Prison Healthcare Study

This study has been commissioned by the Health Foundation
For information on how we use data click here

Data collection for study: Spring 2022  
Publication date:      Spring 2023 (TBC)   

Aim:To identify remediable factors in the clinical and organisation of healthcare for people who died from a ‘natural’ or other ‘non-natural’ death whilst detained in prison or were transferred to an acute NHS hospital or hospice, whilst detained.
To produce focused, evidence-based recommendations to improve the commissioning, monitoring, provision and quality of healthcare in prisons, with the aim of preventing avoidable and premature deaths in the future.

Objectives:

Organisational To review:

• The healthcare provision available
• Networks of care/healthcare pathways
• Access to acute NHS hospitals
• Processes/ standards/ systems and impact of transfers between prisons
• Multidisciplinary team working
• The commissioning of services
• Adherence to national clinical guidelines/quality standards relevant to the organisation of services for the medical conditions being treated (e.g. NICE guidelines and quality standards)
• The use of local policies and protocols
• Training for healthcare related matters
• Healthcare commissioning arrangements
• Interface between healthcare and operational staff
• Professional structures, networks and support for prison doctors
• Examples of good practice

Clinical To review:

• The cause of death
• Whether death was thought to be avoidable or premature
• The quality, nature and timeliness of healthcare provision and delivery, including ‘out of hours’ care
• Recognition and treatment of acute medical emergencies and deteriorating clinical conditions
• The quality of multidisciplinary healthcare delivered
• Evidence of healthcare reviews for individuals
• Prescribing and medicines reconciliation by pharmacists
• Adherence to national clinical guidelines/quality standards relevant to the medical conditions being treated (e.g. NICE guidelines and quality standards)
• The quality of drug and alcohol detoxification, including an assessment of dependence
• The content and quality of the NHS commissioned independent clinical review
• PPOs judgment of whether healthcare received was commensurate with that expected in the community.

Participation:

All prisons and hospitals in England and Wales where an adult prisoner (aged 18 or over) has died of a ‘natural’ or ‘other non-natural’ death whist in custody of HMPPS.
This page will be regularly updated, so please check for updates. Any queries relating to this study should be also addressed to prisonhealth@ncepod.org.uk.
Resources:
Her Majesty’s Prison & Probation Service
Prisons and Probation Ombudsman
House of Commons Health and Social Care Committee report ‘Prison Health’ 2018
Nuffield Trust Research on healthcare in prisons