in prison receive the same standard of care as those outside, new guidance says.
Prison nursing

Nurses must ensure patients in prison receive the same standard of care as those outside, new guidance says.

Every prisoner should have their health assessed before being allocated a cell. Picture: Alamy

The National Institute for Health and Care Excellence (NICE) has produced guidelines aimed at nurses and other healthcare professionals working in prisons in England.

The document advises that every person admitted to prison should undergo a healthcare assessment before they are allocated to a cell. This should be done by a trained healthcare professional, or a healthcare assistant under the supervision of a nurse.

This ‘first-stage health assessment’ should include questions about allergies, heart disease, tuberculosis and learning disabilities, among other conditions.

Further guidance must then be sought from the patient’s specialist team and appointments made with healthcare professionals, such as nurses.

More than 80% of male prisoners aged 60 and above, the largest-growing group of prisoners, are affected by a chronic illness or disability.


NICE also suggests a registered general nurse carries out a second health assessment within seven days of the first one to check on any actions from the original consultation.

This should also cover questions about alcohol or drugs misuse, head injuries and family medical history, as well as planning a pre-release healthcare assessment if the prisoner is due for release in less than a month.

Vulnerable group

Richard Bradshaw, former director of offender health at the Department of Health, and chair of the NICE guideline committee, said: ‘We know that people in prison are a vulnerable population with a high health need, which requires close attention and careful management. The recommendations we have made promote well-being, prevent deterioration, assist in rehabilitation and could help to reduce re-offending.’

Other NICE recommendations include:

  • People admitted to prison should be screened for tuberculosis within 48 hours of arrival, and offered confidential tests for hepatitis B or C, and HIV.
  • The prison population should be offered tailored advice to support their well-being, including exercise, diet and sexual health advice.
  • People released from prison should receive help to register with a community GP; this will ensure any care they need is continued.

Complex health needs

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

‘Delivering the care they require in such a restrictive environment is difficult, but no less important than for anyone else.’

Further information