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

Understanding and supporting the health literacy of young men in prison:a mixed-methods study

Purpose: Prisons offer a public health opportunity to access a group with multiple and complex needs and return them to the community with improved health. However, prisons are not conducive to optimal health and there are few frameworks to guide efforts. This study aims to generate insights into health literacy across a young adult prison population, specifically examining the level of limitations, barriers and characteristics associated with these limitations.Design/methodology/approach: The study took place in a single prison in England for young adult men aged 18–21 years old. A mixed-methods design was adopted with 104 young men completing a quantitative survey and qualitative semi-structured interviews with 37 young men.Findings72% (n = 75) of young men scored as limited in their health literacy. Barriers included structural restrictions, limited access to formal support and social and natural disruptions. No demographic characteristics or smoking intentions/behaviours predicted limited health literacy, but characteristics of the prison were predictive. Physical problems (sleep, nausea, tiredness and headaches), mental health and well-being (anxiety, depression and affect) and somatisation problems were also predictive of limitations.Practical implications: Prison healthcare services and commissioners should undertake regular health literacy needs assessments to support developments in reducing barriers to healthcare and increasing health improvement efforts. Action also requires greater political will and investment to consider broader action on the wider determinants of (prison) health.Originality/value:The study provides a framework to understand and guide prison health efforts and highlights attention needed at the level of governments, prison leaders and their health systems

Participation in sport as a mechanism to transform the lives of young people within the criminal justice system::an academic exploration of a theory of change

Sport is often framed as a panacea for social disharmony, especially within the context of marginalised youth populations, and is widely promoted as a mechanism through which a multiplicity of social policy objectives can be achieved. Yet while political rhetoric has long pointed towards sport’s transformative abilities, the basis for such claims remains unproven. Theory-based approaches to evaluation have been posited as a useful device to explore the impact of specific initiatives and indicate where best practice may operate. The aim of this paper is to highlight one such theory-based framework that has been devised by practitioners in recent years around the operationalisation and evaluation of sporting interventions in criminal justice settings and which has come to be adopted as the dominant ‘theory of change’ across sport and criminal justice practitioner settings in the UK, but has, as yet, eluded academic scrutiny. To address this omission, the present discussion offers an in-depth analysis of this framework with the aim of discerning more clearly ‘what might work’ within sport and criminal justice contexts. In turn, the paper aims to stimulate further academic debate around the instrumental role of sport within criminal justice and the value of such frameworks for both policy and practice

Producing food in English and Welsh prisons

Most prison food research focuses on aspects of consumption rather than production yet farming, horticulture and gardening have been integral to the prison system in England and Wales for more than 170 years. This paper explores the interplay between penological, therapeutic and food priorities over the last fifty years through an examination of historical prison policies and contemporary case studies associated with the Greener on the Outside for Prisons (GOOP) programme. Findings are discussed in relation to how joined-up policy and practice can impact positively on whole population health and wellbeing within and beyond the prison setting

A scoping review of interventions to improve oral health in prison settings

OBJECTIVE: To describe the characteristics of oral health interventions implemented in prison settings and explore the barriers and facilitators towards implementation. METHODS: Following Joanna Briggs Institute scoping review methodology, six databases were searched including Medline (R), Emcare, Embase, AMED, Cochrane and PsycINFO. A total of 978 studies were returned and screened. The inclusion criteria were those studies conducted in a prison population, with an intervention to address oral health and published since 2000. RESULTS: Ten studies published between 2008 and 2021 were included. All were conducted in high-income countries. Three intervention types were identified: health education (n = 5), teledentistry (n = 3) and screening or triaging (n = 2). The barriers and facilitators to successful implementation were grouped into a framework of four overarching concepts. These included prison environment, population makeup, compliance and staffing. CLINICAL SIGNIFICANCE: Evidence suggests that oral health interventions in prisons are focused on improving access to services and oral health messages. A range of drivers including the prison environment, staffing levels, recruitment and intervention compliance influence implementation and the success of interventions