Prison health in NHS Greater Glasgow & Clyde : A health needs assessment 2012

Gillies, Michelle and Knifton, Lee and Dougall, Rona (2012) Prison health in NHS Greater Glasgow & Clyde : A health needs assessment 2012. NHS Health Scotland and Greater Glasgow and Clyde, Glasgow.

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Abstract

Scotland has one of the highest rates of imprisonment in Western Europe and the prison population is rising [1]. In the last decade the average daily prison population in Scotland increased by 27% [1]. The burden of physical and mental illness in the prison population is high; disproportionately so when compared to the general population [2]. This has variably been attributed to socioeconomic disadvantage and lifestyle and behavioural factors such as substance misuse, smoking and poor nutrition which are common in the prison population [2,3]. Prisoners suffer from multiple deprivation [2,3]. Many are a product of the care system, have experienced physical, emotional or sexual abuse and have difficulties forming and maintaining relationships. Levels of educational attainment are low and unemployment high. Homelessness is common. Prior to incarceration prisoners rarely engage with health care services in the community; during imprisonment demand for health care services is high [3,6,7]. Traditionally health care services in Scottish prisons were provided by the Scottish Prisons Service (SPS). On 1st November 2011 responsibility for the provision of health care to prisoners was transferred from SPS to the National Health Service (NHS). The aim of the transfer was to ensure that prisoners received the same standard of care and range of services as offered to the general population according to need. The guiding principle is that of ‘equivalence’ of care. The aim of this Health Needs Assessment (HNA) was to provide a systematic baseline assessment of the health and health care needs of prisoners in NHS Greater Glasgow and Clyde (NHSGGC) and to identify gaps in the current service provision to inform service future planning and development. It focuses on the two operational publicly owned prisons within NHSGGC: HMP Barlinnie and HMP Greenock. A third prison, HMP Low Moss, falls under the remit of NHSGGC but it was under renovation at the time of this HNA. Information about the prison population was drawn from published literature and reports provided by staff from the Justice and Communities Directorate of the Scottish Government. Information about the prisons from HMP Inspectorate reports, direct observation and interviews with members of staff in each prison. To fully understand the level and nature of existing services a service mapping was undertaken jointly with nominated staff from the prison health teams using direct observation and extensive staff and prisoner interviews and focus groups. Overall the findings are in line with other national and international studies on prison health. Despite characteristic differences between the prisons within NHSGGC there was a high level of consensus amongst both prisoners and staff groups about health needs and priorities. The report acknowledges the thoughtful contribution of prison staff and the positive approach to improving health services that they expressed. This has impacted on the formation of recommendations that both validate existing approaches and identify opportunities and 10 priorities for health gain. In addition to more fundamental changes they identify opportunities for quick wins that do not require significant financial outlay.

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