Care or custody?:an evaluation of palliative care in prisons in North West England

This study aimed to evaluate health professionals' views about palliative care provision in prisons in the counties of Cumbria and Lancashire in the North West of England. Seventeen prison healthcare staff and nine specialist palliative care staff participated in semi-structured interviews and 16 prison healthcare staff completed a questionnaire designed to measure knowledge, skills and confidence in relation to palliative care. The findings highlighted tensions between the philosophies of care and custody, and the many challenges in providing palliative care in a custodial setting. This paper presents two illustrative case study examples, and suggests ways in which some of these challenges can be overcome in practice

An evaluation of the CARAT initiative.

CARAT (Counselling, Assessment, Referral, Advice and Throughcare) schemes have been operational in prisons throughout England and Wales for three and a half years, designed to increase the support available to drug-using prisoners both during custody and on release. Specifically the CARAT service has a remit to ‘bridge the gap’ between custody and the community. However, to date there have been few attempts to evaluate schemes or their impact on throughcare provision. This article presents some research findings which highlight a number of shortcomings with current throughcare provision, many of these stemming from ineffective partnership working between the agencies that share responsibility for this. A qualitative design was used, employing semi-structured interviews to ascertain the beliefs and experiences of drug users and those working with them on either side of the prison gate. The authors propose a radical re-structuring of the services in place to support drug-using offenders on release, with the aim of promoting continuity of care, facilitating effective joint working between agencies and securing a responsive and accountable service for users

Incontinence in women prisoners: an exploration of the issues

Aim. This paper is a report of a study exploring the extent and management of bladder and bowel problems in order to inform the provision and practice of prison nursing services and health care services in women's prisons. Background. Nurses and general practitioners provide primary care services inside prisons in the United Kingdom. While high levels of mental health and addiction problems in women prisoners are recognized, there has been less focus on physical problems. Incontinence symptoms are perceived as shameful and stigmatizing, and frequently help is not sought from healthcare professionals. Guidance for assessing prisoner health does not refer to bladder and bowel symptoms. Methods. Women prisoners in a large, closed prison in the United Kingdom were surveyed in 2005 using an anonymous self-completed questionnaire. Women resident in the detoxification unit and the hospital unit, absent from their unit at the time of questionnaire distribution or deemed vulnerable by prison health staff were excluded. Results. Questionnaires were offered to 283 women and 246 agreed to take it. Of those taken, 148 (60%) were returned. Twenty-four per cent indicated that they disclosed information about bladder and bowel problems in the survey not previously disclosed to anyone else. Forty-three per cent reported urinary symptoms. Five per cent reported nocturnal enuresis. The majority of women with symptoms reported using sanitary pads and toilet paper for containment of leakage. Conclusion. Prison nurses and nurse practitioners involved in reception into prison assessments should ask direct but sensitive questions about women's bladder and bowel symptoms

Changing Shape and Shifting Boundaries — The Media Portrayal of Probation in Ireland

Literature on the media representation of probation highlights that probation as a ‘brand’ and concept is poorly understood and lacks public visibility. This has implications for its legitimacy and credibility. In this article we explore probation’s visibility in one country, the Republic of Ireland, through a critical analysis of print media representations of probationover a 12-year period (2001 to 2012). While our study finds that the majority of the coverage of probation was either positive or neutral in tone, we note a recent shift towards a more negative tone that we argue is reflective of the changing shape of the penal-probation boundaries. These changes are linked to resourcing of the criminal justice system and have implications for the public perception of probation. <br/