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Significant improvements have been made in prison healthcare in the last ten years, a comprehensive new report has found.

The review by Public Health England (PHE) looked at 80 research papers and the results of 40 one-to-one interviews with key individuals. Its aim was to highlight the strengths and weaknesses in the treatment of people in secure and detained settings since 2006, when the NHS took the reins from the Home Office.

“The consensus view of the majority of key informants was that prison healthcare services have undergone ‘transformation’ during the ten-year time period…leading to significant improvements in quality of care,” the review states. 

According to the research, there has been a rise in clinical standards and accountability, thanks to the employment of offender healthcare staff who have nationally recognised qualifications and are members of professional bodies. Furthermore, systems for documenting complaints have been useful in monitoring services and making regular progression. 

In particular, credit was given to the National Partnership Agreement between PHE, NHS England and the National Offender Management Service for heightening engagement amongst relevant parties.

Moreover, the report affirms that the successful factors identified “significantly contribute to achieving improved health outcomes for this population”.  

Along with outlining the strengths of the health service in prison settings, the document also draws attention to areas where further enhancements could be made. For example, the research suggests that there is a recognised need for the development of new care models, along with additional practitioners such as nurse prescribers, pharmacy assistants and social care support workers. Efforts should also be made to lessen the impact of prison staffing levels and other operational issues on prisoners’ access to healthcare. 

Services could also be more cost effective, the review continues. Indeed, it states that “challenges were identified around the inadequacy of commissioning budgets to meet the high needs of the population and/or cope with in-year or new demands not associated with specific resources”. 

Meanwhile, early intervention could be more swift in prison settings, in order to avoid “more advanced disease (which is costly as well as harmful) or self-harm/suicide”. It also stresses that healthcare professionals should consider the age and gender of prisoners and detainees when arranging treatment. It asserts: “People in prison with different characteristics require different solutions – not one-size-fits-all.” 

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