Stay Put; Remain Local; Go Elsewhere: Three Strategies of Women’s Domestic Violence Help Seeking

In published domestic violence strategies, there is a tendency to focus on service provision and service responses in each administrative location; rather than recognising the extent to which women and children move through places due to domestic abuse. Whilst a woman’s help-seeking may be local—if she has the information and resources, and judges it possible to do so—such help-seeking whilst staying put is only one of many strategies tried by women experiencing domestic violence. Women’s strategies are often under-recognised and under-respected by the very service providers which should be expected to be supporting women’s recovery from abuse. This article uses administrative data (monitoring records), which were collected as part of a funding programme, to provide evidence of women’s domestic violence help-seeking involving these types of housing-related services in England. More than 180,000 cases of service access over eight years provide evidence of women’s three help-seeking strategies in terms of place: Staying Put, Remaining Local, and Going Elsewhere; and the distinctive patterns of service involvement and responses to these strategies. Service providers typically attempt to assess women’s levels of “risk” and “need;” however, such snapshot assessments in terms of time and place can fail to address the dynamic interplay between women’s location strategies and their needs for safety, wellbeing and resettlement. In contrast, viewing the system from the perspective of what women do provides important insights into leaving abuse as a process—not an event—and highlights the impact of different types of services which help or hinder women’s own strategies

Healthcare governance in prisons in England:prisoners’ experiences of changes over time

According to international law, prisoners should have access to healthcare on an equivalent basis to the rest of the population, and the UK Government has stated its commitment to such equivalence. Healthcare provision in English prisons has seen several reorganisations, notably in 2006 and 2013, with the stated intentions of improving healthcare provision in prisons. This article focuses on prisoners’ reported experiences over the periods of changes in healthcare governance, with the aim of identifying whether there are improvements from their perspectives. Survey data from a sample of prisoners has been collected by HM Inspectorate of Prisons for over 20 years, and these data have been used for secondary analysis of prisoners’ health needs and experiences of healthcare in English prisons. Despite the reorganisations of healthcare governance, the trends from 2003 to 2019 are of increasing health needs of prisoners and decreasing initial access, ongoing access, and quality of healthcare provision. There is little indication of any improvements experienced by prisoners from the 2006 or 2013 reorganisations. Prisoners are widely recognised as having distinct healthcare needs, but the data analysis reveals demographic differences in health needs and health access within the prison population, and an overall decline in quality and accessibility of healthcare provision in English prisons

Healthcare in prison: Does it matter how it is provided?

Objectives From April 2013, responsibility for healthcare services for prisoners was shifted to NHS England. Administrative survey data from English prisons covering 2000-2021 was used to identify if this change affected detainees’ experiences of healthcare quality and/or access; as well as the association with other characteristics of prison or prisoner. Methods Since 2000, HM Inspectorate of Prisons (HMIP) has carried out surveys of detainees as part of its inspections. This presentation will highlight the potential of these datasets by presenting substantive results of analysis on detainees’ experience of healthcare in prison. Merging datasets over time provides continuity of some variables over the whole period, with responses from up to 95,000 individuals. Variables of detainees’ assessment of the ease of access to different healthcare professionals, as well as the quality of services provided, were analysed over time and in terms of association with different types of prison and demographics of prisoner. Results The HMIP data are used to inform inspections and reports, and an ESRC-funded project has now developed these administrative datasets for wider research use. With a timeframe of over 20 years, the data can be analysed on a range of policy-relevant prison issues, such as safety, preparation for release, support within prison, treatment of prisoners, and access to information, legal rights, education, exercise and healthcare. These can be associated with demographic characteristics of detainees, and functional types of prison; as well as the analysis presented here of trends over time and whether these can be aligned to distinct policy or practice changes. The policy change in healthcare provision in April 2013 is contextualised within trends of greater health needs of prisoners and differentials between prisoners. Conclusion HMIP detainee survey data are now archived with the UK Data Service for research use. Cross-sectional analysis on a range of demographic factors shows differential healthcare needs and experiences, and analysis over time indicates both trends and the impact, or not, of policy changes on detainees’ experiences