Improving health in prisons - from evidence to policy to implementation - experiences from the UK
Author(s): ,
Jane Leaman
Public Health England
Anna Richards
Devon County Council
Lynn Emslie
Eamonn O'Moore
PHE ePoster Library. Czachorowski M. 03/21/18; 205857; 12386
Maciej Czachorowski
Maciej Czachorowski
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Abstract Purpose - To review the impact of ten years of NHS commissioning of prison healthcare in England and through this process, identify the components of a high-quality prison healthcare system. Design/methodology/approach - A rapid evidence review was undertaken, which included a review of 82 papers and qualitative interviews with key informants. The concepts and themes identified were summarised and analysed through a framework analysis, designed to improve population outcomes and address health inequalities. Findings - The review found that English prison healthcare has undergone transformation” on transfer of commissioning responsibility from Ministry of Justice to NHS, leading to increased quality of care through organisational engagement, professionalisation of the healthcare workforce, transparency, use of evidence-based guidance and responsiveness of services.The review also highlighted areas for improvement relating to the prison regime and the lack of focus on early/preventive interventions.Research limitations/implications - Time and resource constraints meant that the rapid review was limited to papers published in English and from a small number of mainly Western countries, which may limit international transferability of findings. The lack of quantitative data necessitated the use of qualitative data gathered from key informants. Relevance to Public Health - The review findings support the World Health Organisation position on the value of integrated prison and public health systems in improving quality of healthcare. It also recommends future policy needs to take account of the “whole prison approach” recognising that healthcare in prisons cannot operate in isolation from the prison regime or the community.Originality/Value - This is unique research, which has great value in supporting prison reform in England. It will also be of interest internationally due to the paucity of data in the published peer-reviewed literature on the impact of commissioning models on healthcare or health outcomes.
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