Health, well-being and social care services

Prisoners can access services that assess and meet their health, social care and substance use needs and promote continuity of care on release.

44. Prisoners have equal access to health and social care services that meet their needs, regardless of location, regime, disabilities, language barriers or other risk or need.

The following indicators describe evidence that may show this expectation being met, but do not exclude other ways of achieving it.

  • Partnership working between the prison, commissioners and providers ensures that health, social care and substance use services meet the assessed needs of the centre’s population.
  • Prisoners have prompt access to all clinical and non-clinical health services that diagnose, treat and support patients based on assessments of individual need undertaken by appropriate clinicians. This includes referrals and effective treatment by physiotherapy, optometry, podiatry, dietetics and dental teams.
  • Patients requiring support for addictions, primary mental health or serious and enduring mental health problems have prompt access to registered clinicians.
  • Patients can complain about their treatment in confidence, without recrimination. Responses are timely, easy to understand, address all the issues raised, and are apologetic when required.
  • Clinical consultations are conducted safely in private, in a manner that preserves dignity and medical confidentiality.
  • Patients are always involved in decisions relating to their own care and are consulted on service delivery and health improvement plans.
  • There are effective joint emergency response plans to respond to medical emergencies in line with national guidelines. Competent health staff respond promptly to medical emergencies with appropriate emergency equipment.
  • Patients receive secondary care services within community-equivalent waiting times and care is not disrupted or impeded by prison restrictions.
  • All health treatment and care plans started prior to or during an allocation to the centre continue seamlessly throughout the prisoner’s time there and on departure.
  • The environment and regime of the centre contributes to the physical and psychological well-being of the prisoners. In particular, mental health teams closely monitor the impact of separation on individuals.
  • Health staff attend and make meaningful contributions to multidisciplinary case reviews.
  • All mental health and substance misuse needs are managed through comprehensive written assessments, care plans, risk assessments and interventions. These are regularly reviewed by appropriately skilled, registered professionals and include continuity of care on arrival and departure.
  • Patients have equitable access to medicines in line with national prescribing guidelines, which optimises their health outcomes.
  • Patients who require assessment or treatment under the Mental Health Act are assessed and transferred promptly.

Human rights standards
In relation to expectation 44: prisoners have the right to the enjoyment of the highest attainable standard of physical and mental health. Detainees should be provided with community-equivalent care which takes into account their particular needs. Health and social care needs and substance use needs should be assessed on arrival and monitored throughout detention. There must be prompt access to care in urgent cases and referral to external care when needed. Health care staff must have full clinical independence. See ECHR 2, 3, 8; ICESCR 12; SMR 24–28, 30-34; EPR 39–43.1, 43.3, 46.