Probation Healthcare Commissioning Toolkit
This is a guest blog by Dr Coral Sirdifield of the University of Lincoln.
Ever since I became involved in the offender health field the central themes seem to have included the idea that people in the criminal justice system are likely to have worse health than the general population, but are not likely to engage with healthcare services until they reach crisis point. This is likely to have a negative impact on the individual and on NHS costs. Mental Health Treatment Requirements have been under-used, and there are continuing problems with continuity of care as people transition through the criminal justice system and into the community.
I have found that service users and criminal justice staff recognise the importance of good health for reducing re-offending – identifying both direct and indirect relationships between health and offending behaviour. However, they grapple daily with a lack of (appropriate) service provision, restrictive referral criteria that lead to people falling through the gaps between services, and an ever-changing and complicated healthcare landscape. The roles and responsibilities of different organisations in relation to offender health have changed over time, as well as the structure of organisations and the resources that they have available.
I have recently led a research project funded by the NIHR RfPB programme to examine some of the issues around these perennial problems. The project was conducted by service users, probation staff, and academics from the University of Lincoln and Royal Holloway. It was also guided by an external advisory group that included representatives from her Majesty’s Prison and Probation Service, Public Health, the Health and Justice Clinical Reference Group, the Probation Institute, the House of Lords, Together Women, Public Health England and HM Inspectorate of Probation.
We identified a number of barriers to people on probation accessing healthcare:
- Low literacy and health literacy levels
- Financial barriers
- Competing priorities
- Staff having an uncaring professional demeanour
- People not being registered with GPs
- Inadequate service provision
The project also recommended six approaches to improve access to services:
- Co-location of health and criminal justice services or staff
- Appropriate opening hours and locations for services
- Meeting people at the prison gate
- Greater integration or pathways between health and justice agencies
- Caring professional demeanours
- Sharing health information in plain language
Probation healthcare commissioning toolkit
The overarching aim of the study was to produce a probation healthcare commissioning toolkit, available here.
The service users involved in the project also co-produced an ‘easy read summary’ of the research findings.
We also worked with case study participants to produce infographics around some potential models of good practice like this one:
The toolkit also details the roles and responsibilities of different organisations in relation to the health of people in contact with probation, and has a section on measuring and improving health, and the quality of healthcare that people in contact with probation receive.
The resource is free to download and we would welcome people taking the opportunity to provide feedback on the toolkit.
This study is funded by the National Institute for Health Research (NIHR) [Research for Patient Benefit programme (Grant Reference Number PB-PG-0815-20012]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.