A thematic analysis of Prison and Probation Ombudsman fatal incident reports involving prisoners on palliative/end-of-life care pathways in the long-term high security estate in England and Wales

Abstract

Objectives In this study, the clinical and non-clinical factors that may influence the provision of palliative/end of life care in long-term high security prisons in England and Wales are identified through the lens of Prison and Probation Ombudsman (PPO) fatal incident reports. Methods This work extends that of McParland and Johnston (2019) and contemporary literature published in the subsequent period to 2020 through a thematic analysis of fatal incident reports published by the PPO in the period 2014-2020. The results are discussed in context of the Dying Well in Custody Charter and positioned within the extant literature. Conclusions The results suggest that prisoners in long-term high security prisons who are receiving palliative care are more likely than not to receive care that is comparable to that in the community. Directions for further research are also identified.

The risk matrix: Drug‐related deaths in prisons in England and Wales, 2015–2020

“…As Tomczak (2022, p. 500) argues, 'these detailed, publicly available documents are an underutilized data source, providing extensive information about deaths, prisons, and responses to prison deaths over time.' PPO fatal investigation reports have been analysed to explore self-inflicted deaths or deaths by suicide (Tomczak, 2018) domestic violence perpetration and suicide risk in males imprisoned (Dewar, 2018) and natural cause deaths involving palliative care (Kirkham, 2021). To our knowledge, the research reported here is the first time that they have been used to analyse substance-related deaths.…”