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Serious concerns about health care for women in prison
HMPPS/NHS review highlights eight serious concerns about health and social care in women's prisons

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National Women’s Prisons Health and Social Care Review

The National Women’s Prisons Health and Social Care Review was established in 2021, driven by a commitment to improve health and social care outcomes for all women in prison and upon their release. Last week (23 November 2021), NHS and HMPPS published its report, highlighting eight major concerns.

Background

As most readers already know, women in prison have disproportionately higher levels of health and social care needs than their male counterparts in prison and women in the general population. High numbers of women in prison experience poor physical and mental health and many are living with trauma. Findings from this Review further highlight the vulnerability and adverse life experiences of many women in prison. Mothers feel keenly the separation from their children that imprisonment brings, and women who are mentally unwell are still being sent to prison. The report acknowledges that none of this is new and that women (who make up only 4% of the prison population) can sometimes be overlooked in a majority male estate.

The review has prioritised the lived experiences of women in prison and the report is informed by 2,250 responses from women inside.

The eight strategic recommendations

The evidence gathered throughout the review from women in prison, care providers and a range of other key stakeholders generated eight main findings. Each finding has a corresponding recommendation, all of which have been presented to and fully accepted by NHS England and HMPPS. The recommendations are what you would expect, so, for the sake of brevity, I have just included the eight key findings below:

  1. Health and social care services across the 12 women’s prisons are inconsistent, not always gender specific or sensitive to women with protected characteristics. The prison environment is experienced as unfit for purpose by many women and health and social care providers.
  2. Acutely mentally ill women are still being sent to prison. Prisons are ill equipped to provide the necessary treatment and care for acutely mentally ill women. There is a gap in mental health services across the range of needs including primary mental healthcare and specialist interventions for women who have experienced trauma, including sexual and domestic violence.
  3. For many women, reception into prison and the early days in custody was traumatic, deeply distressing and bewildering. This was especially the case for mothers separated from their children and pregnant women.
  4. The availability and quality of data that describes and informs women’s Health and Social Care Needs Assessments (HSCNAs), and the quality and outcome reporting of services women receive requires improvement. England based research on the health and social care needs, services and outcomes for women in prison is limited.
  5. Most women coming into prison require medication. Medicines management, especially around communication with women and between healthcare and prison staff requires improvement.
  6. The national substance misuse service specification is not gender specific.
  7. Improvements have been made in pregnancy and perinatal care and social care support for women who have been separated from their children, but more needs to be done to drive forward meaningful change.
  8. The period leading up to release from prison is emotionally challenging for many women and often based in fear. Resettlement services provided by prison, probation and health and social care providers should be better integrated. Having somewhere safe and decent to live on release remains the greatest priority for many women. Where RECONNECT services were available, women spoke highly of them.

Thanks to Andy Aitchison for kind permission to use the header image in this post. You can see Andy’s work here

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