Prison Health Discharge Planning – Evidence of an Integrated Care Pathway or the End of the Road?

Abstract

Improvements in offender healthcare are key to the current UK Government's reform of the criminal justice system and the aims of reducing reoffending and protecting the public. Current approaches to offender health care emphasise the importance of ‘continuity of care’. Reference to the ‘offender health pathway’ suggests the existence of seamless delivery and experience of care; however, evidence suggests these remain some way off. This research explores prison health discharge planning in four North East prisons and uncovers elements of good practice, but also a number of challenges the prisons continue to face in their attempts to improve clinical pathways for prisoners being released or transferred, including institutional, staffing and prisoner issues. These challenges need to be acknowledged and addressed if robust discharge planning and continuity of care at the end of the offender health pathway is to be achieved.

The effectiveness of the Older prisoner Health and Social Care Assessment and Plan (OHSCAP): a randomised controlled trial

“…This percentage is lower than in the Hayes et al 20 study and may reflect older prisoners prioritising other issues, rather than their physical health, immediately on entry into prison. Note review ≥ 60 100 n/a n/a n/a n/a 38 n/a 33 19 3 Self-report [65][66][67][68][69][70][71][72][73][74] 16,443 n/a n/a 1 n/a 29 25 12 9 n/a n/a, not applicable; SF-12, Short Form questionnaire-12 items. a For the Kingston et al 32 study self-reported findings are presented in brackets and findings from inmate records are present outside the brackets.…”

“…The UK government has argued that effective release planning is a key priority to reduce barriers to resettlement. 70 However, it has been argued that the current discharge planning process and a lack of effective multiagency working are current barriers to effective resettlement in the UK 71 and the USA. 68 The HMCIP review of older prisoner care identified grave concerns that needs were not planned or provided for after release, 18 based on identifying only four prisons in England and Wales that provided specific resettlement support for older prisoners.…”

‘They just throw you out’: release planning for older prisoners

“…Nacro, a charity that aims to reduce crime, recommends that the resettlement needs of every offender should be considered from the start of their prison sentence (Nacro 2005) and the UK Government has stipulated that the reduction of barriers to resettlement is a key priority (Ministry of Justice 2011). However, current discharge planning processes and a lack of effective multi-agency working have been cited as inhibiting the effective resettlement of prisoners into the community (Binswanger et al 2011; Dyer and Biddle 2013).…”

Development and implementation of a discharge pathway protocol for detained offenders with intellectual disabilities

“…In prisoner healthcare settings the importance of continuity of care is acknowledged, however discharge planning from these settings is considered to be inadequate. Prisoners leave prison with little or no support resulting in a range of negative health outcomes associated with prison release, including increased drugrelated deaths and suicide (Dyer & Biddle, 2013). Fazel and Baillargeon (2010) Clearly these patients should not be detained in hospital any longer than necessary.…”